Sleep Handout ( for Ages 6 Months to 2+ Years )

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Sleep Handout ( for Ages 6 Months to 2+ years )

Dr. Todd Wolynn

FewDear moments Mr. Smith are as precious as rocking a baby to sleep. But equally precious is the ability of a baby, without difﬁculty, to settle itself to sleep. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita For the most part, we all develop the ability to settle ourselves to sleep without the help of others. How kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur and when we develop this tremendous skill has implications that affect us for our entire lives. sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam Understanding the concept and learning how you can teach your child to “self-soothe” is the focus, and voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata the lesson, of this handout. sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et Beforejusto Iduo suggest dolores a changeet ea rebum. in a Stetchild’s clita sleep kasd gubergren,pattern, I noneed sea to takimata learn sanctus est Lorem ipsum dolor sit amet. more about the child, the family, and their sleep history. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel illum dolore eu feugiat Doesnulla the facilisis family at feel vero there eros etis accumsana problem? et iusto What odio are dignissim the family’s qui blandit praesent luptatum zzril delenit augue duis culturaldolore beliefs? te feugait Does nulla thefacilisi. family Lorem want ipsum a change dolor sit in amet, the child’s consectetuer adipiscing elit, sed diam nonummy nibh sleep?euismod If so, tincidunt why? Does ut laoreet the sleepdolore history magna aliquamreveal aerat potential volutpat. sleep issueUt notwisi recognized enim ad minim by veniam,the family? quis nostrud Is there exerci a family tation history ullamcorper of suscipit lobortis nisl ut aliquip ex ea sleepcommodo issues orconsequat. something Duis in autem the child’s vel eum sleep iriure environment dolor in hendrerit that in vulputate velit esse molestie consequat, vel posesillum a risk?dolore Theseeu feugiat factors nulla help facilisis to determine at vero eros if et any accumsan attempt et toiusto odio dignissim qui blandit praesent luptatum modifyzzril delenita child’s augue sleep duis pattern dolore iste likelyfeugait tonulla beneﬁt facilisi. the Nam child. liber tempor cum soluta nobis eleifend option congue nihil imperdiet doming id quod mazim placerat facer possim assum. Lorem ipsum dolor sit amet, consectetuer Thereadipiscing are many elit, differentsed diam nonummyopinions nibhabout euismod how, when tincidunt, and ut if laoreet you dolore magna aliquam erat volutpat. Ut wisi shouldenim let ad yourminim child veniam, fall quisasleep nostrud without exerci assistance tation ullamcorper in the infant- suscipit lobortis nisl ut aliquip ex ea commodo toddlerconsequat. period. Duis I have autem an vel opinion eum iriure on thesedolor insubjects, hendrerit and in vulputate I’ll do my velit best esse to molestie explain consequat, my thoughts vel illum on the dolore subjecteu feugiat throughout nulla facilisis. this handout. Consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed But understand that it’s just that: an opinion. An expert opinion based on many years of personal and diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata professionalsanctus est experience,Lorem ipsum but dolor still sit anamet. opinion. Lorem It’sipsum not dolor The sitAnswer, amet, consetetur The Right sadipscing Way, or elitr, The Onlysed diam Way. nonumy It’s justeirmod An Opinion. tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. TheLorem sleep ipsum approach dolor I sit describe amet, consetetur in this handout sadipscing works elitr, quickly sed diam to nonumy allow childreneirmod tempor 6 months invidunt to 2ut years labore to et establishdolore magnaself-settling-to-sleep aliquyam erat, sed behavior. diam voluptua. This clearly At vero structuredeos et accusam technique et justo allowsduo dolores your et child ea rebum. to learn Stet how clita to fallkasd asleep gubergren, independently. no sea takimata sanctus est Lorem ipsum dolor sit amet.

