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Sleep & Life Hacks

When to Transition from Two Naps to One Nap A Day

2/23/2020

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Dear Abby,

My fifteen-month-old naps from approx 10am to 12p. He has been rejecting his second nap (typically around 2:30/3p.) He nurses to sleep for nap time and also wakes to nurse or to be rocked 2-6 times during the night. I'm wondering if I need to drop or adjust morning nap? 

Thanks,
S, mom to 15-month-old twins H & B


Many toddlers transition from two naps a day to one too early. 

This transition often takes place in daycares at around 12 months, while most toddlers aren't actually ready to drop a nap until 15-18 months, although it can range from as early as 12 months to as late as 21 months.

There are typically two patterns we see when children are ready to transition from one nap a day to two. The first, and more common, is that they take a long morning nap and then can't seem to fall asleep for the second nap, resulting in late afternoon overtiredness and misery. This can also lead to nighttime or early morning wakings as a result of the overtiredness. 

The other pattern we see is children that skip the first nap in favor of playing in the crib. These children generally have an easier time transitioning to one nap a day as they essentially make the switch themselves. 

If your toddler is struggling to keep two naps a day, preserve that second nap as long as possible. Here are some sugestions as to how this can be done: 

  1. Cap the morning nap. I know it's painful to wake a sleeping child but we need your little one to be sufficinently tired to sleep again in the afternoon. If she's sleeping two hours now in the morning, cap it at one and a half hours. If that doesn't work after within a few days, make the first nap even shorter, only one hour. After you wake her, expose her to plenty of natural light and go outside if you can. 

  2. Make sure the naps are at bilogically appropriate times. Twice-a-day nappers should be napping at about 9 am and 1 pm. If your child's nap times are at different times, it will make it harder for him to sleep because his melatonin won't be peaking then.

    If this doesn't help, move the morning nap a little earlier, to 8:30 am. This will allow your child to get sufficiently tired for the second nap. 

  3. Make sure that bedtime and waking times aren't too late. The number one reason that children have trouble sleeping is that they have a too-late bedtime. The ideal bedtime for most toddlers is around 6:30 pm while in reality, many toddlers go to bed at 8 pm or later. This is too late and will make it harder for your child to sleep. It's very hard in today's world to get your child to bed early... but try anyway. It will pay big dividends in better sleep for the whole family. 

    If your child is sleeping past 7:30 am, it's going to make it hard for her to be sufficiently tired for a 9 am morning nap. Even 7 am is probably too late if you are trying for an 8:30 am nap -- try waking your child at 6:30 am instead. I know, ouch! 

If capping the morning nap, timing the naps appropriately, and confirming that bedtime and wake times are not resulting in a consistent twice-a-day nap schedule after a couple of weeks... it's time to make the dreaded transition to one nap a day. 

This can be a tough transition to make so plan for a couple of low-key weeks, if possible. There's no magic trick to make it easy. I recommend moving the morning nap time back by 10-20 minutes per day. You can expect that it will take him a bit longer than usual to fall asleep because he will be a little bit overtired. I suggest you allow a minimum of 90 minutes in the crib. If your child sleeps less than an hour, leave him! He may well fall back to sleep if given enough time. 

While you are making the transition, you may temporarily need to offer a very early bedtime, as early as 5 pm. You'll know you need to do this if your child is cranky or alternatively, acting wound up and bouncing off the walls in the late afternoon. If this is happening, you can expect that your child may not eat much dinner. Don't worry about it -- she is unlikely to wake from hunger (really!). It's much more likely that she will wake up from being overtired. So just get her to bed as early as you can. 

As you are able to move the nap later, your child will gradually be able to lengthen out the nap with the single nap ideally being around two hours, though this will vary for each child. Your child will likely need an earlier bedtime now than when he was taking two naps a day, though likely later than 5 pm. 

Some children do well with having an occasional day with two naps a day as they transition to one nap a day. If your child is just miserably tired by 9 am on some days, this may be a good option for your family. Rest assured, as she gets older and as the transition to one nap a day stabilizes, it will get easier!

