Introduction Of all the anxieties that plague expecting parents as the due date approaches, fear of sleep deprivation is among the most intense. Everyone knows that the first several weeks are the most difficult. But it is actually what happens after those weeks that determines how well you and your family will function during the first year and beyond. My clients often ask about my own children. And, yes, they are great sleepers. I was dedicated to shaping their sleep habits from the start, partly because I needed them to sleep. I am not one of those people who can function without a decent night's rest. When I was pregnant with my son, fear of months (or years) of exhaustion inspired me to put together quite a sleep library. At the hospital where I was working, I'd already spent the prior year and a half immersing myself in research to develop a treatment program for adult and geriatric insomnia. While child and adult sleep differ in many ways, certain common principles apply (see Chapter 1). In reading about infant sleep, I was most intrigued by Marc Weissbluth's model of keeping babies well rested and preventing them from becoming overtired. This became the single most important parenting strategy that my husband and I employed. We tried to ignore the raised eyebrows of friends and relatives who could not believe how much our son was sleeping. I noticed that what often seemed like common sense to me was counterintuitive to others. But soon it became apparent to them that my "trick" was working, and I started helping friends get their kids' sleep on track. Pregnant with my daughter, I began thinking about opening a specialty practice to help other new and expecting parents get off on the right foot. I developed a class called Raise a Good Sleeper and later launched my clinical practice, NYC Sleep Doctor, to work with families stuck in a cycle of bad sleep. Since then, I've helped hundreds of families make simple changes to improve their sleep, and I've supported them through the process of making the difficult ones. It is my firm belief that good sleepers are not born but raised. In this book you will find the basic information you need to raise a good sleeper. There are plenty of sleep manuals on the market to guide you through the specifics of various sleep-training strategies. The trouble is, there is no one-size-fits-all technique. Every family is a complex mix of individual temperaments and philosophies. The sheer number of options is overwhelming, deterring many parents from even trying to read up on the subject. And parents who do delve into the literature too often give up because they cannot agree on a strategy or because they don't fully understand the reasoning behind it. This book is my effort to help people sift through the vast and often confusing information out there and identify strategies that make sense. My goal is to give you a fundamental grasp of infant sleep: how it works, how much is needed, and how to shape good habits. Understanding these principles will help you figure out which strategies will work for you and your family. In my work, I insist on having parents work together to create a plan. It takes a team effort to stay focused and consistent. I recommend that you read this book together and discuss your priorities and fears before the baby is born. Once he or she arrives, you won't have time to read, digest, discuss, plan, or do much more than cope. Of course, your best-laid plans will have to be adjusted and calibrated once your baby arrives. But it is well worth doing the advance planning. The quality of your baby's sleep will have a tremendous impact on your quality of life. If you did not plan ahead, you certainly aren't alone. Reading sleep manuals is never high on most expecting parents' list of priorities. If you and your child are stuck in a cycle of bad sleep, you are probably doing whatever is necessary just to get through each day and night. But your coping strategies might not be improving the situation--and they could be reinforcing the problem. Once you're mired in it, it's very hard to decide which strategy will lead you out. Having a good sleeper is not about luck or genes; it is a part of raising a family, and it requires skill, knowledge, and dedication. It is about developing the confidence to identify problems and get back on track quickly. My children are great sleepers, but they have hit the same bumps in the road that all children do. We have dealt with colic, crying, bedtime battles, early waking, illness, repeated pacifier replacement, room-sharing issues, overstimulation, and more. Sometimes we have struggled to know how to respond, but when we make a wrong turn, we go back to the basics and change course. This book will give you those basics, too. The Good Sleeper Approach to Infant Sleep Since opening my private practice, NYC Sleep Doctor, I have entered new parents' homes and lives when they are at their most confused and vulnerable. I have listened to hundreds of exasperated couples as they describe their love for a baby whose sleeplessness is threatening their confidence as parents, their sanity, and even their marriage. They describe how lost they feel as they listen to friendly advice and pore over countless books about sleep. But by the end of our 90-minute visit, they have a firm understanding of what they have missed all along: the simple facts of infant sleep and how to use that knowledge to teach their baby to sleep. It's not particularly complicated, yet no one seems to have figured out how to explain these concepts and strategies to parents. Pediatricians assess virtually every developmental milestone except sleep. Books, as I will show, are confusing and make promises they can't deliver on. Friends, family, and "parenting coaches" give advice based on their personal experience, which does little to reassure frightened parents who fear doing psychological or physical damage to their child. In my practice, I have immersed myself in the world of infant sleep--the science and the psychology of it. When I first started charging fees for my services, I had the usual crisis of confidence: Was I really doing something for these families that they couldn't do themselves? Wasn't this information so straightforward that anyone could figure it out? What I found, as enthusiastic reports came back from parents and as their friends started hiring me, was that what seemed common sense to me was not evident to most parents. I also discovered that I could transform the necessary information into common-sense guidelines for my clients. I spent eight years at the Manhattan Veterans Affairs Medical Center helping patients suffering from arguably the most challenging of sleep issues. Through my experience working with veterans suffering from posttraumatic stress disorder and other serious mental illnesses, I learned how to relate scientific and clinical knowledge to lots of very tough real-life situations. I taught psychology interns how to be concise, responsible writers. I am known among my colleagues and friends as a straight talker--a trait that has gotten me into trouble from time