When we say No to children at this age, when we don’t let them do whatever they want to do, we’re not surprisedSincerely, if they cry. Self-settling to sleep is no different. In fact, it may be the ﬁrst big No they experience, so it’s completely reasonable for them to cry. On average, crying associated with this technique is much less then you might imagine. The vast majority of kids “get it” within 2-5 days, and a goodChad percentage Hermann of our Kids Plus patients complete the process within 1-2 days. Communications Director The majority of the world’s children co-sleep in a family bed. I respect a parent’s decision on the approach they wish to take regarding their children’s sleep habits when based on cultural/social beliefs. There are risks and beneﬁts to this practice, and I refer parents to the AAP guidelines on co-sleeping.

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June 10, 2010 If you, as a parent, have a separate room and crib/bed for your child, then you probably want your child to feel comfortable and sleep soundly in that place. This handout is intended to have your infant-toddler gainDear conﬁdence, Mr. Smith security, and success in the “going-to-sleep” and “staying asleep” phases. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita LkasdEARNING gubergren, & CnoONDITIONING sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam Human beings learn through their daily experiences and through repetition. This conditioning process voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata shapes they way we respond to various situations. The situation I will focus on conditioning here is the sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy process of going to sleep. eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. By 6 months, the vast majority of infants no longer require feedings throughout the night. They’ve simplyDuis autem matured vel eum and iriure developed dolor in enough hendrerit that, in vulputate physiologically velit esse speaking,molestie consequat, they don’t vel needillum fooddolore between eu feugiat goingnulla facilisisto sleep at at vero night eros and et accumsanwaking up et iusto10 hours odio dignissimlater. By quithis blandit age, it’s praesent reasonable luptatum to zzrilexpect delenit sleep augue duration duis todolore be greatly te feugait improved, nulla facilisi. in both Lorem overnight ipsum dolor sleep sit and amet, napping. consectetuer Medical adipiscing disorders elit, sed such diam as nonummyneurologic nibh or gastroenterologiceuismod tincidunt utconditions laoreet dolore can magnaimpact aliquam sleep, eratbut volutpat.they’re not typically the cause of early childhood sleepUt wisi problems. enim ad minim veniam, quis nostrud exerci tation ullamcorper suscipit lobortis nisl ut aliquip ex ea commodo consequat. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel Soillum what dolore about eu youngerfeugiat nulla infants facilisis (up at to vero 4 months)? eros et accumsan et iusto odio dignissim qui blandit praesent luptatum zzril delenit augue duis dolore te feugait nulla facilisi. Nam liber tempor cum soluta nobis eleifend option congue I nihilbelieve imperdiet younger doming infants id quod can’t mazim be spoiled placerat with facer too possim much assum. attention. Lorem Rocking ipsum dolor and sit holding, amet, consectetuer nursing and feeding,adipiscing and/or elit, sed using diam paciﬁers nonummy to nibh assist euismod your childtincidunt to gout laoreetto sleep dolore aren’t magna “wrong” aliquam or erat“bad.” volutpat. You’re Ut notwisi spoilingenim ad minimyour young veniam, infant quis nostrudby picking exerci her tation up; ullamcorperyou’re providing suscipit thelobortis care nisl and ut love aliquip that ex your ea commodo child needs. Someconsequat. infants Duis require autem littlevel eum assistance, iriure dolor while in hendrerit others inrequire vulputate extensive velit esse parental molestie involvement consequat, vel to illum fall asleep.dolore eu feugiat nulla facilisis. So when is it appropriate to alter this pattern? Consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata Thatsanctus depends. est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et (Justjusto forduo the dolores sake et of ea clarity: rebum. theStet descriptionclita kasd gubergren, of crying no children sea takimata below sanctus assumes est Lorem children ipsum older dolor than sit amet. 6 monthsLorem ipsumwho aredolor not sit ill amet, and consetetur do not need sadipscing to feed.) elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita Infantskasd gubergren, rapidly developno sea takimata physically sanctus and est cognitively. Lorem ipsum As dolor they sit grow, amet. their ability to learn increases. A 1- month-old infant crying in the crib is not going to “learn a lesson” by “crying it out.” A 6-month-old infant crying because you’ve just placed him in the crib to go sleep is a different situation. So is the 7- month-oldSincerely, who’s placed in the crib asleep but awakens in the middle of the night crying.

