Tuesday 18 September 2018

Sleep, interrupted

Sickness and teething are two issues that can affect your child's sleep routine - Lucy Wolfe offers solutions on how parents can get through these trying times

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Lots of factors affect your child's sleep - the timing, the environment and way in which they go to sleep, developmental leaps and stages, travel and maternal mood, for example. Another significant sleep-wrecker is sickness and teething.

Sickness and teething can have ongoing impact on your child's ability to sleep well. Many children will experience bouts of routine illnesses such as ear, throat, chest infections, colds and viruses, with minimum sleep disturbance.

Others may have parents up at night (sometimes all night) as they work their way through feeling under the weather and sometimes this can carry forward for a few weeks after the illness has passed.

If your child gets sick or starts to teeth, then you can reasonably expect that your sleep will be disturbed and if you have recently achieved better or started to work on improving your sleep, you can expect a deterioration and that will potentially not make progress at the anticipated rate or it may be more difficult to see your hard work and also to stay on track.

In my experience, it can often take seven to 10 days after the antibiotic/medication is finished before you start to see improved sleep. Mostly, in order to expect better sleep, your child will need to be 100pc well and symptom free; off any medication; with restored appetite and improved mood and behaviour.

It can often be helpful to return to the doctor for a review and confirmation that they are better. That being the case, it will still take more time to get back on track.

For those parents whose children sleep well most of the time, very often the first indicator of a sickness period is night waking. I try to encourage parents to recognise subtle changes that may indicate their child is teething or starting to come down with something. Symptoms include:

1 Temperature

2 Off food

3 Change in mood/behaviour

4 Uncharacteristic crying/clingy behaviour

5 Messy nappies

6 Constipation

7 Flushed cheeks

8 Sore bottom

9 Excessive drooling

10 Untypical frequent night waking, sleep resistance, short naps, early awakening.

You will see symptoms of teething during the day, not just at night, however it is definitely more pronounced at night when there are no distractions and also when your child is lying down. In my experience, the teething cycle seems to last for eight days at a time. And be warned that if one tooth erupts, they come in pairs, so another is due shortly...

During the period of sickness or teething I would encourage parents to have a response plan so that you don't operate a crisis management approach to sleep challenges that may undermine your previous hard work and that may linger long after the sickness itself.

Unfortunately, what you do during a sick and teething period can often become ingrained in as little as one to three days, so it can be important to manage a sick period appropriately, understanding that, during this time, no one is going to get much sleep anyway.

Bear in mind that a talented sleeper may be knocked off course by sickness or teething, so if you are mid-cycle of a sleep-learning exercise, then it will be even more challenging and disheartening, but try not to worry - if you are patient and share the load between you, then your efforts will start to yield.

Keep a focus on your goals and desired sleep practices, and potentially even how far you have already come, and operate as follows:

1 Use medication and pain reliever as directed by your GP or pharmacist.

2 Be responsive at all times and don't allow your baby to cry when unwell. A pain cry is often represented by high pitched and constant and may not come under control immediately on pick up. Protest crying, although it may be high-pitched with some children, generally is not constant and can be stopped immediately on pick up.

3 During your time of sickness, if you are not typically bed-sharing or plan to co-sleep or have recently broken this cycle, then it may not be the best idea to bring your child back into your bed. Very quickly they may start to prefer your sleep environment to theirs and then wake at night to be brought back in again. Camp out in their bedroom, perhaps on a spare bed or makeshift bed so that you can supervise and monitor your child if they are significantly under the weather.

4 If you have weaned night-time feeds, then try not to go back there, but certainly offer a sippy cup of water to keep them hydrated.

5 If in doubt about intake and you have night weaned, then you could always provide a dream feed around 10pm/1130pm - you initiate this and wake your child - so that you don't re-engage the expectation to feed at night again, but you do ensure that they get what they need.

6 If they are very unsettled overnight, it can sometimes help to just get up for a while, go downstairs, don't turn on the lights or TV but just take a break, give meds as appropriate, and then return to bed with a bedtime routine to help them go back to sleep.

7 Make sure that during a sick period you observe a relatively early bedtime, 6pm to 7pm is often best and will help prevent your child struggling to go to sleep.

8 You can let them nap more but always curtail nap one to 1.5 hours and finish the day for naps based on their age-relevant feeding and sleeping balance.

9 Try to keep your usual way of going to sleep in place, even if you need to support them more or go back to being beside the cot or the bed. Do this and when they are better quickly get back to where you would normally be when they are going to sleep or use my stay-and-support-method to weaken parental dependency.

10 Provide extra reassurance at bedtime and overnight as appropriate; you may find that overnight is very challenging, so just do your best to support them. It will start to improve again, once they feel systematically better.

11 Make sure they are well-rested during the day - if they are cot-resistant then perhaps use the backup plan of the car/ buggy/couch etc until they are back to being themselves.

However….

As soon as your child starts to recover - good indicators would be completion of their antibiotic, improved mood and behaviour, back on their food - then I would try to work your way back to positive sleep practises. Routinely, post-sickness many parents find their good sleep habits return - their child goes to sleep easily, without them present at bedtime and sleeps again all night.

Others may find that their child is more clingy and needy. In this case, once you are confident they are 100pc well, you may need to implement my stay-and-support approach to restore good sleep.

I find it can often take the child three to four weeks post-sickness to get back to their typical sleeping patterns, so give them a chance, without being aggressive, and view this challenging time as part of our journey as parents.

If your child is aged 10 months plus and unfortunately, routinely doesn't sleep through the night, then once they are well, it may be worth considering adjusting your sleeping habits so that your child can start to get better sleep.

All children can be helped to sleep better - bearing in mind that, ultimately, consolidated, uninterrupted sleep will allow your baby to have an improved immune system, enhanced mood and behaviour, and that sleep itself can be a natural anaesthetic and remedy in times of sickness and teething.

Lucy Wolfe, CGSC, MAPSC, is a paediatric sleep consultant, Author of 'The Baby Sleep Solution', creator of 'Sleep Through' Body and Bed Sleep Spray and Relaxing Rub, and mum of four young children. She runs a private sleep-consulting practice where she provides knowledge, expertise and valuable support to families across the country.

See sleepmatters.ie, t: 087 2683584 or e: lucy@sleepmatters.ie

Irish Independent

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