to time but has also been one of my defining professional qualities. My colleagues refer patients to me who need a no-nonsense therapist, one who won't mince words. My presentations are well edited and concise, focusing on the essential points I need to communicate. I don't use jargon, and I don't try to impress people with fancy explanations of simple concepts. My goal is to be an effective communicator, and I do that by getting to the point. When I treat my patients, when I teach classes about sleep, or when I lecture students or executives, I typically check in and ask: "Does that make sense?" I do this because I care about my audience, whether it be an individual client, a couple, or a room full of students. Parents often contact me hoping to put the problem in my hands, expecting me to do something magical to make it disappear. From the beginning, I emphasize that the solution is not magical. My job is to help parents unravel the problem, to determine how and when to intervene, and to arm parents with the knowledge and confidence they need to work through the problem themselves. Parents often ask if I do overnight stays. I don't--and not just because I have my own family. I don't do overnights because parents have to learn how to manage their child's sleep on their own. I have worked with countless babies with uneventful histories or minor issues like colic. But I have also worked with babies who have had a much harder time: deaf babies, babies who have had neonatal heart surgery or long NICU stays, and babies and toddlers who have developmental disabilities and serious medical issues. Obviously, special circumstances can affect the methods. But even in these cases, the basic principles apply. The first things I look for when I'm working with clients are: 1. The bedtime: The bedtime is almost always too late. Parents fear that putting their babies to bed too early will cause them to wake up early in the morning. The exact opposite is true. An early bedtime is the key to a good night (and reasonable wake-up time). 2. Naps (where, when, and how long): Parents often fear that allowing a baby to sleep during the day will compromise night sleep. Most parents do not understand the importance of naps and nap quality. 3. Short-term survival strategies that are undermining long-term progress: These can include responding immediately when the baby fusses, co-sleeping, excessive baby wearing, or always waiting to put the baby down fully asleep. Once parents understand their child's process of learning to sleep, they become willing to loosen their grip on survival strategies that are only serving to reinforce the problem. Another very common problem is the parents' fear of their babies' crying or distress. Parents in the United States struggle to foster healthy sleep in their children because they are afraid to allow them to experience distress. They are unable to differentiate between what the child wants and what she needs. Either that, or they simply can't bear to side with the needs over the wants. It's a short-term solution (ending distress or crying by "helping" a baby sleep) that creates a long-term problem (a child that cannot rely on himself to fall asleep independently). Over the years, I have seen this problem play out in countless ways. There are the men who want to be different from their overbearing fathers and will do anything to avoid "causing" their child distress. There are the parents who coslept with their own parents and recall the difficult transition out of the family bed (when they were old enough to remember); they want to avoid cosleeping but feel judged by their families or peers. There are parents who are essentially traumatized by colic or extreme fussiness in their baby or in an older child and feel unable to tolerate any more crying. There are parents who believe that depriving a child of their attention will create long-term personality defects or even sociopathy (much more on this later). There are parents who fear that they simply don't possess the skills to raise their children effectively, and parents who simply can't agree on a strategy. Parenting styles naturally shift over the generations in response to changing mores, as well as medical, educational, scientific, and technological advances. But parenting styles also shift as people embrace or reject the merits of their own childhoods. From the late 1960s through the 1980s, the pendulum seems to have swung toward less involved parenting. Society was more focused on self-exploration and fulfillment. As parents made their personal goals and happiness the priorities, the focus on children became less central. As those children have become the next generation of parents, they have swung the pendulum back, overcorrecting for what they perceive to have been their own parents' disengagement. Many parents today feel compelled to be involved in every aspect of their child's experience, to be omnipresent, to soothe away every discomfort. These are impossible tasks, and they create a lot of problems. Children who cannot tolerate normal discomforts like boredom, sharing, or having a toy jerked away from them by another baby don't develop the essential life skill that psychologists call distress tolerance. These children believe they are entitled to be entertained and joyful at all times. Of course, it's important for children to be happy and entertained. But parents' efforts to prevent or soothe away all discomfort teach children that there is something dangerous about being unhappy. As parents, we all must accept that a child's needs come before his or her wants. I see it as my job to teach parents that one of the primary challenges they will face is accepting that a child's needs must come before his wants. Clarifying this battle of needs and wants helps parents to understand the challenge at hand. It gives them the courage to begin the task of parenting. It gives them permission to prioritize needs and take care of their child's best interest, even when the child is protesting. I teach parents about authoritative parenting , which provides the structure to keep the child safe by setting appropriate limits while also allowing the child room to explore and experiment, precisely because he knows that his parents will be there for him if he fails. (Not incidentally, it is this type of parenting that has been found to result in secure attachment and healthy adjustment in the long term.) The principles and strategies in this book will help you to find a rhythm that brings some sanity to your new life as a parent. The information here will inform your decisions about how to get your baby the sleep she needs while also remaining flexible enough to enjoy your time with your newborn. Countless couples have told me that they wish that someone had explained these things before they became stuck in a cycle of bad sleep. That is precisely what The Good Sleeper will do. Copyright © 2015 by Janet Krone Kennedy, PhD Excerpted from The Good Sleeper: The Essential Guide to Sleep for Your Baby--And You by PhD, Janet Krone Kennedy All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.
