The DOs and DON'Ts of Sleep

If there's one thing guaranteed to make you feel down in the dumps it's not getting a decent night's sleep

If there's one thing guaranteed to make you feel down in the dumps it's not getting a decent night's sleep. But when your sleep is disturbed for months on end because of a baby or young child's sleep patterns - or lack of them - you can get ground down, worn out and your health can be on the line.

Parents can feel demoralised if their child can't sleep through the night. It can reach crisis point if the mother must return to work before the child has established a regular pattern of sleep. So what can parents do?

Elizabeth Quinn, co-ordinator of the National Association for Parent Support (NAPS), urges parents not to take their children into their own bed: "Experience proves it's not a good idea to have them in bed. It's an immediate solution - from the day they're born they're surprisingly able to manipulate. They come equipped with all this stuff. They're way ahead of you."

She has no problem taking them into bed in the morning which can be a family time. She also recommends that babies sleep in the same room as parents: "Otherwise you're tip-toeing into the nursery to make sure it's still breathing."

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Mothers need to rest if they're going to be a good parent, says Quinn. "Older parents who are more mature can get more upset" if their child doesn't sleep well: "They feel they ought to be perfect - especially successful career women. Then they're handed this bawly-scrawly little child."

Anne O'Connor, a senior clinical psychologist with a special interest in pre-school sleep problems, says sleep difficulties usually relate to a child's "sleep associations." If a child always falls asleep while at the breast, sucking a soother or in its mother's or father's arms and wakes in the middle of the night, it believes it needs the breast, soother or parental arms to go back to sleep again.

O'Connor's aim in meeting with parents is to hear the case history and to get beyond the child's current sleep association to teach the child to sleep by itself. There are two broad approaches, she says. The first - traumatic but fast - is to let them "cry it out" while parents carefully monitor them: "Decide on bedtime and a short bedtime routine. Say goodnight and leave the room."

You can go back in to reassure them, she says, but "not to lift them up" and to "leave them while they're awake." Before trying this short sharp shock approach she cautions parents to ensure that other factors such as family

tensions or illnesses are not causing the child any distress. It's also important to ensure that the sleep environment is neither too hot, too cold nor too bright.

There might be an hour or two of screaming initially, she concedes. She doesn't advise parents to take this approach if the child wasn't receiving enough affection during the day.

The second approach is gradual and takes longer. If a child needs to be rocked asleep, the plan would be to start with the goal of letting the child sleep with the parent lying on the bed. Some nights later the parent would only sit on the bed. Later still, he or she would sit on a chair and so on until the parent is no longer associated in the child's mind with getting to sleep.

Geraldine French, training officer with Barnardo's in Dublin, says that if a child gets into a good sleep pattern before six months it probably won't have problems later on. She recommends a routine: "Don't do anything too stimulating. Maybe a bath, brushing teeth, then snugly into bed."

French agrees with Quinn: "Taking them into the bed is very nice and cuddly. But it's not fair to begin that practice if at some stage you're going to kick them out. Don't expect them to want to go willingly." If parents have let the child into their bed they need to plan carefully how and when to move them to their own room, she says. Letting them choose the colours can help or you could start the change when they're on holidays. "If a child comes back in, you must bring her back again firmly but consistently. It's much easier to take her back into the bed again."

PARENTS whose older babies continue to demand milk in the middle of the night should substitute water for one night-time, she advises. They'll not like it but their tummy gets the message that there's little point in waking up for it.

What if they wake screaming in the middle of the night and there's evidently nothing wrong with them?: "Don't take them out of the cot. Reassure them. Over a period of time walk out. Tell them it's time to go asleep. They're going to complain if that's not what they're used to in the past."