Infants 6 months and older frequently are conditioned to wake and alert us that they want a parent presentChad Hermann to go back to sleep. (They don’t need a parent; they want a parent. That’s an important difference toCommunications remember.) This Director pattern can be easily modiﬁed, or reconditioned, to allow the baby to gain the skill set necessary to fall back to sleep without assistance.

A 6-month-old infant understands much more than a 1 or 2 month old. After 6 months of age, infants

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June 10, 2010 crying in their crib are often stopped merely by the sight or sound of you approaching their crib. This is because they’re anticipating that your next action is something they want: to be picked up, held, or fed. TheyDear have,Mr. Smith in short, been conditioned.

Specifically,Lorem ipsum they’vedolor sit learned:amet, consetetur CRY, andsadipscing someone elitr, will sed immediately diam nonumy comeeirmod to tempor the crib, invidunt pick utme labore up, andet hold/rock/feed/givedolore magna aliquyam me erat, what sed I diamwant. voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur Withsadipscing sleep elitr,problems, sed diam think nonumy of crying eirmod as tempor the child’s invidunt attempt ut labore to callet dolore for Room magna Service. aliquyam It’s erat, appropriate sed diam for yourvoluptua. child At to vero expect eos ethis accusam crying etto justo be attended duo dolores to rightet ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy away. There’s nothing wrong with that expectation, just eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et asjusto there’s duo doloresnothing et wrong ea rebum. with Stet adult clita expectation kasd gubergren, that no sea takimata sanctus est Lorem ipsum dolor sit amet. when we call for room service in a hotel, someone will answerDuis autem our call.vel eum But… iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel illum dolore eu feugiat nulla facilisis at vero eros et accumsan et iusto odio dignissim qui blandit praesent luptatum zzril delenit augue duis dolore te feugait nulla facilisi. Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh …after 6 months of age, this pattern can cause night euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. awakenings to persist and even to worsen. And those endlessUt wisi roomenim ad service minim callsveniam, are quis ones nostrud no parent exerci wants tation toullamcorper suscipit lobortis nisl ut aliquip ex ea keepcommodo answering. consequat. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel illum dolore eu feugiat nulla facilisis at vero eros et accumsan et iusto odio dignissim qui blandit praesent luptatum zzril delenit augue duis dolore te feugait nulla facilisi. Nam liber tempor cum soluta nobis eleifend option congue By approximately 6 months of age, your child’s normal nihil imperdiet doming id quod mazim placerat facer possim assum. Lorem ipsum dolor sit amet, consectetuer developmentadipiscing elit, includes sed diam advancesnonummy innibh motor euismod and tinciduntverbal ut laoreet dolore magna aliquam erat volutpat. Ut wisi skills.enim adIt minimalso includes veniam, thequis baby’s nostrud ability exerci tationto fall ullamcorper asleep on hersuscipit own, lobortis and to nisl stay ut aliquipasleep exwithout ea commodo parental intervention.consequat. Duis In autemother velwords: eum sheiriure may dolor call in hendreritfor room in service, vulputate but velit she esse really molestie doesn’t consequat, need it. vel illum dolore eu feugiat nulla facilisis. Children learn to walk and talk through independent trial and error, and children learn to fall asleep the Consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed same way. If parents caught their children every time they fell while learning to walk, their children diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata wouldsanctus never est Lorem learn ipsum to walk. dolor Because sit amet. they’dLorem ipsumnever dolorfail. Andsit amet, children consetetur learn sadipscing through failing.elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et Parentsjusto duo who dolores regularly et ea rebum. assist Stettheir clita child kasd in gubergren, falling asleep no sea often takimata don’t sanctus understand est Lorem why ipsum their dolor child sit has amet. so muchLorem difficulty ipsum dolor falling sit amet, asleep consetetur on their sadipscing own or stayingelitr, sed asleep diam nonumy through eirmod the night. tempor But invidunt if your ut child labore is et dependentdolore magna on aliquyamyou (or aerat, caretaker) sed diam to voluptua. fall asleep, At vero then eos it’s et unreasonableaccusam et justo to duo expect dolores your et eachild rebum. to Stet clita instantaneouslykasd gubergren, nobecome sea takimata independent sanctus estin theLorem process ipsum of dolor falling sit amet. asleep. Each time your (non-ill, older-than- five-months) child cries (during typical sleep hours) in the crib, he’s pushing the Room Service button. And as long as he keeps getting room service delivered, he’s going to keep pushing the button. Sincerely, Infants come to expect the rocking, holding, feeding when they cry to help them get back to sleep. This is usually a result of the child being conditioned to fall asleep outside of their crib (in the arms of their parents,Chad Hermann or in their parent’s beds or TV rooms with the TV on, or while being fed, rocked, etc). Therefore,Communications when Directorthey awaken, they expect and desire the same conditions to go back to sleep. Children who require parental assistance almost every time they go to sleep are dependent on someone other than themselves to get them to go to sleep.

