| The big sleep issue
A perfect night’s sleep seems a dim and distant memory when you have a new baby. Jane Bartlett looks at the debate about how you settle a crying infant If you really want to wake up a room full of new parents, talk about sleep. It’s the equivalent of letting off an ideological hand grenade, because a good night’s rest is so much more than just a practical matter. How you handle the big sleep issue says lots about you and your most profound beliefs about parenting. The perplexities are many, starting with whether you let junior sleep in your bed. Should you ever let a baby cry itself to sleep? At what age do you shunt them into the nursery? And the angst doesn’t stop there. You are likely to be worrying about setting bedtimes right up to the time they’re old enough to witness the TV watershed and risky programmes after 9.00pm. It seems that in recent years parents have not been very successful in establishing good bedtime habits: research suggests that 50% of British mothers have problems getting babies and toddlers to sleep. According to Professor Gregory Stores, head of research into child sleep disorders at Oxford University, sleep disturbance among young children has become epidemic, and as a result, NHS funded sleep clinics are springing up nationwide to help bleary eyed parents get the shut eye they desperately need. In the past Just a few generations ago the prevailing baby care wisdom was based on the virtues of a strict nursery routine, centred on four hourly feeds, and wheeling them down the bottom of the garden where they could holler themselves to oblivion in their prams. Babies were seen to be willful little blighters whose selfish spirits needed to be broken. All that changed in the 1970s when matron mum became a hippy. Attachment parenting became the cherished philosophy, inspired by the study of indigenous peoples and their apparently well-adjusted infants. This is an overwhelmingly child-centred approach, where baby sleeps in the parental bed, is fed on demand and remains in constant physical contact with their carers. It’s still popular, especially in circles where epidural is a dirty word, but the pendulum does seem to be swinging back the other way. Maybe it’s simply too hard to put baby first in a culture where mum is frequently isolated, and the nearest she gets to an extended family and local community is an episode of EastEnders. A return to routine Structure and routine is a very good thing, according to Gina Ford, author and maternity nurse, who has really rocked the cradle with the publication of her ‘The Contented Little Baby Book’ (Vermilion £7.99). ‘All children love routine,’ she claims, advocating an exacting schedule for babies as young as two weeks, which includes six feeds, three naps and bed by seven. Those who champion demand feeding are not pleased; thus the battle of opinions most publicly aired in a fierce Radio Four debate between Gina Ford and Dr Miriam Stoppard on the ‘Today’ programme. Gina is not at all in favour of baby in the bed, and believes that it’s fine for a healthy, well-fed, winded and clean baby to cry itself to sleep for short periods. ‘I used the ‘crying down’ method, which you start in the first few weeks,’ she explains. ‘You leave your baby in his cot for five to ten minutes and teach him to settle himself.’ The new wave of sleep philosophy Gina’s book has been the focus of the controversy, particularly because she suggests starting a routine at such a young age, but what she is advocating is in fact not original, and the basis of her approach is the one adopted by the new wave of experts in sleep clinics across the country. Most of these use the ‘controlled crying’ technique advocated by the Director of the Center for Paediatric Sleep Disorders in Boston, Dr Richard Ferber. Research into sleep has shown that adults and babies alike have three different phases of sleep: arousal sleep, dream sleep and deep sleep. Approximately every 90 minutes, we wake up. We’re not aware that we do because we usually feel so safe and relaxed we immediately nod off again. But if your baby has been allowed to fall asleep in your arms and then transferred to a cot, when they wake they are startled by their new surroundings and cry in panic. The solution? Put your baby into the cot while he or she is still awake so that they recognise where they are when they have these wakeful moments. This means establishing a number of sleep ‘cues’ so that the baby is able to settle itself to sleep.
The Ferber way Dr Ferber recommends a progressive approach to getting your baby to sleep. Of course, it only applies if you know your baby is healthy, well fed and not mushing around in a dirty nappy. Controlled crying is not an appealing prospect, but advocates claim that it works, and quickly. Step one Begin with a cosy pre-bedtime routine – try a bath followed by a cuddle and bedtime story or feed. Step two Crucially the infant then has to be put in their cot or bed whilst still awake, and then leave the room. Step three If your baby cries, wait for a certain amount of time before checking, rather than rushing in immediately. The amount of time you wait is determined by how many days you have been following the programme, how many times you might have already gone in, and what your nerves can take. Step four When you go in, soothe your baby by gently talking, but don’t pick her up, rock or feed her. If your baby knows that crying brings them these rewards they will only do it more. Step five Gradually increase the amount of time in-between checks. According to Ferber, after one week your baby will learn that crying gets nothing more than a quick appearance from you, and isn’t worth the lung power. Sleep clinics If you are having problems with getting your baby to sleep, your health visitor may be able to refer you to an NHS sleep clinic, which works using the Ferber technique or something similar. These are usually for babies over six months old. For those under three months you have to remember that a night-time feed is still a biological necessity, so expecting a blissful night of uninterrupted slumber is not realistic. If you need some moral support from other mums with newborns try our message board. (link) One of the helpful aspects of attending a sleep clinic is getting support through what is a trying and tiring time. You may meet other parents facing the same problems and realise that you are not alone. Many sleep clinics expect to see results within one week, so that good night’s sleep can very soon be more than just a dream.
Chat, share tips & get advice on the Sleep Problems & Toilet Training messageboard. Useful books
The Contented Little Baby Book by Gina Ford (Vermilion £7.99)
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