attachment

Even With Older Children, Attachment and Connection Support Sleep

A photo from quite a few years back of a relaxed and joyful part of our bedtime routine —hanging out together. Sleep is important. And so is connection. The two can work together. (It is recommended that children under two not bed share next to a sibling.)

A photo from quite a few years back of a relaxed and joyful part of our bedtime routine —hanging out together. Sleep is important. And so is connection. The two can work together. (It is recommended that children under two not bed share next to a sibling.)

There was a time before kids when I was not as attachment-focused in my sleep approach. And if I am completely honest with myself, there have been times even after becoming a mother where I have struggled with attachment-based approaches to supporting sleep. Shifting my perspectives and expectations this much has been a process.

But now, with my youngest at age 4, and with my two older boys, I’ve hit my stride (without perfection, but with calm intention) when it comes to supporting their sleep most nights.

Tonight’s bedtime routine (with all it’s imperfections, and bumps) feels like a story worth telling, in that it reflects how profoundly I’ve shifted my priorities around night time parenting. I don’t dismiss the importance of sleep (enough of it, and of good quality). But I do know that more often than not the best way for our kids to get good sleep is to meet (and exceed) the need with an open heart and a calm, unhurried state of mind.

Perhaps some nights an open heart and a calm, unhurried mind are a struggle. On those nights it’s a challenge to dig deep and meet the need. It becomes a war against our intentions, which often comes out looking like a battle against our kids: them resisting sleep, and us trying to overpower their resistance.

But tonight there was no strong arm, no temptation to coerce, and no resistance. Instead, the evening started with rather feeble efforts on my part to start the routine, and ended with a sense of such connection that I am smitten.

At the usual bedtime, as I do on nights when I am distracted and trying to get work done, I was verbally guiding my two older kiddos (6 and 9) to bed. But as with so many pieces of parenting, you’ve got to walk the walk….and actually walk with them upstairs! Instead, I was giving instructions about shutting down screen time while tapping on my laptop, and listing off bedtime steps without modelling them myself. Hardly “leading by example”.

Now I do know that my children are capable of walking up stairs independently. Of brushing their teeth independently. Of getting dressed independently. Of climbing into bed and crawling under the covers independently. But I have learned well both through research and through parenting experience, that the ability to do something independently is not the only factor in accomplishing a task. Not by a long shot. Coming alongside, and “doing with” are powerful strategies for connecting and accomplishing.

So instead of escalating the volume of my voice, getting sharper and snappier and frustrated, I paused, and heeded the call from my spouse to please come upstairs and help usher them to bed (we both play integral parts in the bedtime wind-down) —tonight things weren’t going all that smoothly. There seemed to be a frenetic energy in the upstairs loft (full moon?!). A lot was happening that had very little to do with bedtime. There were push ups and jumping jacks, karate punches and kicks into cushions, building of forts, requests to make elaborate paper plate faces to tape to these “punching bags” (yes that sounds terrific; yes, it will have to wait till tomorrow), and a lot (a lot) of talking.

But step by step, slowly and calmly, we made our way to their beds where story time was pulled off the roster but gratitude questions and a review of their day remained intact. By now it was very late and despite having more work to take care of, I lay with them a while, and I closed my kindle (did I say screens shouldn’t be part of bedtime? Direction not perfection!), and just lay there as my middle child told me elaborate explanations of how things work. He chatted while holding my hand. His volume was louder than usual, and we kept having to remind him that his little brother was sleeping. He talked with excitement and enthusiasm and while he talked he played with my hair. And then, interrupting his story, he requested that I get the detangling brush….so that he could brush the knots out of my hair.

Now the old me —before I became a mother, or before we got to a point where I was getting enough sleep most nights to make flexibility and patience easy— would have said no, it’s bed time, good night. But tonight I paused, considered how comfortable and content he was: he was getting one-on-one time with me as he peered at the full moon out his window and lazily shared contemplative explanations of zombies and werewolves.

Here was a kiddo whose one-on-one time often gets squeezed out between the needs of his younger brother and the activities of his older brother. The kiddo who sometimes stops talking out of frustration that no one is listening, or that he’s been interrupted again. Here he was chatting to me, connecting with me. So I did what I felt compelled to do: I got the comb, I brought it up, and he combed my hair while talking, while solving dilemmas of his day, while unwinding for sleep.

When all the knots were out I said good night, gave the boys kisses, and left. They both fell asleep without another peep.

There is something liberating about approaching night time this way. For all the conflict, or upset, or missed opportunities to connect during the day, night time has fewer distractions. Night time is a chance to put a cherry on top of the day, no matter how bad the day has been. Night time could be (and often is!) a stressful, exhausting ritual of resistance when we as parents can be maxed out. But by “finishing strong”, and finishing with connection, I’ve made up for some of the less-than-ideal parts of today.