The primary problem, then, is simple:

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June 10, 2010 The child is dependent on his parents to help them to sleep. And so the child is unwilling to self-settle.

As adults,Dear Mr. you Smith should be independent of this process of going to sleep. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita LOCATIONkasd gubergren, / SLEEP- no seaO NSETtakimata A SSOCIATIONSsanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam We voluptua.all have Atour vero own eos sleep-onset et accusam associations.et justo duo dolores What et are ea rebum.they? Whatever Stet clita kasd it is gubergren, that makes no yousea takimatafeel comfortablesanctus est so Lorem you canipsum fall dolor asleep. sit amet. Since Lorem you’re ipsum independent, dolor sit amet, you consetetur can recreate sadipscing these elitr,associations sed diam everynonumy timeeirmod you go tempor to sleep: invidunt flipping ut labore your et pillowdolore magnaover, turningaliquyam on erat, music, sed diam pulling voluptua. your Atcovers vero eosup oret accusamdown, and et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. getting your body into a comfortable position. Imagine if you were DEPENDENT on someone else to get Duisyou comfortableautem vel eum to iriure fall dolorasleep. in hendreritImagine inringing vulputate a bell, velit calling esse molestie out until consequat, someone vel cameillum doloreinto your eu feugiat roomnulla to flipfacilisis your at pillow,vero eros or et pull accumsan up your et iustocovers, odio or dignissim position qui your blandit body. praesent luptatum zzril delenit augue duis dolore te feugait nulla facilisi. Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh To falleuismod asleep tincidunt independently, ut laoreet dolorea child magna has toaliquam learn erat how volutpat. to recreate their OWN sleep-onset associations. Ut wisi enim ad minim veniam, quis nostrud exerci tation ullamcorper suscipit lobortis nisl ut aliquip ex ea Rocking,commodo holding consequat. and feedingDuis autem interventions vel eum iriure can dolor become in hendrerit problematic. in vulputate Other velit possible esse molestie interventions consequat, vel whichillum can dolore become eu feugiat problematic nulla facilisis include at vero singing, eros et patting, accumsan stroking et iusto the odio baby, dignissim putting qui ablandit pacifier praesent in the luptatum baby’szzril mouth, delenit augueshaking duis a doloretoy, or te having feugait tonulla keep facilisi. turning Nam a libertoy or tempor music cum “on.” soluta If yournobis childeleifend regularly option congue requiresnihil imperdietyour assistance doming idin quodthese mazim ways, placerat this means facer hepossim is probably assum. Lorem not yet ipsum be able dolor to sit “do amet, it” consectetuerfor himself. adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi Bottomenim line:ad minim keep veniam, the sleep quis environment nostrud exerci simple. tation ullamcorper suscipit lobortis nisl ut aliquip ex ea commodo consequat. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel illum dolore Ofteneu feugiatSLEEP-ONSET nulla facilisis. ASSOCIATIONS problems involve where (location) the child falls asleep. If a child almost always falls asleep on a parent’s shoulder, or in the TV room on the couch with the TV on, or whileConsetetur being sadipscing driven around elitr, sed in diama car, nonumy then the eirmod child temporcomes invidunt to expect ut laboreand “require” et dolore thismagna setting aliquyam to fall erat, sed asleepdiam regularly. voluptua. ItAt is vero unreasonable, eos et accusam in etone justo night, duo todolores place et your ea rebum. child Stetawake clita in kasd her gubergren, crib and expectno sea takimataher to sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy happily fall asleep. eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. What about the child that falls asleep outside the crib and is then put in his crib already asleep? If this Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et child awakens (not sick, and not requiring food) is it really a surprise that he won’t fall back to sleep on dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita his own? Of course not. It is, after all, more than a bit unsettling to go to sleep in one place and wake up kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. in another.

