Sleep and mindfulness

Dr Elisa Rough (Paediatrician) has provided the information below to help you navigate infant and toddler sleep, as well as mindfulness.

It is important children get enough sleep to reach their full potential.

Mindfulness can be described very simply as “being in the present moment”. The ability to focus attention and concentration on one activity sounds simple but is not always so.

 

                              Sleep

After having spent many months nestled securely in the mother’s womb, the transition to the extra uterine environment can be a difficult one for many babies. The concept of day and night and of having breastmilk or formula coming through the digestive system is something that many babies have an early and difficult time adjusting to.

It often takes up to six weeks for a mother to establish breastmilk supply and it can be during this period of time that babies spend many wakeful hours crying and unsettled. It is most important during this time to ensure your baby is having adequate nutrition and is growing well. Support can be provided through your maternal and child health nurse, general practitioner or a lactation specialist. A baby who cries at night and is not gaining weight, may have a serious underlying medical condition and it is important that prompt medical attention is sought.

During the early weeks and months of life, a baby requires responsive parents to develop a secure attachment. It is important during this period of time that babies are not left to cry for long periods. There are many settling techniques by which you can responsively settle your baby. These may include feeding, comforting by patting or rocking and holding. The baby needs to know that you are there and can attend to them.

After approximately six months of age, some responsive settling (i.e. following your baby’s cues) and comforting techniques can be used to help your baby learn to sleep for longer periods of time. In doing so, understanding your baby’s basic needs is helpful. A baby’s day can be thought of as a series of cycles, with each cycle presenting with certain needs. These needs include food, comfort and sleep and during the day, a baby also needs to be stimulated and engage in play. A basic routine to which many babies respond is: 1) awake; 2) nappy checks/clean; 3) nutrition; 4) playtime; and 5) sleep.

Should your baby’s sleep behaviour change suddenly, it is important that they be evaluated for possible underlying medical causes, for example an ear infection.  A baby who has a fever and is sleeping poorly should have a review with a doctor.

There are many sleep resources available and explanations of infant sleep cycles.  A good resource is a book by Renee Kam entitled “The Newborn Baby Manual’.  Further information and support can be sought through your maternal child health nurse, or the Safe Sleep Space organisation, which provide both telephone consultations and in-home care and support. Safe Sleep Space has a website and downloadable app that parents may find helpful.

Most toddlers get enough sleep for normal growth and development, even though they may wake during the night and cause some disruption for the family. Disrupted nighttime sleep and sleep deprivation can be difficult for the families of young children. When disturbed sleep impacts upon a parent’s ability to work or function in their day to day activities of caring for children, it becomes something which should be addressed. This is especially so because being emotionally available as a parent is important for your child’s development and proper sleep can help achieve this. With an aim of restful sleep for the whole family, parents can help their young children establish good sleep patterns.

In different cultures, there are varied approaches to sleep environments and encouraging good sleep patterns. There is no one correct way to help your young person sleep; the correct method is one that is safe, you feel comfortable with and that works with your child. Some children seem to naturally establish good sleep patterns, while others may inherently have more difficulties. This is not a reflection of your parenting ability.

Toddlers generally need approximately ten to twelve hours sleep per night, often with a day sleep of one to two hours.  Toddlers can learn to sleep through the night without waking their parents, but vary in how much time and help they need to achieve such a pattern.  Young children can become overtired easily and it is helpful if you learn to recognise the tired signs in your child. Tired signs in a toddler may include being clingy, grizzly, clumsier than usual, fussy with meals and requiring constant attention. You will often know your own child’s tired signs better than anyone else  It is generally much easier to settle your child when you first see the signs of tiredness, as overtired children can be difficult to settle and generally do not sleep in longer. Rather they can wake up not fully refreshed, making for a more difficult new day for everyone.

A good starting point is to try to understand your child’s sleep and sleep patterns and to take a positive attitude towards their sleep and develop healthy long-term sleeping habits which are important as children progress towards the school years.

