How to Prevent Your Child's Sleep Problems

[Tom Adams]

Alice Callahan is doing how great work on this very neglected topic:

https://scienceofmom.com/2016/02/17/my-sleep-mantra-and-babyms-sleep-story/

The key is gentle methods that give your child some early experience with independently falling asleep. The details of the method are mostly in another blog post linked off the first:

http://www.janetlansbury.com/2016/02/how-i-helped-my-baby-learn-to-sleep-guest-post-by-alice-callahan-phd/

This topic is so neglected that the phrase "How to Prevent Your Child's Sleep Problems" got no hits in a google search till I started using it today.

Of course sleep association is not a new idea, but parents usually learn about the idea after their child already has developed problem sleep associations.  I have never before seen anything that does such a good job of covering gentle methods for preventing problem sleep associations, particularly methods that seem (to me anyway) to be consistent with attachment parenting.

[Robin Lee Powell]

On Thu, May 19, 2016 at 08:23:21AM -0700, Tom Adams wrote:
>
>
> Alice Callahan is doing how great work on this very neglected topic:
>

> *https://scienceofmom.com/2016/02/17/my-sleep-mantra-and-babyms-sleep-story/*

> <https://scienceofmom.com/2016/02/17/my-sleep-mantra-and-babyms-sleep-story/>
>
> The key is gentle methods that give your child some early experience with
> independently falling asleep. The details of the method are mostly in
> another blog post linked off the first:
>

> *http://www.janetlansbury.com/2016/02/how-i-helped-my-baby-learn-to-sleep-guest-post-by-alice-callahan-phd/*

> <http://www.janetlansbury.com/2016/02/how-i-helped-my-baby-learn-to-sleep-guest-post-by-alice-callahan-phd/>
> This topic is so neglected that the phrase "How to Prevent Your Child's
> Sleep Problems" got no hits in a google search till I started using it
> today.
>
> Of course sleep association is not a new idea, but parents usually learn
> about the idea after their child already has developed problem sleep
> associations. I have never before seen anything that does such a good job
> of covering gentle methods for preventing problem sleep associations,
> particularly methods that seem (to me anyway) to be consistent with
> attachment parenting.

I wonder (as I have before) if I should write up my kids' sleep
behaviour, or if they are just *so* far from the mean that it
wouldn't be useful to anybody at all, but if you'll permit me to
whine for a minute... (IOW: there is no useful information below
this point)

In the second article (which I read almost all of), near the top
there is:

When there was an opportunity, we put him down awake in a bassinet
in the living room, and after looking around for a while and
sucking on his hand, he would often drift off to sleep peacefully.

and already I know this article is going to have zero bearing on the
experiences I had. To the best of our recollection, neither of my
twins went to sleep except on a person or in the car in the first
*year* of life. They literally could not be laid on a flat surface
at any point, for any length of time, without screaming (I have
video of this).

Later she describes letting the baby fall asleep lying on a pillow
on her lap. I did equivalent things, and they "worked", if you want
to describe "screaming as loud as possible for 45+ minutes until
passing out" as "worked". This is a fully-cared-for baby being held
physically by a parent; the only reason for the screaming was that
she was tired and it was night and she wasn't on a boob.

Seriously, WTF was wrong with my kids??

It *still* takes me thirty minutes to an hour to get K asleep (at
least, if I want her asleep at 23:00 instead of 01:30), at 4.5 years
old, but at least that hour is spent singing to her, rather than
getting screamed at, which is a *considerable* improvement.

[Tom Adams]

 It seems the randomized controlled trials are mixed on the effects of the stuff Alice was doing before 14 months, so I don't feel like claiming it works.

"When there was an opportunity, we put him down awake in a bassinet  in the living room, and after looking around for a while and  sucking on his hand, he would often drift off to sleep peacefully." 

The key word here is *opportunity*, It's an opportunistic  method. Your kids did eventually go to sleep I assume.  And just before they went to sleep they were awake.  And there was a "drowsy but awake" transition phase. That phase is the opportune time to experiment with removing a sleep association.  If they wake up and start crying, then comfort them, this it not meant to be a CIO/extinction method.

If your offspring ended up always needing sleep associations that involved you (SATIY), then they could never survive without you since they can't survive without sleep.  So, they either have to die shortly after you die, or eventually make the transition to no SATIY.  It's just a matter of when and how.  Sleep associations that don't involve you don't require this transition, like white noise generators.   Some sleep associations are in a grey area, pacifiers don't involve you except when the kid wakes up and can't find one so he/she cries you awake. Since Alice's kid sucked his own hand, it looks like Alice did not introduce the pacifier or weaned from it earlier.   You can just avoid some sleep associations like pacifiers, rocking, bouncing, vibrating.  Or you can buy a automatic sound operated device for a crib that rocks the crib or makes it vibrate like a car if the baby makes some noise.  So you can have rocking or vibrations that don't involve you.

There must be more than 700 "drowsy but awake" transitions to work with during the first year.  You don't think you even have to remove skin contact for the whole period while they are asleep, all that is required is to give them experience with finishing the transition to sleep without skin contact.  There is one sleep book that recommends manufacturing even more "drowsy but awake" transitions by tickling the feet of a sleeping baby so they can practice resettling down without any SATIY.

Another trick that experts recommend is setting up a nurse-play-sleep schedule rather than a play-nurse-sleep schedule.

[Tom Adams]

"To the best of our recollection, neither of my 
twins went to sleep except on a person or in the car in the first 
*year* of life."

In a car, huh?  Same with my kids.

The environment that results in sleep is nothing more than a vibrating car seat and some noise.

This seems to be another example of how a supposedly intractable condition that measures out as having a large heritable component is really only requires an well-designed environmental intervention.

[Tom Adams]

 'It seems the randomized controlled trials are mixed on the effects of the stuff Alice was doing before 14 months..."

That should have said the studies are mixed on results before 14 weeks for post-partum prevention training.

Maybe the picture is better at 14 months but that probably includes both extinction and early preventive methods,  I am not really up on the studies.

[Tom Adams]

Actually, an invention based on this probably might not be all that successful.  Most American parents accept the cultural practice of training their kid into a car seat and they typically have to use the behavioral extinction method at some point to accomplish the training and they are willing to train their kid because they believe that it's an important safety practice. But many parents will not use extinction to train their kids into a crib of any design and reject the notion that it is a safety practice and believe that it is not healthy. It seems to me that bed based on the principles of a car seat would require the parents to be willing trainers to overcome at least some resistance from the kid.

Basically,  when you use your car seat to get your kid to go to sleep, you are taking advantage of the "car seat training" that you were willing to engage in at an earlier date.

[Tom Adams]

Maybe this is kind of obvious at this point, but I forgot to explicitly mention another tool in the kit: sleep associations that do not involve you can be used a replacements for SATIY. 

[Tom Adams]

1/2 of parent drive there kids to sleep,

http://www.dailymail.co.uk/news/article-2225590/New-parents-drive-1-300-miles-year-driving-children-sleep-spending-547-petrol.html

I did this with my kids.

Note that this is not using a car seat for safety, because the drive itself has no other purpose than to get the kid to sleep.

We give ourselves permission to strap our kids down to get them do stuff.  Of course, we train them in to the straps using behavioral extinction.  Parents are natural pros at extinction training in this one area, Skinner could not do better. There are no books on car seat training, an army of child psychologists are not employed to help parents pull it off.  Where are the attachment parenting gurus who are objecting to this strapped down isolation?  Where are the researchers taking saliva samples to prove that stress cortisol rises during the training?  Where are the claims that this causes toxic stress?

Hidden in plain sight.