ImagineSincerely, if you went to sleep in your bed every night, then woke up every morning on your kitchen ﬂoor. You’d be freaking out! You’d be calling your friends and saying, “I’m telling you, it’s the same thing, every night! I go to sleep there, but I wake up here! What’s going on here??!!” Chad Hermann ThisCommunications comparison really Director isn’t far off from the experience of an infant who falls asleep while rocked on a caretaker’s shoulder and then wakes in her crib. Unless a child is conditioned to learn to fall asleep independently in her own crib, it’s unreasonable for parents to expect that she will easily fall back to sleep if she awakens in the middle of the night.

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June 10, 2010 Infants are completely dependent on someone, other than themselves, to recreate a SLEEP-ONSET ASSOCIATION that is impossible for them to do for themselves. So it makes sense that they cry until someoneDear Mr. helpsSmith to recreate the going-to-sleep process for them. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita FkasdEEDING gubergren, / SLEEP- no seaO takimataNSET A sanctusSSOCIATIONS est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam Infantsvoluptua. frequently At vero eos get et usedaccusam to falling et justo asleep duo dolores while et being ea rebum. fed. StetOnce clita again, kasd thisgubergren, is perfectly no sea naturaltakimata with a nursingsanctus estinfant Lorem and ipsum will alsodolor happen sit amet. with Lorem bottle-feeding. ipsum dolor sit For amet, some consetetur infants, sadipscing this becomes elitr, sed an diamembedded nonumy parteirmod of thetempor going invidunt to sleep. ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. AtDuis what autem age vel is eumthis patterniriure dolor considered in hendrerit as inan vulputate unnecessary velit esse molestie consequat, vel illum dolore eu feugiat barriernulla facilisis to self at settling? vero eros 6 et months, accumsan 9 months,et iusto odio 12 dignissim qui blandit praesent luptatum zzril delenit augue duis months,dolore te or feugait 2 years? nulla facilisi. Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. It really depends on your philosophy and parenting style. ThereUt wisi is enim no right ad minim answer veniam, here. quis But nostrud if you exerciwant yourtation ullamcorper suscipit lobortis nisl ut aliquip ex ea infant/childcommodo consequat. to self-settle, Duis autem it’s not vel likely eum iriure to happen dolor in if hendreritthe in vulputate velit esse molestie consequat, vel babyillum requires dolore eu a feugiat feeding nulla to fallfacilisis asleep. at vero For eros the et reasons accumsan I et iusto odio dignissim qui blandit praesent luptatum listedzzril delenitabove, augue I believe duis dolore6 months te feugait is a reasonable nulla facilisi. time Nam to liber tempor cum soluta nobis eleifend option congue letnihil the imperdiet child learn doming self-soothing id quod mazim techniques. placerat facer possim assum. Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi Here,enim adI want minim to veniam, address quis a BIG nostrud NO-NO exerci regarding tation ullamcorper suscipit lobortis nisl ut aliquip ex ea commodo Feedingconsequat. and Duis Sleep. autem Some vel eum parents iriure take dolor huge in hendrerit risks by in givingvulputate an velit infant esse a molestiebottleful consequat, of milk to vel drink illum in dolore his cribeu feugiat while nullafalling facilisis. asleep. This can lead to severe dental disease requiring extensive oral surgery. “Bottle Tooth”Consetetur Caries sadipscing (cavities) elitr, result sed diam when nonumy infants eirmod typically tempor drink invidunt formula ut labore or juice et dolore from magna a bottle aliquyam as they erat, fall sed asleep.diam voluptua. These liquids At vero haveeos et sugars accusam in etthem, justo andduo doloressince the et eainfant/child rebum. Stet is clita groggy kasd gubergren,and headed no into sea takimatasleep whilesanctus he’s est drinking,Lorem ipsum he failsdolor tosit clearamet. hisLorem mouth ipsum of dolorthe liquids sit amet, as consetetur efficiently sadipscing as he would elitr, whilesed diam awake nonumy (thankseirmod temporto decreased invidunt swallowing ut labore et doloreand mouth magna cleansing). aliquyam erat, Thus, sed thediam liquids voluptua. coat At the vero teeth, eos et allowing accusam et bacteriajusto duo to dolores grow etand ea causerebum. them Stet clitato rot. kasd This gubergren, condition no seacan takimata be extensive sanctus and est Loremserious ipsum and candolor lead sit amet. to significantLorem ipsum infections. dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita Onekasd final gubergren, note: ano belly sea takimata full of foodsanctus or estdrink Lorem at night ipsum means dolor sit your amet. child’s stomach is actively digesting when it should be resting. This leads to increased pooping and peeing, which causes your child to wake.