Whatever needs he had not had filled during the day seemed topped up well by my spending this time with him as he lay in bed. And his need for sleep is fulfilled too: maybe not as early as ideal, but certainly as smoothly as I could ever wish for.

Snug as kittens: even older kiddos need to feel relaxed and to unwind with parental support sometimes.

Snug as kittens: even older kiddos need to feel relaxed and to unwind with parental support sometimes.

Infant Mental Health

Infant Mental Health: A primary goal of attachment-based parenting

Early in my career as an occupational therapist, I had the privilege of participating in York University's inaugural Infant Mental Health certificate program.  The focus was on understanding the environmental and biological basis for infant mental health. 

Since that time I have studied the science of attachment theory and ecology, and learned the impact of our parenting approaches on infant mental health. What has struck me most across all of this learning was appreciating the impact that our environment can have on the developmental well-being of infants and young children. Our children’s environments are largely created but us in the early years, and we have a significant influence on how nurturing their environments are.

Nurturing, stable, safe, and loving environments can have a positive influence on children, including those with a history of trauma. Although we cannot change the past, what we do today to shift towards more nurturing environments can support infant mental health.


The passion I have for connected parenting in the early years and beyond is reflected heavily in my approach to supporting infant sleep.  Sleep deprivation can make even the most patient parent short-tempered and less compassionate.  Sleep-deficient infants are more easily upset, more 'wired', and often more difficult to get to sleep.  And yet, at the heart of it, infants need proximity to a loving adult who has the capacity to parent in a nurturing way. It is helpful to listen to our instincts about how to support their biological and emotional needs, and to seek support (from family, from friends, from skilled mental health care professionals) to do that.

My approach to infant sleep is to inform, to guide decisions, and to change the environment and expectations in order to progress towards sleep practices that support everyone's sleep needs.  For families who have additional challenges, including mental health issues, and trauma history, I connect families with local health care professionals who can continue to support families in ways that respect the family's needs and goals.

Understanding the huge impact that we, as parents, have on our children’s well being is not intended to add a burden. Rather, it can help make decisions easier: we can choose to meet the need. We can choose to connect. We can choose to be present with our children. And we can choose to take care of ourselves and to get support when we feel overwhelmed.

Key Messages:

  1. Attachment based parenting improves infant mental health.

  2. Our environment impacts our health.

  3. Decisions are easier when we know why attachment is important.

  4. Self-care is critical: fill your own cup so you can fill theirs too.

I am not a mental health professional. But there are talented and compassionate people in our community who are. If you are concerned about mental health and about your capacity to support a nurturing relationship with your child, reach out and seek support.

Niagara Resources:

In Niagara, local supports for infant and family mental health include:

  • Pathstone Mental Health Services, pathstonementalhealth.ca

  • Emily Pollak, Social Worker, individual and family counselling, St. Catharines, emilypollak.ca

  • Niagara Infant Mental Health website (Early Childhood Community Development Centre), http://www.eccdc.org/infant-mental-health/

Within and beyond Niagara, supports include:

  • 911 for medical emergencies

  • 411 for information about local mental health services in some jurisdictions

  • Your family physician

  • Local initiatives to support infant and child mental health

What is Normal? Six Month Sleep


Photo credit: Studio 7042, Pexel.

Photo credit: Studio 7042, Pexel.


When it comes to understanding the normal development of independent sleep, knowing the facts can make a profound difference in our perspective on the “problem”. Understanding normal sleep patterns in childhood can be incredibly reassuring. And, frequently, this involves realizing there is no problem at all!

Knowing what is typical can help us figure out if the expectations we have (or our family has, or strangers have!) match with what is developmentally reasonable. To know that frequent night waking doesn’t indicate that we have “done something wrong” to cause our babies to have frequent night waking, but rather that it is biologically normal, can take away a lot of pressure! Putting energy into coping with the phase rather than fighting our child’s nature can be a refreshing shift from trying to fit our babies into the expectations,. This way we can model our expectations on our babies’ abilities.

In my September 12, 2018 facebook interview with Built to Birth’s Melanie Farrell, we spent an hour online chatting about what is normal, how to shift perspectives on the problem, and how to manage the challenges that come with supporting infants and young children to gradually develop the holy grail of parenting: independent sleep. One of the papers I mentioned was Sadler’s 1994 paper called (most encouragingly!) Sleep: what is normal at six months?

Here is a bit more of the detail of that paper, and why it is relevant to parents of young babies.

  • Of 640 parents who completed a survey about the sleep of their infant, only 16% reported that their 6 month old “slept through the night”.

  • 16% of the infants were reported to not have a regular sleeping pattern at 6 months of age (meaning a sleep pattern maturing from within the child, rather than a lack of ‘routine’ from the parents). This suggests that the internal regulation required for a regular sleeping pattern takes several months or more to develop. This fits with our understanding of infant development and neuro-maturation.

