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!)

Getting Baby to Sleep: A Case Study

The following is the story of a couple that sought my advice to help get their baby to sleep. I’ve changed all information that might identify them in order to preserve their privacy.

Baby Name: Darcy, age 4 months, is the healthy baby girl, product of an uncomplicated pregnancy, labor, and delivery. Darcy has been exclusively breast fed since birth

Mother: Melanie, 26 years old married, first child, living in Framingham MA.  Married three years to Jim.

Melanie is a graphic designer who runs her own business.  Jim is an attorney at his first job post-law school. Melanie would like to return to working but is not taking new clients until Darcy will be at least a year old. Then her mother (Darcy’s grandmother) will assist with child care during the day.

The problem

Melanie and Jim cannot sleep.  The sleep deprivation is creating an enormous amount of stress for Melanie, for Jim and for their marriage. They fear it’s negatively affecting their daughter and her relationship with them. They are worrying now that they are not enjoying parenthood as much as they were. Melanie describes feeling “like she’s at the end of her rope”.

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They are begging for some help getting the baby to sleep long enough for the parents to get some sleep themselves and regain their sanity.

Melanie and Jim filled out an Intake Form and made some guesses as to what they chose as their SMART goals. They scheduled a consult with me. I spoke with

baby to sleep
Sleep. Something Melanie and Jim were not getting

both parents together.

After explaining again the stresses, physical, emotional that they were feeling, I asked Melanie to walk me through a typical day for Darcy.

We talked about her feeding schedule, how often and for how long. The baby had just been to the pediatrician to be weighed, so we knew that Melanie’s milk supply was adequate. The baby was peeing and pooping normally.

baby to sleep
Darcy nursed a LOT

She was feeding on demand, but Darcy “fed like clockwork” every two hours, including at night. Lately she’d been waking up every 90 minutes at night, adding further stress.

I asked Melanie specific questions about how she fed Darcy before bed and naps. Melanie told me that Darcy would fall asleep at the breast. Always. Melanie would then put Darcy’s pacifier in her mouth, swaddle her, and put her down in her crib.

Darcy would sleep well as long as she had the pacifier in her mouth. Sometimes it would fall out and she would stay asleep. But lately she would root and “look” for her pacifier, rouse herself and cry, about 90 minutes after falling asleep.

I wondered aloud if part of the problem might be that Darcy’s falling asleep at the breast was causing her to associate sleep with breastfeeding. In other words, maybe nursing was becoming a sleep association.

baby to sleep
A cat nap before heading back inside

Getting Baby to Sleep

Darcy was four months old now, and she was a normal thriving full-term baby, so I felt it was possible that she was now able to develop her own internal self-soothing mechanisms. I speculated that Darcy might be developing a more mature sleep-wake cycle. I explained that this would mean that Darcy was now cycling between deep and shallow sleep. When she would arrive at the shallow stage, she would arouse briefly, look around for the breast or the pacifier, not find it, and become distressed and cry. It could be the case, I explained, that if Melanie and Darcy could make some space between breastfeeding and falling asleep. For the baby to sleep, she would have to develop her own abilities to self-settle.

Melanie, Jim, and I began to develop a sleep plan. They both felt that if bad sleep associations were interfering with Darcy’s ability to stay asleep, then they would be willing to tolerate a bit of crying on Darcy’s part if it meant she’d be able to fall asleep on her own.

We developed a schedule based on the schedule Melanie was already following. The only difference was that Melanie would try to keep Darcy awake through the end of the feed, first for a minute, then gradually up to ten minutes before putting her down. We would do this over 5 days.

We discussed ways to keep Darcy more stimulated so that she wouldn’t sleep while feeding. We talked about keeping her baby clothes open so that the baby could feel some cooler air on her skin. Or Melanie could play with Darcy’s feet or blow gently on her face.

Then Melanie would swaddle Darcy and place her, awake, in her crib, stroke her a few times, and leave the room.

Based on this plan, Melanie and Jim wrote up a SMART goal for Darcy. She would sleep four hours straight at night, and she would accomplish this goal in seven days.baby to sleep

We also decided that we would try to go without the pacifier, as this might also become a sleep association for Darcy.

We followed up by email and phone several time over the next few days. The first two days were rough, according to Melanie.  Darcy would cry and fight her way out of the swaddling blanket. Melanie confessed she’d put the pacifier in and Darcy would fall back asleep.

The good news was that Darcy was indeed settling herself to sleep.  It turned out that she would cry for about 3-4 minutes after being put down, but she’d fall asleep.

baby to sleep
Blessed relief

Then at day four the magic happened.

At 7 PM Melanie nursed Darcy, put her down in the crib awake, and left the room.  Darcy fussed for a few minutes and settled.  On the baby monitor, Melanie could see Darcy sleeping quietly.

And she stayed asleep until 11 PM.