So,Sincerely, bottom line: No bottles in bed.

FeedingChad Hermann Your Child to Get Her to Go Back to Sleep in the Middle of the Night Communications Director Feeding your infant when she awakens in the late evening and early morning (usually between 10pm & 5am) is a problem typically related to making Feeding-to-Sleep a part of the bedtime routine. When parents discuss this concern, they tell me, My child is HUNGRY, and that’s why she’s awake and eating.

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SomeJune 10, parents 2010 tell me, Look, he eats two 8 ounce bottles through the night; he MUST be hungry.

But if I wake up in the middle of the night and someone gives me two cuts of Mineo’s Pizza, with the cheeseDear Mr. bubbling Smith and slightly browned and the crust toasty warm and crisp, a cold cup of Pepsi sitting rightLorem there, ipsum I’m dolor eating sit amet, it! I conseteturdon’t have sadipscing to be hungry elitr, tosed want diam tononumy devour eirmod that. tempor(Talk about invidunt Room ut labore Service!) et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita Sokasd if agubergren, 15-month-old no sea istakimata offered sanctus a bottle est orLorem breast, ipsum and dolor she sitdrinks amet. it Lorem up when ipsum she dolor awakens sit amet, at 3AM,consetetur was shesadipscing hungry? elitr, Did sed the diam child nonumy need toeirmod eat? Thetempor answer invidunt is almostut labore always, et dolore NO. magna She aliquyam didn’t need erat, tosed eat. diam She atevoluptua. because At eatingvero eos is etpleasurable, accusam et justo and duobecause dolores she et wasea rebum. offered Stet the clita chance kasd gubergren, to eat. Especially no sea takimata if that chancesanctus andest Lorem that feeding ipsum dolor are associated sit amet. Lorem with ipsum holding, dolor rocking, sit amet, and consetetur cuddling. sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et Byjusto 6 monthsduo dolores almost et ea all rebum. infants Stet can clita sleep kasd thegubergren, night without no sea takimata REQUIRING sanctus estfood Lorem intake. ipsum Their dolor bodies sit amet. can storeDuis upautem and vel use eum the iriure energy dolor they in hendreritneed until in vulputatemorning velitwhen esse the molestie next feeding consequat, is to vel occur. illum Almostdolore eu all feugiat childrennulla facilisis older at than vero 6eros months et accumsan who “have et iusto to odiofeed” dignissim to fall backqui blandit to sleep praesent at night luptatum are trained zzril delenit or augue duis conditioneddolore te feugait to benulla nightfeeders. facilisi. Lorem They ipsum can dolor learn sit (and amet, be consectetuer reconditioned adipiscing) to fall elit, backsed diam to sleep nonummy without nibh eating.euismod This tincidunt also utincludes laoreet dolorebreastfeeding magna aliquam babies erat (yes, volutpat. including the ad lib/feed-on-demand babies).