  • 61% were sleeping in their own room by 6 months, but many ultimately shared a bed with the parents upon waking: a whopping 43% were always, almost always, or routinely (34%) brought into mom and dad’s room upon waking.

The author suggests that knowing that these sleep patterns (frequent waking, proximity to parents during sleep) are normal can be reassuring.

What may help in re-framing the perspective of night waking in your 6 month old:

  • It is normal for babies (even at the ripe age of 6 months) to wake often and prefer proximity to mom.

  • “Sleeping through the night” is typically defined as 5 consecutive hours, not the 8-hours-a-night we come to expect as adults.

  • The pressure to have young babies “sleeping through the night” does not coincide with biologically normal sleep.

  • Trusting your instincts regarding sleep problems can be helpful, especially if baby is not sleeping as well as they ought to be because of colic, reflux, food allergies, sleep apnea, or poor air quality.

  • A return to more frequent night waking at 9 months, after a period of relatively good sleep, is normal. This tends to improve after 12 months of age.

  • The route to independent sleep is not a linear one.

  • Sometimes the best strategy is to anticipate the wave, hang on tight, recruit help, and ride it out. When mother nature is the one dictating the rules, changing course may be futile! Nature has a way, and we’d do well to consider that although our environment has changed a great deal, the nature of sleep has not.

So, what is a parent to do if they are struggling with their young child’s sleep but think it might be developmentally normal? Get support! Support can go a long way in reassuring you, in tweaking some strategies for sleep, and in emphasizing (giving you permission!) to focus on your own self-care. Parents who have sought my help and needed, primarily, reassurance, are among the most rewarding consults I’ve done because it puts the power back in parents’ hearts that what they are doing feels right, is supported by evidence, and, in the end, works to create healthy, and even joyful, bedtimes and a happy and confident independent sleeper. It may not take much to bring this power back to parent decision-making, but it can make a world of difference to how you feel about your child’s sleep.

References:

Sadler (1994). Sleep: what is normal at six months?. Prof Care Mother Child. 4 (6): 166-7.

How Becoming a Mother Changed My Practice

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I have been an Occupational Therapist for almost 18 years. Most of that time I have worked with families of infants and young children, many premature, and each of them with some risk factor or developmental difficulty that led families to seek support from our government-funded home-visiting program or hospital-based clinic. I was surrounded by strong, nurturing intelligent women service providers who had empathy galore, and whose hearts and minds were focused on the needs of vulnerable families and children. I couldn’t ask for better mentorship.

I had also studied attachment theory and connected parenting, infant mental health, and maternal mental health. I had the book smarts, and nurturing mentors, and yet I still, when I pictured parenthood for myself, I had an image of a Dr. Spock-inspired authoritarian parent, and my advice on parenting reflected that. Despite whole-heartedly believing in attachment theory, and its importance, I had no real sense of just how that applied to figuring out how to meet the need of a tired moms and dads who needed practical advice right now that didn't contradict their baby's needs.

It was not until I became a parent myself that my perspective on nurturing and attachment and what that means in practical terms shifted dramatically. My views became more child-focused, and was more aware of the evolutionary needs that babies are born with, regardless of the books that are published, the advice that family physicians give (which, generally, was as naive and self-oriented as my own), or the plans I had.

I also had a baby who would not sleep. And very little support on how to manage this. My sweet and lovely baby boy would finally fall asleep at the breast late at night, only to wake up the instant I lay him down beside me. I would pick him up and start again. When he finally ‘crashed’ into a reasonably deep sleep at close to midnight, I’d nearly start to cry at the thought of wanting to get dressed for bed and brush my teeth: I was exhausted, and I knew that getting ready for bed was eating into the precious short time before he awoke again. I counted his sleep time in minutes, not hours, hoping somehow that a sleep interval that was two minutes longer would somehow mean I was doing something that was working.

Eventually we got through it. With reflux medication, baby-wearing, positioning, and diet changes. And also with patience, and an eye on the long game of wanting sleep to be a state that our son felt comfortable falling into, and staying in. We got through. But we would have gotten through with a lot more grace (and a lot more sleep) had we had more support.

What I needed as a new mom was a professional who could help me navigate things: who could value my knowledge, put that knowledge into perspective, and couple it with drawing on the instincts and goals we had as parents.

With so much conflicting information out there (both on-line and from health care providers), parents are left feeling over-informed, overwhelmed, and under-supported. Parents need help finding evidence-based information, and may need help uncovering the instincts and knowledge they already have.

Now that I run my own private practice, I see much more clearly how my roles as an OT and as a mom allow me to draw on the evidence, the experiences, and the empathy, to help families. Parents benefit from support in gathering information, problem-solving, and finding the joy in meeting the needs of infants in personal, unique, and empathetic ways.

Parenting transforms us. A little help to get through the tough spots can make a big difference.

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