She started to stir. Melanie took her out, changed her and breast fed her again for 10 minutes.  She struggled to keep Darcy awake because the baby was so sleepy. She isn’t sure Darcy was awake when she put her down. But the baby slept again until 3 AM.

Two four-hour stretches in one night!

Over the next few weeks, Melanie worked on making sure that she put the baby to sleep surrounded by all the things that would be there when she had her periodic brief awakenings every 1 ½ – 2 hours. Darcy was developing good sleep associations.

baby to sleep
Almost normal

By five months she was sleeping from 11 PM to 5 AM, a six-hour stretch.  Se was feeding more often during the day to compensate, but Melanie did not care: she was ecstatic because everybody, baby and parents, were sleeping better at night. Melanie said she was starting to feel “almost normal again”.

Now that they were both better rested, Melanie and Jim told me that they really felt good again about being parents. The admitted that they had feared they’d turn out to be terrible parents and they’d hate the whole experience. Now they were both feeling confident and competent to handle anything that parenthood might throw their way.

Melanie and Jim were able to restore their sanity and begin to enjoy being parents because I helped them drill down into what Darcy’s real sleep problem was: she had begun to associate being at the breast with falling asleep. Together we worked out a plan to dis-associate nursing and sleeping, and it worked!

This all occurred a few years ago. Melanie and Jim had a second baby, another girl. This second baby had no sleep problems at all. Melanie stayed wary of negative sleep associations and made sure #2 daughter didn’t develop any.

baby to sleep
Happy ending

They referred Melanie’s sister to me when Darcy’s aunt was having trouble getting her baby to sleep. And Jim told a few associates at his firm about me and I ended up being the unofficial “sleep consultant to [Jim’s Firm]”

 

 

 

Is There Such a Thing as an Illness Sleep Regression?

This one almost qualifies as a sleep regression… but at the end of the day, it’s not. Neither the illness sleep regression nor any of the so-called regressions I’ve discussed at this blog are true “regressions” in the sense that they represent a developmental step backward for your child. Rather, the illness sleep regression is nothing more than another bump on the road of life. We go over the bumps and we move on, no worse for wear.

A sick child is always the mother’s property; her own feelings generally make it so – Jane Austen

Debunking the Illness Sleep Regression

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There’s one fairly obvious reason why babies and other children don’t sleep well when they’re sick: they do not feel well! When kids don’t feel well, they get knocked off even the best-planned and executed routines that a mother can design. They may sleep more during the day, or try to. If for example, an 18-month old with a fever sleeps 6 hours during the day, she may be up in the middle of the night, not because she’s feeling better but because her sleep-wake cycle has been screwed up by that long nap!

Another reason for the apparent “illness sleep regression” is that the child needs more attention while ill: more holding, more attention, more TLC. This is natural, and, frankly, helpful to making the child better soon. The child who is still breastfeeding is doubly blessed: she is getting the extra comfort she needs while ill, and she’s also getting fluids, which is so important to her recovery. All this may lead to long sleepless nights on the couch with the sick child in your lap.

The Problem with the Nose

When a child has any kind of upper respiratory tract infection (URI, or a cold), chances are her nose is going to be at least partially clogged. This is a problem for several reasons. First, the nose is already responsible for most of the resistance to breathing in the human airway system. In other words it’s hard enough breathing through the nose: having a clogged nose makes it even harder to breathe! It’s worse than that: the laws of nature have decreed that if you clog up one of your nostrils, you make it 16 times harder to breathe than if both nostrils are clear (not 2 times harder, as you might assume)!

illness sleep regression
It’s not good to get sick

And of course, how many babies and small children do you know who are any good at blowing their noses?

For babies it’s even worse. Babies are “obligate nose breathers“. That means that they have no choice about breathing through their nose or their mouth: they must breathe through their noses. So how do they breathe when their noses are clogged? They cry. Crying is taking breaths through the mouth. Face it: colds are tough on babies. With a baby, they can stay at least partially congested for up to 8 weeks after the beginning of a cold. If they get cold after cold (as they might during Winter in a large out-of-home day care), you might truly believe in the illness sleep regression.  But it’s still a myth. These poor kids are just sick a lot in Winter.

How to Manage Sleep With a Sick Baby

illness sleep regression
Nurse is here to take your temp!
  • Toss your sleep plan out the window.  No reason to stick to it.  The baby needs you and sleep training will have to wait. If the baby is already sleep trained, her normal pattern will resume after she’s better, provided you try really hard to avoid bad sleep associations after the illness.
  • Apart from the sleep thing, try to keep your routine as consistent and predictable as possible.
  • Don’t be afraid to suck the boogers out of your child’s nose: she may hate it while it’s happening, but she will thank you later!
  • Any sleep the baby gets, at any time, is good! Do not worry about naps vs. night time: sleep is good for sick babies!!! (and people)
  • If you have any concerns at all about the baby, especially if she is not eating well, please consult your pediatrician!