Sleeping

There is a lot of pressure and expectation that is put on parents when it comes to their babies’ sleep patterns. Everyone wants to know, “Is he sleeping through the night?”  If he isn’t, you are made to feel you’ve done something wrong. But often your baby will need you during the night.

Perhaps partly because of our pressurised, fast paced lives, Western society has become very uptight about the need for babies to sleep ‘through the night’. Tumi Jantjie, in a paper delivered at the Congress on Infant Mental Health in Cape Town in 1995, explained that in African cultures, during the first three of four months of life, mothers and babies sleep together in a confined space, the baby is breast-fed on demand any time of the day or night and there is no regulation of the baby’s sleep-wake behaviour. At around four months of age, different caretakers may be introduced but even from this stage onwards, sleep is related to in a much less rigid way than in Western culture. Judging from informal dialogues that I have had with African women, it would seem to me that babies (and toddlers) are not necessarily expected to sleep through the night. Should they wake, they are offered the breast and they are soothed back to sleep as many times during the night as they require it. Mother and child most often sleep together so the child is comforted by the mother’s presence and probably feels less isolated and afraid than if he was alone in a room. These mothers do not interpret a few night-time awakenings as indicative of any kind of problem. They see it as an inevitable part of how babies just are.

When sleep is a problem
It can happen, of course, that night-time waking becomes abnormally frequent, causing great distress both for the infant and for the parents. We hear about babies who wake many times or for long periods almost every night, exhausting themselves and everyone in the house. This obviously needs to be addressed. As always,  first consult with your paediatrician to check for any physiological problems like teething pain, colic, reflux, ear-ache and so on. Once the physical has been addressed, you can start to look at the psychological factors that may possibly be contributing to disrupted sleep.

The psychology behind sleep problems
I believe that most of the time, a simplistic step-by-step approach of teaching a baby to sleep by himself is not useful. When there is a significant sleep difficulty this approach often does not work because there are very powerful, underlying psychological processes at work which contribute to and sustain sleep problems. These psychological processes are very often alive in one or both parents and in the dynamic between parent and child. The dynamics are most often unconscious. This complicates things somewhat because if it is unconscious, you cannot see it or recognize it, so you have no way of fixing it.

Separation anxiety 101
Dilys Daws, consultant child psychotherapist at the Tavistock Clinic in London, says that babies who struggle to sleep often have separation anxiety which is linked to the relationship with the mother. When your baby goes to sleep he enters into a world away from you. He is alone in his mind. He is separate from you. This separateness might be so terrifying for him that it could interfere with his sleep.

Other psychological reasons for sleeplessness
Anything that makes your baby feel insecure could disrupt his sleep, even going away on holiday. If you or a family member goes away for a while it could also effect your baby’s sleep. Stressors such as moving house, parental separation or divorce, the birth of a sibling, illness or death of a family member could all bring about sleep disturbances in your baby. The point at which you go back to work or start to spend a significant amount of time away from your baby might correspond with sleep difficulties. If you work long hours, your baby might try to stay awake when you are home so that he can prolong his time with you. He might be afraid you are going to leave again.

Without anyone being aware of it, babies can carry all kinds of psychological baggage for their families. They are like sponges, picking up or sensing tension, dark secrets, unhappiness and deception. Babies often sense unspoken (or overt) conflict between the parents and this seems to make them feel very insecure. Ambivalence towards your baby and mixed signals towards him can cause him to experience sleep difficulties. And lastly, a wakeful baby might be reacting to the emotional absence of either parent. This would include a parent who is depressed or preoccupied with his or her own turbulent, conflicted state of mind.

Each family is unique. No one sleep rule-book is going to have the solutions for every sleepless infant. If you have a baby with sleep problems, unless you know what is causing the sleeplessness, consult with a parent-infant psychologist or with a psychotherapist who has training and expertise in infancy.

What about the mother’s needs?
The truth is that if your baby isn’t sleeping, neither are you. If you are feeling a pressure to get your baby to sleep through the night, it is probably because you are exhausted. It is very hard to function on insufficient sleep and when both parents work full-time, the demands can be overwhelming. From this perspective it is completely understandable that you don’t want your baby to disturb you during the night. Unfortunately, it is just not realistic. Babies (and young children) often have disturbed nights and they often cannot manage the whole night alone.

If you are the parent of twins or triplets, or if you have more than one young child keeping you up at night, you might strongly disagree and insist that your babies not wake you during the night. If you have post-natal depression or if you are physically or mentally ill, you may be unable to attend to your baby during the night. Some family circumstances are so pressured and stressful that parents need to do everything in their power to get a good night’s sleep. Try to arrange for a spouse, nanny, nurse or other family member to be available to your baby under these circumstances. Leave your baby to cry alone at night only as a very last resort if you are absolutely desperate and you have no other alternative. Going in to soothe him at increasing intervals of time may or may not work for your baby. But be aware that leaving your baby alone to cry at night might not be in the interests of his future mental health. It could contribute to feelings of insecurity and lack of trust and it could also interfere with the bond between you and your baby.

Each family has to decide where its own limits are. But if you can be available to your baby during the night if he needs you, that is first prize for him. He will feel more secure and will be psychologically strengthened by your availability.

Survival plan for sleepless parents

• Get your baby checked by a pediatrician if he is experiencing disturbed nights and treat physical problems accordingly.
• go to bed early in case your night is disturbed
• catnap, meditate or do relaxation exercises when your baby has day-time naps
• arrange to have a spare bed somewhere in the house so that you can lie down with your baby if that means you both get more sleep
• do not exhaust yourself during the day. Conserve energy and beware of over-committing yourself and trying to do too much
• before you go to sleep at night, get everything ready in your baby’s room for an anticipated night-time awakening. For example, an extra bottle, a torch, or whatever you might need
• be kind and forgiving with yourself. Do not be critical of your parenting abilities
• try not to see your baby’s sleeplessness as a pathology, a weakness or a failure, unless it is very severe
• remember that many, many babies wake during the night. It is not abnormal or unusual and it is not an indication that you are doing anything wrong
• accept that this is going to be a time of disrupted sleep and don’t waste too much energy fighting against this reality
• try to ascertain the kind of sleep pattern that best suits your baby at this particular stage 
• do what you can to facilitate a daily rhythm that facilitates his sleep
• consult with a parent-infant psychologist if the sleep problem is severe, if it persists and if it is causing distress or impairment in the functioning of any family members.

An adapted version of an extract of Babies in Mind (Juta)
by Jenny Perkel