As a nurse working in a development centre, I’ve come across many young children and babies in the last 15 years. It still astonishes me to see how many children have difficulty sleeping the whole night through and the effects it can have on them, their parents and on the family as a whole.
The effects
Around 20–30% of children have some kind of trouble sleeping, which often results in parents making appointments with pediatricians. These same parents have to fight through and keep trudging along with their usual routines, even through the long, sleepless nights.
Sleep deprivation in kids can have serious long-term effects, which can manifest in the form of health problems, behavioral disorders and, in the long run, even learning disabilities.
The endless number of articles on the subject can become mind-boggling for parents, but the bottom line is that, in order for parents to have even a decent shot at maintaining a good quality of life, they must sleep.
Crying may be necessary sometimes
Many parents are told to ignore their children crying and let time sort it out. In most cases, this statement is true—however, nowadays, parents are becoming more reluctant to let their babies cry for fear of the scarring effects it may have on them later on in life.
Your child’s tears are a way of communicating his or her emotions to you (in this instance, frustration), so you need to help him or her find a way to go to sleep without you. Think of it as the very first step towards autonomy.
Learning to sleep is an important milestone in your baby’s life, just like learning to walk. Your baby might fall every now and then, but you’ll be there to help him or her up and keep trying over and over until the goal is reached.
After so many years of clinical experience with babies, I’m convinced that letting them cry isn’t so bad for them. It all depends on the way you do it—and there’s plenty of literature out there about the right way to do it.
Parental withdrawal
I’ve taught many methods to different parents and families on their journeys to a good night’s sleep. The 5-10-15 method, in particular, will help your child fall asleep without you needing to wait by his or her side all night long.
Some babies spontaneously sleep entire nights at two or three months old, indicating that they’re ready to sleep for longer periods of times and that their biological clocks are functioning better and better. However, I recommend applying this method when your child is approximately four months old.
Clinical case
Take Michael’s story, for example. He’s a healthy five-month-old baby, who is breastfed to sleep every night around 10 p.m. and wakes up every three hours to be fed. At 4 a.m., his exhausted mother brings him into her bed and the night ends at approximately 7:30 a.m. During the day, Michael takes several naps after being fed and when he’s taken for a ride in the car or the stroller.
First of all, five-month-old babies are ready to sleep for the entire night. In addition, keep in mind that, physiologically speaking; babies this age don’t need to be fed during the night, especially if they’ve started eating solid foods. Your baby is probably just asking to be fed because he or she doesn’t know any other way of falling asleep, but this habit needs to be gradually dissolved.
Another thing to remember is that bedtime routines are crucial and should always include a bath or thorough wash just before bed.
The 5-10-15 method
Finally, here is the big secret to a great night’s sleep. For starters, I suggest feeding your baby before taking a bath, in order to prevent him or her from falling asleep while feeding. You have to change the conditions in which your child falls asleep to make the routine easy to reproduce without you. Try replacing your physical presence with a comforting transitional object like a stuffed animal, a blanket or a piece of clothing that smells like you.
Younger babies don’t tend to feel naturally attached to these types of objects, simply due to the fact that their parents do a far superior job at reassuring and taking care of them. However, it can still be useful to add a small toy (the size of your hand) or stuffed animal into your baby’s crib while he or she is still awake.
Avoid giving your baby a pacifier, as your child could become dependent on it to fall asleep. It won’t replace your presence and you’ll just have to put it back in his or her mouth during the night anyway. It would be better, if he or she has a big suction reflex, to place your baby’s fist next to his or her mouth.
Next, leave your child’s room and close the door for five minutes. That might seem like an eternity for parents, but remember, it’s not the case for your child.
When five minutes has elapsed, go back in the bedroom, and tell your little one that you love him or her and that it’s time to go to sleep. You can place the blanket or stuffed animal near your baby’s neck (your scent will be reassuring). Don’t stay in the room for more than a few moments, especially if your baby cries louder when you enter the room.
The next visit to your baby will be after 10 minutes, followed by a 15 minute visit until he or she falls asleep.
Variations
This technique can be used with shorter intervals, such as one, three and five minutes. The important thing is to increase the time between visits, in order to allow your child to develop his or her own strategies for falling asleep. With babies under four months, a parent can stay by the baby’s side while rubbing his or her back or sitting in a rocking chair until he or she falls asleep. The parent can then reduce the amount of intervention time every night until the baby learns to fall asleep on his or her own.