I’mUt wisia Lactation enim ad minimConsultant veniam, and quis a hugenostrud breastfeeding exerci tation ullamcorperadvocate. I’m suscipit passionate lobortis nislabout ut aliquippromoting ex ea and supportingcommodo consequat. breastfeeding. Duis autem But in vel spite eum ofiriure this, dolor I have in hendrerit sometimes in vulputate found myself velit esse at molestieodds with consequat, other vel breastfeedingillum dolore eu advocates feugiat nulla who facilisis clearly at verosupport eros breastfeedinget accumsan et iustoon demand. odio dignissim The mantra qui blandit is that praesent babies luptatum don’t knowzzril delenit from aaugue schedule, duis dolore so you te feugaitshould nulla breastfeed facilisi. themNam liberon demand. tempor cum And soluta I agree. nobis eleifend option congue nihil imperdiet doming id quod mazim placerat facer possim assum. Lorem ipsum dolor sit amet, consectetuer Thatadipiscing said, dependingelit, sed diam on nonummy your parenting nibh euismod style tinciduntand sleep ut philosophy,laoreet dolore I magnadon’t feelaliquam that erat “on volutpat. demand” Ut wisi breastfeedingenim ad minim has veniam, to continue quis nostrud through exerci the tation night ullamcorper for a child suscipit past 6 lobortis months nisl of ut age aliquip when ex a ea family commodo wants the consequat. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel illum dolore child to learn self-settling. If you plan to practice an Attachment Parenting style, then you most surely eu feugiat nulla facilisis. will be breastfeeding and co-sleeping. If your culture or belief is sleeping in a “Family Bed,” I don’t try toConsetetur impose this sadipscing sleep approachelitr, sed diam(though nonumy I do eirmod review tempor co-sleeping invidunt risks ut labore and benefitset dolore andmagna discuss aliquyam how erat, to sed avoiddiam voluptua.co-sleeping At vero risks eos related et accusam to adult et justo bedding duo dolores and adult et ea characteristics rebum. Stet clita during kasd gubergren, an office no visit). sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. SLoremELF- SipsumETTLING dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita Therekasd gubergren, are many no different sea takimata ways sanctus to approach est Lorem this. ipsum You dolormay sitchoose amet. another way, and that’s fine. But the way I’m describing here works almost 100% of the time – IF you carry it out as instructed.

ThisSincerely, approach is all about helping your child develop SELF-SETTLING sleep skills.

Some people describe this parenting sleep approach as the cry it out method. The intent is certainly not Chad Hermann to make your baby cry, of course, but most 6-+-month-old infants will cry when not given what they Communications Director want. This is normal and should absolutely be expected. It’s the exception, not the rule, for the 6+month- old who is not given what he is demanding to sit quietly rather than protest.

Sometimes, this crying makes parents feel guilty. But should it? If a child wants to play with a sharp toy, or run into the street, or stick a ﬁnger in an electrical outlet, his parents stop them from doing these

