Thursday 22 August 2019

Rising to the cot refusal nap challenge

Sleep expert Lucy Wolfe offers guidance for parents of little ones who will sleep anywhere but their cribs

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Lucy Wolfe

It is undeniable that helping your child to achieve daytime sleep can be a real challenge for some parents.

There are so many force factors that contribute to your child's sleep responsiveness, typically represented in many different ways.

Some parents may report that they just cannot get their child to take a nap, that they just refuse to sleep; others will report that the duration of the nap is only short; some may say that daytime sleep durations vary hugely in any given day/week, while others will observe that their child will only sleep in their arms, in the car or the buggy and point blank refuses their cot for day sleep.

Nap challenges, as with most sleep issues, have lots of different dimensions. Let's see if we can get underneath one of the most common concerns which is cot refusal for naps.

Firstly, it may be useful to mention that in the early weeks and months, most children will sleep anywhere but the cot. This may mean that you safely use your arms, the pram, the sling and driving in the car, all of which would be considered appropriate sleeping arrangements for your young child, for as long you deem appropriate.

You will note that using the car seat for sleeping when not driving is not advised and that you will only allow your baby to stay in the car seat for the recommended period of time anyway.

I would suggest that young infants benefit hugely from lots of support such as rocking, sucking and motion, both by day and by night, and this is ideally acknowledged by new parents. And rather than resisting this dynamic, you would lean into it and see this very much as an early sleep tendency. That is not a problem in and of itself but a very natural inclination on their part to want to be within close proximity to your, in arms, for example, even if this feels restrictive. Consider it to be a way of building your loving, trust bond and nurturing your early relationship.

Helping young children to just achieve their naps is perhaps the first mission rather than worrying about where they sleep or how.

I also encourage parents to focus less on the amount of sleep per nap that your child does and more on the dynamic between naps by reading your baby's language for sleep. This approach means that you try to provide a nap before they become visibly tired, a cue-based approach encouraging parents to practise "responsive sleep signalling".

At the start, if you can attempt to provide the nap in any way that may currently suit, when you see initial sleep cues such as brief eye rubs and yawns and moments of quiet or zoning out, this is considered the first step towards achieving sleep in general with greater ease, and actually starting to stay asleep for as long as they need to.

Mostly, nap lengths do not regularise for many children until six months-plus and a very common nap duration would be 30-40 minutes, which may mean that you need to factor in a series of shorter naps any one day.

Some children will naturally nap longer, but many aren't developmentally able until six months and beyond, and even then nap durations can still be varied. I always encourage you to set the scene, then we can build on this further as needed as your child gets older. The science does show us that the more rested your child is, the longer and more restoratively they will sleep, so this is a great starting point.

At any age range you can start to practise reading the language for sleep and then in terms of helping them nap in the cot. I wouldn't attempt this before six months unless they are willing participants and you have been quietly shaping their sleep from early on.

I do think that helping them learn to sleep in the cot for daytime sleep is a good idea, but ultimately it is an in-house decision for what you want for your family.

I encourage parents to think about this decision, as your child will likely nap until at least age three, and on that basis the cot is possibly one of the most sleep-friendly solutions, most of the time. That is not to say that you couldn't have some level of flexibility between the cot and maybe the buggy, but overall as they get older, a conventional sleep space may be 60-80pc of the time desirable for many parents.

Furthermore, if your child will attend crèche then undoubtedly they will nap in a cot there, so it is ideal to establish this skill initially at home and then transfer the skill to daycare which tends to be a smoother operation.

In order to avoid a large protest around daytime naps in the cot then it is likely that your child will require a good relationship with the cot at bedtime. Skills and associations ingrained at bedtime seem to be much more easily transferred into the day than the other way around, so strangely, I will propose that whatever changes are required are best introduced first at bedtime. This may mean at bedtime your child would benefit from being awake going into the cot and to start to gain the ability to put himself to sleep, with your support as needed, and once that is established then introducing the same approach for daytime tends to be effective.

To achieve this, the following suggestions may help:

l Time the nap accordingly based on your child's early sleep cues and age-relevant feeding and sleeping balance. Use bright and natural lighting during non-sleep time and ensure that between sleeps your child is stimulated and well fed, based on their needs.

l Always provide a pre-nap sleep ritual in the bedroom that your child is going to nap in. Spend 10-15 minutes winding them down - change their nappy, use the sleeping bag by day too if you typically use one at night.

l Read stories and engage in lots of hugging, chatting and eye contact. Do this ritual in a dimmed lamp light.

l It is helpful if you make the bedroom super dark for daytime sleep to help underpin the sleep message and to encourage a longer session of sleep, if they can do it.

l If they are not used to napping in their cot routinely, use my stay-and-support-approach to comfort and reassure them as they transition from what you have been doing. Attempting this for about an hour may be necessary as you begin, but I would anticipate that this would shrink quite quickly as the skill and associations become stronger and their sleep ability improves.

l At the start, as before, don't worry about the length of the nap. First concentrate on helping the nap to happen in the cot and then over the course of about 10-14 days very often the nap naturally lengthens.

If after about two weeks naps one and two as required are still under one hour, I may once again use the start and support approach to try to knit the nap need together so that at least one nap is at least one hour-plus in duration. That is my only real goal with nap durations - that at least one nap in the day is one hour-plus. Not two hours or anything like that, unless your baby naturally does that himself (it is not the most usual nap amount). Knowing this is helpful as I find parents are sometimes anticipating longer naps than developmentally possible.

Continue always to set the scene, develop the associations, growing the ability, and most often your child's body will respond in kind. They will start to sleep both in the cot and for as long as needed to keep them optimally rested, further supporting more consolidated nighttime sleep and positive outcomes for health and well-being.

Lucy Wolfe is a Sleep Consultant, and Author of the bestselling book The Baby Sleep Solution.

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