Michael’s case
Since Michael falls asleep at 10 p.m., he should be put to bed 10–15 minutes earlier every night, so he can gradually get accustomed to falling asleep between 7:30–8 p.m.
The first night: Michael’s parents applied the 5-10-15 method, he still woke up every three hours to be fed. I suggest gradually decreasing feeding time by 3–5 minutes every night. However, since Michael’s mother is trying to teach him to fall asleep on his own, she’ll wait five minutes before checking in on him the first time, in case he falls back asleep.
It’s only on her second visit that she’ll feed him for 10 minutes instead of 15. Also, as soon as he seems to slow down and become sleepy, she’ll put him back in his crib with his little blanket and his teddy bear by his side.
Michael cries even more, but then he surprises his mom because he’s already fallen asleep after crying for 10 minutes—she won’t have to go back into his room.
Of course, he wakes up two more times during the night and she uses the same technique: she waits for five minutes, comforts him, waits 10 minutes and feeds him a little less. For Michael, it was much easier than his mother feared because he fell asleep quickly after his second feeding, around 4 a.m.
In the morning, at 6:30 a.m., he wakes up in his own bed in a good mood. Mom doesn’t rush in but instead, waits until he gets a bit impatient. She breastfeeds only at 7 a.m., the time she would like him to wake up every morning.
As the nights go by, a new schedule will be established. Michael will wake up later because he won’t be hungry beforehand and he’ll eat cereal around 7:30 a.m.
During the day, his mother will try to put him back to bed two hours after he wakes up, around 8:30 a.m. It’s also around that time that she’ll notice him becoming grumpy and yawning. Because he was already fed around 7 p.m., she’ll put him to bed without breastfeeding him, using the same combo as the night before, 5-10-15 plus comforting objects. Alternating between naps and feedings every four hours is recommended in the daytime.
Here’s an example of an ideal schedule:
- 7:30 a.m.: Wake up, breastfeeding/bottle-feeding or meal
- 9:30 a.m.: Nap
- 11:30 a.m.–noon: Breastfeeding/bottle-feeding or meal
- 1:30 p.m.: Nap
- 3:30–4 p.m.: Breastfeeding/bottle-feeding
- 5 p.m.: Meal (if necessary)
- 5:30 p.m.: Short nap (until six months)
- 7:30-8 p.m.: Breastfeeding/bottle-feeding and nap
- 9 p.m.: If your baby is napping, put him to bed later
The second night: Michael is put to bed 10 minutes earlier, but this time, it’s his father who enters the room every 10, 15 and 20 minutes. Michael’s parents notice that he cries less when he hears his father’s deeper voice and actually falls asleep after only two visits.
Throughout the night, his mother waits 10 minutes and then 15 before offering milk to her baby, but surprisingly, he falls straight back to sleep before being fed. The first feeding of the night has now been eliminated. For the following feedings, Michael’s mother makes sure to cut feeding time down to five minutes and puts her son back into his crib. Michael now manages to fall asleep 10 minutes later. Michael wakes up the next morning at 6:30 a.m. and day two goes by with less crying and longer naps (one hour at 8:30 a.m. and one at 12:30 p.m.). Michael’s mother manages to reduce the 5 p.m. nap to 30 minutes by gently talking to her son to wake him up.
The third night: Michael didn’t sleep much during his 4:30 p.m. nap, meaning he was grumpy and tired much earlier than usual. His parents decide to start the bedtime routine at 7:30 p.m. with Michael’s dad putting him to bed around 8:30 p.m.
Baby Michael cries and hugs his stuffed animal for 15 minutes before falling asleep. That night, Michael wakes up a couple times, but very briefly and without the need of parental intervention. At 5 a.m., he wakes up and is unable to fall back to sleep. His mom walks in to reassure him after 15 minutes and waits another 20 before going back in to breastfeed, which is brief. Michael quickly falls back to sleep after 10 minutes and wakes up for the last time at 7 a.m.
Subsequent nights: Michael goes to sleep quickly, crying only a few times here and there, and doesn’t wake up until 7:30 a.m. His mom hears little cries throughout the night, but doesn’t go into his bedroom.
Once the new sleep routine is established, it’s recommended to wait at least 15 minutes before intervening when your child wakes up crying. With time, naps will last longer and your baby’s crying will become less frequent. Michael’s mother finds that her baby is now in a much better mood throughout the day and is much less irritable.
As we can see from Michael’s example, the 5-10-15 method should work in approximately 3–4 days.