Toddler sleep example

An example of a toddler sleep pattern would be waking at six or seven am, a nap of one to two hours after lunchtime, wake up in the early afternoon and a bedtime at around 6.30 p.m. to 7.30 p.m. If a toddler has a longer daytime nap they may not be ready to sleep until much later at night. A consistent bedtime routine can help children prepare for sleep. Deep sleep is often best between 8.00 p.m. and midnight.

Some toddlers like to wake early at 5.30 a.m. or 6.30 a.m.  This is not easy to change, so parents may consider shifting their own sleep patterns so they also settle earlier in the night and rise early with their children. This can be both a productive and beautiful time of the day.

A settled evening routine may include a 6.00 p.m. bath and dinner, then brushing teeth and some quiet time such as reading a story, having a massage or listening to some gentle relaxation music. Reading stories is a wonderful way to enhance your child’s language development. Following this, a kiss and a “good night” by parents. Always ensure that the environment is safe before turning out lights.

Toddlers are full of energy and may have the desire to spend every minute of their lives awake so that they do not miss anything exciting. Toddlers can be delightful as they grow and learn to experience the world. Of course, life can be exciting and confusing for toddlers; common changes involve the arrival of a new baby, parents returning to work or commencing child care and all of this can make it more difficult for toddlers to settle to sleep.

Some ideas on separation at night-time

To help your toddler adjust to separation at sleep time, allow them some choices during wakeful times so that they have a sense of control and do not feel the need to control so much at sleep time.

Toddlers seek attention, good or bad.  If they do not get positive attention, any attention will do, so you can help by commenting on positive behaviours and achievements, rather than focusing on negative ones.  Try to avoid to saying ‘no’ to your toddler for a whole day and you will be surprised by how many times you actually say it.  Use lots of positive comments for them.  Try to “catch your child being good“. Toddlers thrive on attention and positive attention can help your child’s self-esteem.

Other general tips to help promote sleep

  1. Avoid screen time for one hour before bedtime, this includes television, iPads etc.
  2. Avoid boisterous play before bedtime as it can make it hard for your child to settle. Do, however, have plenty of active and outdoor play during the day.
  3. Establish a consistent calming bedtime routine, based on the above descriptions.
  4. Before leaving the room, check your child has everything that they need and remind them to try and stay quietly in the room.

Most children move from a cot to a bed somewhere between two and three and a half years of age. If you are having a new baby it is often good to transition your older child earlier, not exactly at the time of the arrival of the baby, as two changes at once can be hard for a toddler. Moving to a ”big bed” can be a cause for celebration; be creative, reorganise the room, choose a special doona cover or pillowcase.

If you are worried about your child’s sleep seek advice from your maternal and child health nurse, general practitioner or paediatrician.

Lovely descriptions of examples of responsive parenting and responsive settling techniques can be found at www.safesleepspace.com.au

Mindfulness

Mindfulness can be described very simply as “being in the present moment”. The ability to focus attention and concentration on one activity sounds simple but is not always so. Modern life can be very busy and time pressured. Our lives are full of technology -phones,
iPads, the internet.  This technology can be helpful, but it can also distract our brain from enjoying and appreciating the calm that can come from focusing on a single activity.

Children thrive on simple activities -a play in the park, helping with gardening or learning to hand wash dishes. Sometimes young brains can become overwhelmed by exposure to electronic devices, which can activate the part of the brain involved in generating stress responses (amygdyla) and potentially hamper the development of frontal lobe or executive functioning.

For children with social communication difficulties and attention and concentration difficulties, training in mindfulness activities can often be very helpful.  Similarly such activities can assist with childhood anxiety. They are also useful skills for all children facing our busy modern world.

A mindful activity can be walking in the park.  It can be closing your eyes and listening to birds. It can be performing yoga or a five minute meditation.  A graded muscle relaxation can be a mindful exercise.

Practising these activities with your children can help develop family rhythms and enhance relationships. Try it today, for just five minutes with your child……

More information on mindfulness for children is available at http://www.meditationcapsules.com/

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