In the case of the family with 15-month-old twins, we tried many things. We eliminated the sleep crutch of nursing and rocking to sleep -- took only two nights! -- and capped the morning nap at 1 hour. We moved bedtime earlier. They weren't able to move the morning nap earlier than 9:15 am due to some medical issues, unfortunately, and after a week, the afternoon nap was still erratic. Ultimately we decided to move the morning nap later again, making it 15 minutes a day later. The toddlers are currently working on making it to 11:30 am for a two hour+ nap. 

The transition from two naps a day to one is a tough one but it's a beautiful opportunity for a family to get a little further from home. In daycares, the transition often means that all toddlers sleep on the same schedule, which means it's easier for children to sleep. 

If you would like help transitioning your toddler from two naps a day to one, or if you need support with any other sleep challenge, schedule a free chat with me. Let's get your family the sleep you all deserve so you can better enjoy your time together!
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Ready to Have Your Bed Back? How to Stop Co-Sleeping, Peacefully

2/18/2020

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Transition out of cosleeping
Are you ready to reclaim your bed as your own? Tired of waking up with a small foot in your face? Exhausted from middle of the night bed musical-beds or every-two-hour feedings? Maybe Valentine's Day has even inspired you to pursue a little romance and "adult time" in your life?

Whatever the reason, it's never too early, or too late, to stop bed-sharing. If it's not working for one of you, it's not working for any of you. You can't be the parent you want to be if your sleep is frequently interrupted. And most likely, your little one will feel a lot better once her sleep isn't so broken, too. 

(If your family is bed-sharing and everyone loves it, there's no problem. Just be as safe as you can possibly be. The American Academy of Pediatrics does not recommend bed-sharing under the age of one, due to the increased risk of SIDS.) 

The most important thing to focus on is connection... during the day. Many families bed-share because they love feeling connected. But there are many ways to connect, ways that don't compromise sleep. Whenever you make a big change to your child's routine, you will want to focus on connection even more. 

For working parents, before you greet your child after work, take a few minutes to breathe and center yourself. You might even want to have a snack so you aren't ravenous and can focus on your child. When you get to him, let your face light up at the sight of your child. Offer a big hug but don't insist on one. Spend the first few minutes at home together completely focused on your child. Set a timer on your phone so you won't be checking the time. Let your child pick your activity together.

Roughhousing (as unappealing as it sounds, I know!) is a fabulous way to reconnect. Children love it when they are bigger, stronger, and faster than their parents. Chase your child around the table, and let her win the race. Wrestle and let her pin you down. This physical contact and reversal in roles is hilarious to children, and all that laughter helps them empty their emotional backpacks. If they are too wound up to play and keep pushing limits, hold the boundary and let them cry. Crying also helps to empty the emotional backpack so that children can release all the big feelings they've been feeling all day while you were gone. Once they've released all those emotions, you will be much more able to enjoy your time together. Please don't feel guilty about enforcing a limit, even when you've been gone all day. Children test your limits because they need limits to feel safe in the big, scary world.

For parents who have been home, you may want to do something to mark the end of the day as well. Perhaps a quick walk around the block or a bath before dinner will do the trick. 

I suggest that you do not try to cook anything complicated or open mail or make phone calls while you are spending the early evening with your child. Try to focus on them instead. By focusing on them now, you'll get a break a little bit later in the evening. 

If you have an older child, you'll want to have a family meeting before making a big change like changing beds. Talk about it on the weekend, when everyone is well rested, and not at bedtime. Give your child time to adjust to the idea. Make a sticker chart and let him decorate it. Promise a small reward for staying in bed each night, and a bigger reward at the end of a few weeks of stickers earned. Let your child pick out special sheets or a new stuffy for his bed. 

When the big day arrives, be prepared for big feelings. Plan on an early bedtime for your child. Spend plenty of time cuddling and reading together. Give her a warning before bedtime. When bedtime comes, stay strong. Do not lie down with her while she falls asleep as she needs to learn to sleep alone. Otherwise, she'll wake up during the night because she won't know how to put herself to sleep. You can sit next to her for a few minutes, if desired, but try to do so without continuous physical contact. On future nights, try to sit in a chair and each night move the chair a little closer to the door. 

When your child leaves his room in search of your company, you need to be prepared with a strategy. Do you want to do "silent return," where you bring him back to his room without any response, as many times as it takes? This method works but it takes a lot of patience. You have to outlast your child. And you have to not react at all to the popping out of bed. Any reaction -- besides the silent return -- reinforces the behavior, even negative reactions.

