Sleepless children: The long day's journey into night?

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Comforting a crying infant in the small hours requires patience and stamina. Coram Family look at ways to settle the sleepless.

You expect to be up and about in the middle of the night with a small baby. Until they're three or four months old, they usually need a late evening or night feed. You're prepared for that. What the manuals don't tell you is that four months is rarely the end of the story. Some young children take an age to get the message about sleeping through the night which is why so many parents find themselves treading the boards in the small hours - for months on end. If you're in this situation, you begin to understand the tortures of sleep deprivation, as the idea of unbroken sleep becomes a dim and distant memory.

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Perhaps the first thing to realise is that you're not alone - it just feels that way. In his 'A-Z of Child Development' Dr Richard Woolfson (Souvenir Press) reported that:

• 20% of one-year-olds wake once or more during the night, at least four nights a week
• 17% of 18-month-olds are wakeful.
• 10% of four-year-olds still don't sleep through the night.

This all adds up to a huge number of restless children and exhausted parents.

Settle down, children!

In desperation, parents develop lengthy rituals at bedtime and during the night. Babies and young children are nursed, rocked, walked up and down or given a repertoire of songs and stories. The rituals get longer and longer but still the child doesn't drop off to sleep. As hard as if may be, it would be better to cut back to a short, affectionate settling time.

The checking procedure

When your older baby or young child wakes in the evening or night:

• Don't go in at the first whimper; see if she will settle herself.
• If whimpering becomes crying, then go in. Comfort and settle your child briefly, tuck her in or give her a special blanket or cuddly toy. Do not pick them up.
• Go out of the child's room and wait for a short crying period - no more than a few minutes.
• If the crying does not stop or quieten, then go back in and follow the same short comforting approach. It may help to say very similar reassuring words, whether or not your child is old enough to understand them.

This checking procedure works because you change the message to toddlers or children. They learn that you are there, you hear their crying and will comfort them, but you are not available for lengthy routines or play. Parents who adopt this approach find it works gradually, but it's not a magical solution. Give it time and be persistent, because you will almost certainly have some worse nights before things get better. In a two-parent family, both of you have to keep to this pattern.

This is definitely not a revival of the old 'crying it out'. Babies and children need to feel secure that they are not abandoned to the dark, and lengthy crying can terrify children.

When children are scared at night

It's hard to know for certain why young children develop fears that are triggered by the dark. Can you remember what made you frightened when you were a child?

Sometimes it seems to be a fertile imagination - curtains that look friendly in the daylight, but turn into ominous shadows in the dark. Gurgling pipes and noisy central heating may sound like something nasty behind the walls.

• Be reassuring as part of your checking procedure. Sometimes children wake after bad dreams. They need physical comfort, soft words that tell them, 'It's only a dream, I'm here'.
• If your child is old enough, talk about what troubles her. Explain about the pipes or creaky stairs. Sometimes it helps to listen to the same noises in the daytime. Let them describe their fantasies. One four-year-old we know felt stronger when she challenged the 'witches' with: 'My mum says you're not real.'
• A source of soft light can reduce fears of the dark.

Do you take them into your bed?

When everyone is exhausted and you've already been up several times, it's tempting to take children into bed with you.

Two cautionary notes about letting babies sleep in your bed

• Adults who are heavy sleepers, particularly after too much alcohol, can lie on the baby and suffocate them.
• Babies, tucked up with one or two adults, can become too hot. The causes of cot death or sudden infant death aren't fully understood, but overheating can be a contributory factor.

When young children are still waking at night, parents face a different decision. It is probably better to use the checking procedure, take children back to their own bed and put up with some disturbed nights in the short term. When children have moved into a bed from a cot you do have the option to join them in their room if need be. This avoids the well-known 'musical beds' scenario, when child and one parent end up in the big bed, with the other parent in the child's bed. Obviously this is a personal decision and the odd night when children have had an awful dream or are ill and want to share your bed will probably not set a pattern.

If you've succumbed and now need to get the cuckoo back in its own nest, bear in mind that this may take a while. Explain that this bed is for adults and you would like your child to sleep in his or her bed. Be calm and ready to take your child back, perhaps many times, without getting cross.

Accept help
When you start another day after another exhausting night, you wonder how long you can survive with such a limited amount of sleep. So take what help is available. If your partner is willing to take the night shift for you or your parents offer to have a night 'on duty', don't turn it down.