We talk a lot about sleep in the context of a child’s whole day and supporting sleep via many approaches, including ensuring that your child has enough of the right amount of movement and at the right time of day. Active movement woven through the day expends energy. The by-product of this expenditure is a biochemical called adenosine. When adenosine builds up, our body is signaled to rest to restore the balance of adenosine. Therefore, if we are not active enough, our body will not biologically be ready to sleep. This is just one piece of the sleep puzzle, but it’s a very important one.
Here are some ideas to help you maximize the energy expenditure for the most active little people in our lives – toddlers and preschoolers! These are park ideas.
- For your early walker, have him walk on different surfaces – uneven, gravel, sand, grass. All these challenges will engage his large motor muscles more than just walking on a flat, even, predictable surface.
- Blow bubbles and have your child chase them and pop them by clapping. Try to blow them up high so they reach up to pop the bubbles.
- Slide down the slide on his bottom or tummy (feet first).
- Roll down a grassy hill like a sausage.
- Practice hanging on the monkey bars.
- Jump off of low equipment or wooden beams with an adult’s help.
- And of course, lots of time on the swing, respecting the child’s tolerance for how high or fast to push.
Enjoy your park time. And if you want to build up your biological drive to sleep, too, you may want to have a game of chase or tag. You’re IT!
To combine these ideas with other strategies, get to the park in the morning to expose your child and yourself to daylight and set your circadian rhythm. Use activity soon after your child wakes so that you can wind down closer to sleeping time.
Healthy Families BC/Participaction/CSEP recommendations support these ideas by suggesting that parents minimize the amount of time children are restrained or sitting (car seat, stroller, high chair, etc) to no more than one hour at a time. Then it’s time for a movement break. Screen time is not recommended for children less than 2 years old, and for children 2-4 years old screen time should be limited to no more than one hour per day. Less is better.
There are lots of ways to support healthy sleep. Taking a close look at the amount, type and timing of activity can certainly help to promote healthy sleep for all the members of your family, from the youngest to the oldest.
It is common for our littlest clients to have day/night reversals. When babies are born, they have not yet developed an internal clock, known as their circadian rhythm. Waking is driven by hunger and because their stomachs are so tiny, they need to eat often. Think about how much growth a newborn goes through in those first few months, both physically and cognitively. A newborn infant looks vastly different than their four month old counterpart, both in size and their cognitive function. There is an amazing amount of development that happens in those short months.
One of the developments that happens after those first few months, around the third to fourth month of life is the development of a circadian rhythm, mediated by secretion of hormones from a part of their brain called the pineal gland.
Before this, the sleep wake cycle is a constant repetition of a little bit of awake time (45 minutes at a time for newborns) that will include all care giving, feeding, and socializing and then back to sleep again. Parents often find themselves with a baby that is more alert at night as opposed to daytime and this can be difficult as our circadian rhythms are telling us that it is time for some shut-eye at midnight, not party time!
Here are some things to consider and implement to switch back to a day/night rhythm that works for everyone:
1. Notice if your baby is getting over stimulated during the day and prefers to “wake up” at night during the quieter hours. If so, dial back the visitors and outings during the day to allow them to have a calmer more peaceful daytime environment to take in.
2. At night and during the day, keep your baby’s sleep environment quiet and calm.
3. Encourage regular and frequent feeding during the day, especially in the early evening when it’s common to see “cluster feeding” occur.
4. Do your best to achieve some awake time during the day, working on keeping your baby awake during feeding to both achieve that awake time and also promote active feeding where milk is being efficiently taken.
5. During the night, do your best to keep the feeding very calm and quiet. Keep the lights low and the interactions to a minimum. Even eye contact can signal a baby to alert and wake up promoting more wakefulness at night.
6. Get outside during the day and expose your baby to daylight. While they may not be producing melatonin just yet, it’s a good practice to establish and fresh air is good for everyone (including parents!).
Persist with these changes for a few days to a week to help your baby differentiate day time and night time.
One of the typical developmental stages that we see with the families we work with is the stage of separation anxiety. Separation anxiety is a common and completely normal phase of development that can have a negative effect on sleep. It usually emerges between 7-10m of age and can persist into toddlerhood.
Below are some ideas for playtime that can help your child work through this stage. To deal with normal age-appropriate separation anxiety, you need to make your baby feel secure with separations. Consistency is key to make sure your baby becomes secure that you are still there and you will return! When you separate from your child, always let him know you are going (to another room, out, etc.) in a matter-of-fact manner and when you reunite, come back with a big cheerful greeting.
You can play these games to help your child develop object permanence and show him that separations are met with cheerful reunions:
Peek-a-Boo: Playing Peek-A-Boo can help with the separation anxiety that is disrupting sleep. Use a cloth or scarf to very briefly hide your face or your child’s face and then revealing yourself to him can help him realize that you exist even though he can't see you.
Find-the-toy: Place an interesting toy under a cloth and ask your child "where's ______?" Lift up the blanket to show him. Once he starts uncovering the toy, you'll know he's getting the idea of object permanence.
Hide-and-seek: Introduce your child to "Hide-and-Seek". While you're likely not quite at the stage of counting to 20 and yelling "ready or not, here I come", you can start by hiding yourself around the corner or behind the couch and then call to your child. If he responds by looking toward your voice or crawling to you (if able), respond really positively with a big smile and laugh. This will teach him that separation okay, that you are still there when he can't see you and that happy reunions always happen after separations.
Separation anxiety can be a tough stage for your child and for you but working towards building the skill of object permanence and practicing with short separations will go a long way in helping you and your child sail through this stage.
It’s a simple truth. When babies don’t sleep, parents don’t sleep. Not only are babies over tired and have difficulty sleeping; parents can become zombie-like while racking up huge sleep debt.
When we arrive at a family’s home for our home visit (a part of our Occupational Therapy Consultation process) one of the things we talk about is how the child’s sleeping problems are affecting the family as a whole.
Most parents are stoic and re-direct the conversation to their child and the benefits their child will gain from better sleep. All true.
But the real picture here is as follows: If your baby is sleeping better, chances are you are too. If you are sleeping better, the whole world around you is easier to cope with. Your thinking is clearer, your emotions more in check, your immune system is chugging (not limping) along and you actually have energy to get out to baby groups or the park. Take sleep away and parents can get into some serious sleep related danger such as:
Increased risk of post partum depression
Increased propensity to have a motor vehicle accident
For parents that are at work during this phase – their work safety may be compromised. If you are someone who relies on sharp cognition or precise motor control, consider addressing sleep now.
There are normal levels of daytime sleepiness; every parent feels some level of tiredness. But when it starts to affect your ability to perform daily tasks, it’s time to take a look at your sleep. And this often means addressing your baby’s sleep so you have the opportunity to sleep, too.
Sleep well parents. For everyone’s sake, do not minimize the importance of your sleep. Your ability to safely and effectively navigate your day to day activities is important. If you are not well, you can’t do your best to look after your baby.