Other parents prefer an extra-tall baby gate in the doorway, or a Door Monkey, a gadget that holds the door very slightly ajar, so that the child can't leave the room. Some families do a combination -- after two pop-ups, the baby gate or Door Monkey goes up. The important thing is to be absolutely consistent in your approach. Once you've set the expectation and the rule, you must stick to it. As soon as you make an exception, your child knows he can wear you out. 

With preschoolers and older children, an OK To Wake clock can be very helpful. You can tell your child that when the light turns green, he can join you in bed for early-morning cuddles. If you are nursing, please don't nurse in bed, though, at least for the first few weeks of the change in beds. Nurse in a chair -- where everyone stays awake -- and then offer cuddles in bed afterwards. 

Understand that this may be an unwelcome change for your child. Prepare yourself to be extra patient, and make space for her big emotions. Holding a boundary -- in this case, sleeping in her own bed -- while she cries does not mean you are making a mistake. If you are consistent, I promise she'll get over it. Younger children generally adjust more quickly than older ones but all will get used to it in the long run.

The end of the family bed does not mean the end of your strong connection. Many parents feel they are actually more able to connect with their children when everyone gets a break at night.

Of course, all these changes are easier said than done. I am confident any family can make these changes, but some parents appreciate coaching and emotional support through the transition. If you'd like some support, schedule a free chat and let's see if I can help. 


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Sleep Training Builds Stronger Families

2/10/2020

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Some folks claim that children can't be well-attached to their parents if the parents choose to sleep train.

This is wrong.

The happiest families are those that are getting their biological needs met. Just like being fed when you're hungry, you need good sleep to be feel your best. 

An exhausted child and parent are not at their best. A tired mom or dad who feels guilty about their low energy, propped up on too much cafffeine, definitely isn't getting the most enjoyment out of their parenting experience. And if you're anything like me, odds are you are more short-tempered with your child when you are exhausted. 

And the poor exhausted child who is waking up multiple times a night to nurse or cuddle back to sleep? Her body is on overdrive, pumping out stress hormone in a desperate attempt to stay awake during the day. Unfortunately, this strategy backfires and keeps her awake during the night, too. 

Toddlers who don't sleep well become preschoolers who don't sleep well become adults who don't sleep well.

Here's a few not-so-fun medical facts to further convince you that sleep deprivation is a real issue:

  • Eighteen month olds with three or more night wakings were more likely to have emotional and behavioral problems at age 5. 
  • Disrupted sleep in preschoolers resulted in higher levels of aggression, defiance, oppositional behavior and hyperactivity.
  • Short sleep duration at age 5 predicts obesity at age 9. Of note, naps have no effect on the development of obesity and are not a substitute for sufficient nighttime sleep. (Naps are important in younger children but as a bridge to get them to have quality sleep at night.) 
  • Sleep problems at age 8 predict symptoms of depression at age 10.
  • Teens with sleep issues are more likely to be depressed, attempt suicide, and use alcohol and drugs at age 21.
  • And overtired adolescents are more likely to be overweight or obese and suffer from high blood pressure, higher cholesterol, and insulin resistance (at-risk for diabetes). 
  • Mothers who don't get enough sleep are at increased risk for depression.
    ***Healthy Sleep Habits, Happy Child by Marc Weissbluth

Let me add that for those families who co-sleep their toddlers and nurse all night and feel great... that's great. No need to change anything. (Most likely you aren't reading my blog anyway!) It's when the family's sleep is disrupted that there is an issue. 

Clearly getting enough sleep is a biological need, just like being fed. But parents still worry that sleep training will damage their children. This is a great article demonstrating that crying associated with short-term sleep training is safe. 

Even beyond being safe, after sleep training, parents enjoy their children because their children aren't alternatively wound up and acting like the Energizer Bunny or cranky, irritable, weepy, and defiant from exhaustion. Parents have more to give and are more relaxed when their own cups are full after a good night's sleep.  

