I've been meaning to write on this topic for a while, but I
never managed to get around to it. There
always seemed to be a more pressing issue to address. Then, one of my 2.5 year-old twins made it personally
relevant. A little over a week ago, she
fell off the top of a playground set at school, and she broke her leg – badly. The officially diagnosis is a “displaced oblique
fracture of the tibia.” Basically,
the larger, weight bearing bone in the lower part of her leg broke into two
pieces, and the two pieces were not lined up.
Needless to say, she was in A LOT of pain, and it affected
her sleep. She needed her pain
medication every 6 hours, and the medication didn’t fully cover the pain so didn’t
sleep soundly even when she was medicated.
So, what did I do? I did what any
mommy would (and what I have told my clients to do); I took care of my baby! I slept on the floor in the twins’ room
(thank you Aerobed
Inflatable mattress), and I set an alarm on my phone to make sure I gave
her pain medication as soon as she was due.
I didn’t end up needing that alarm – she woke up crying. Each time she woke, I held her hand, rubbed
her back and head, and I reassured her that I was there. Did I comfort her back to sleep? Yep! It wasn’t appropriate to expect her to do it
herself while in pain, so I didn’t. That’s
actually why I spend so much time going over client histories. We have to make
sure the child isn’t hurting before we can expect independent sleep.
If you look at Maslow’s
Hierarchy of Needs, it’s clear your child’s physical and security needs
have to be satisfied BEFORE they can learn self-soothing and independence!
 |
| Playing in her chair |
Thankfully, my little one is doing
a lot better now.
Getting a cast
seemed to provide enough stability that she was finally able to relax, and she
loves that it is bright pink (even if my husband thought she needed something
more subdued!) She is only taking
Ibuprofen now, and she doesn’t even need that all the time. She’s not going to be swimming for about 2
months, and she has a little wheelchair to use at school now, but she’ll be ok.
For a lot of families, the story would end there, and it’s
very possible that they’d have a sleep problem.
The two nights of sleeping on the floor, soothing and comforting at
every wake-up, may have caused the child to want to see Mommy in the middle of
the night. That was certainly the case
with my little girl. She asked me to
sleep in her room, and she asked me to help her fall asleep. So, how did I get her back to falling asleep independently
and sleeping through the night again? Extinction,
also known as “cry it out” would certainly work. She already had the skills, so it wouldn’t
even take very long, but I wasn’t comfortable with a lot more crying after all
she had just been through. So, I did a
modified version of the fading approach known as “The
Sleep Lady Shuffle,” which allowed me to sit next her while she fell asleep
on her own initially and then move away from her gradually. Normally, this process takes about 2 weeks,
but when you’re “reminding” a child how to sleep independently again, it’s only
a couple days. For my daughter, it took
three days to get her back on track, and there weren’t many tears, just a lot
of complaining.
To answer the question I get regularly, please go to your child in the middle of the night if there is really something wrong! If it's a minor issue with a clear resolution, like teething or a leg stuck in the rail, help him and then let him fall back to sleep on his own. If it's something more significant that isn't easily resolved, like a broken leg or the stomach flu, parent through it. Do what you need to do to make your baby feel better (even if your baby is 6 years old)! As parents, loving and caring for our little ones is our primary responsibility. (I'm sure I don't have to tell you that part though!) Once the crisis has passed, however, it is critical that you help him return to sleeping independently. Yes, he'll still want you to hold him and cuddle all night, but he doesn't NEED it anymore. If you make it clear that the expectations haven't changed, your child will pick up on that very quickly, much faster than the first time you taught this skill. Once again, it’s
about consistency.