Here's a lovely quote from a client that exemplifies the changes I see in families after sleep training, "before Abby’s help, it was taking my daughter 2 or more hours to fall asleep every night. We had hours of fighting and screaming before we got to that point, and she ended up in my bed every single night, where we both tossed and turned and kept waking each other up for the rest of the night. She was chronically exhausted and so was I! Now my daughter sleeps in her own bed, falls asleep in as little as an hour (we’re still working on that!), stays in her room all night long until her ok to wake comes on, and we rarely have tantrums at night or in the morning!" Cyndi, mom of C, age 3

Meeting the biological needs of a child and his parents makes everyone happier and more able to enjoy each other. It actually strengthens family bonds. 
Sleep training is a gift to the entire family. 

If you'd love to give this gift to your own beautiful family, let's schedule a free chat and get you on your way to sweet, sweet dreams. 

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"Nap Training and Other Disasters": Fraternal vs. Identical Twins

2/4/2020

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Sleep Training Identical and Fraternal Twins
​"They each got up and intermittently played and cried. Clementine was okay. Cecilia acted exhausted. They ate once, or maybe twice, each. I tried to get Cecilia to nap in her swing. She cried desperately. I gave up. They played, and whined. Cecilia fell into a bottomless pit of despair and I carried her up to her crib, where she settled happily and admired her jellyfish and sucked her thumb. I came downstairs. Clementine was trying to sleep on the floor. I carried her upstairs. She rolled over in her crib, spun 180 degrees so her feet was where her head should be, and shouted. I tried to wait it out. Cecilia started occasionally crying (wouldn’t you?). I went upstairs and removed Clementine. Cecilia saw me and sobbed. I put Clementine in the swing. She fell promptly asleep. Cecilia cried for several minutes, remembered her jellyfish, and then fell asleep. From the time they needed that nap until they fell asleep was an hour and a half. That’s insane." 

Twins are tough! I recently wrote another post with tips for sleep training twins and higher order multiples. Today I'll delve a bit deeper. 

Identical twins usually have similar sleep needs, while fraternal twins' sleep needs are are different as any other set of siblings. This means it will be more challenging to get your twins on a similar schedule if they are fraternal... but there are things you can do to help the process along. 

In any given set of fraternal twins, there is typically one who is considered one who is the more sensitive sleeper and another who is considered the more challenging sleeper. The sensitive sleeper is more reliant on routine and can't adapt well to changes in the schedule but generally sleeps well. The more challenging sleeper struggles with falling asleep independently and tends to take shorter naps. 

In order to prevent overtiredness -- which makes it harder for children to sleep -- parents should generally focus on prioritizing the sleep needs of the more sensitive sleeper, the one with apparently higher sleep needs. 

If the children will be sharing a room, it is generally recommended that parents sleep train their twins in the same room. Yes, they may wake each other initially, but it's the only way they will eventually learn to sleep through each others' noises. The American Academy of Pediatrics recommends that twins do not share a sleep surface. Room-sharing with parents for at least the first six months, but ideally until one year, can reduce the risk of SIDS by up to 50%.

As discussed in my previous post, put the cribs as far apart as possible. Put a white noise machine on the floor between them. Use blackout curtains for every nap as well as at night. If one baby wakes at night for a feeding, wake the other for a feeding also unless they are past four months and your healthcare provider has given the okay for night weaning. In that case, don't wake the sleeping baby for a feeding. I know this can be scary because it might mean twice as many night wakings for you! Try to delay the first feeding until after midnight.  

Fraternal twins typically do not consolidate naps at the same time. But you want them on the same schedule. This can be tricky! When one wakes after a short nap... don't let him get up! He needs practice putting himself back to sleep. Even at the risk of disturbing his twin. Give the catnapper at least 15-30 minutes to fall back asleep, for at least a total of 60-90 minutes in the crib. If he still won't sleep, get both babies up and out of their cribs so that they are sleepy at the same time for the next nap. 

Night sleep training typically takes about 2 weeks for twins and naps can take even longer to fall into place. But don't despair, with time and consistency, things will get better.

I love working with twin families! You guys amaze me. Let me help you get your little ones sleeping through the night. Let's set up a free chat and see how I can get your family the sleep you deserve. 




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    Author

    Abby Wolfson is a pediatric nurse practitioner, certified child sleep consultant and certified life coach for parents. She divides her time between Brooklyn, NY and San Miguel de Allende, Mexico. 

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