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June 10, 2010 things. When the child cries because he didn’t get his way, do the parents feel guilty? Of course not. And they shouldn’t – because they’re doing what’s best for the child at the time, and they’re also teaching the childDear importantMr. Smith lessons in safety that will condition him for later in life. ALorem child ipsumwho isdolor completely sit amet, conseteturdependent sadipscing on his parents elitr, sed to falldiam asleep nonumy will eirmod cry iftempor placed invidunt in the utcrib labore awake et and leftdolore alone. magna We aliquyam don’t like erat, to sedhear diam crying, voluptua. of course, At vero but eos we et accusamneed to etremember justo duo doloresthat all et crying ea rebum. does Stet not clita meankasd gubergren,children are no seain pain, takimata in fear, sanctus or sufferingest Lorem ipsuman illness. dolor Takingsit amet. a Lorem toy from ipsum a 6-month-old dolor sit amet, infant consetetur may resultsadipscing in crying, elitr, sedbut diamthat’s nonumy fairly easyeirmod to tempor figure inviduntout. If a ut 6-24 labore month-old et dolore magnachild whoaliquyam expects erat, yoused diamto rock/ hold/cuddledvoluptua. At vero her eosto sleepet accusam is placed et justo into duo crib dolores wide et awake ea rebum. without Stet clita these kasd desired gubergren, behaviors, no sea takimatashe will cry. sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy Manyeirmod parents tempor feelinvidunt uncomfortable ut labore et dolore withdrawing magna aliquyam this erat, sed diam voluptua. At vero eos et accusam et assistancejusto duo dolores that the et childea rebum. “needs” Stet clitaget tokasd sleep. gubergren, The crying no sea istakimata sanctus est Lorem ipsum dolor sit amet. oftenDuis autemperceived vel eum as fear,iriure pain, dolor orin somehendrerit other in vulputate negative velit esse molestie consequat, vel illum dolore eu feugiat condition.nulla facilisis Parents at vero feel eros guilty et accumsan because et iustothey’ve odio caused dignissim the qui blandit praesent luptatum zzril delenit augue duis crying,dolore teand feugait because nulla they’ve facilisi. Loremabruptly ipsum removed dolor sit something amet, consectetuer adipiscing elit, sed diam nonummy nibh theireuismod child tincidunt has both ut laoreetgrown doloreaccustomed magna aliquamto and incorporatederat volutpat. intoUt wisi a sleep enim routine. ad minim But veniam, consider quis this:nostrud is theexerci abrupt tation onset ullamcorper of suscipit lobortis nisl ut aliquip ex ea cryingcommodo from consequat. the healthy, Duis well-fedautem vel 8-month-old eum iriure dolor with in hendrerita clean in vulputate velit esse molestie consequat, vel diaperillum dolore really eu any feugiat different nulla fromfacilisis the at abrupt vero eros onset et accumsan of crying et iusto odio dignissim qui blandit praesent luptatum fromzzril andelenit 8-month-old augue duis fromdolore whom te feugait you’ve nulla just facilisi. taken Nam away liber a tempor cum soluta nobis eleifend option congue sharpnihil imperdietor dangerous doming object? id quod mazim placerat facer possim assum. Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi Notenim really. ad minim veniam, quis nostrud exerci tation ullamcorper suscipit lobortis nisl ut aliquip ex ea commodo consequat. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel illum dolore Theeu feugiat child criesnulla facilisis.and protests, because he wants what you’ve taken away. Whether you’re withholding the sharp object or the rocking-to-sleep, you’re child is upset and therefore cries. But either way, you’re doingConsetetur the right sadipscing thing. elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata Despitesanctus estthis Lorem reasoning, ipsum manydolor sit parents amet. Lorem feel so ipsum uncomfortable dolor sit amet, or conseteturguilty about sadipscing not meeting elitr, sedtheir diam child’s nonumy going-to-sleepeirmod tempor inviduntdemands ut thatlabore they et dolore continue magna to doaliquyam so even erat, though sed diam it repeats voluptua. the At cycle, vero eos and et evenaccusam though et it continuesjusto duo doloresto make et theea rebum. child dependentStet clita kasd on gubergren, them to fall no seaasleep. takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita You don’t want to hear your child cry, just as you don’t want to see your child fall. But when your child kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. is learning to walk, he will fall. And fall again. We don’t like it, but we accept it as an unavoidable part of the learning process. The child gets up, on his own, over and over again until he masters the skill and learnsSincerely, to walk independently. Crying while learning to self-settle is the same thing. Chad Hermann WhenCommunications children learn Director how to sooth themselves to sleep, it’s often the first time they learn about boundaries. In fact, it’s often the first No they really learn from: NO, I am not going to take you out of the crib. You have to go back to sleep on your own.

Consider this analogy: Do you give your child candy or cookies every time they ask? No. What if they

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June 10, 2010 cry? No again. (I hope.) Say your child loves Elmo, and she already has several Elmo dolls in her room at home. While walking through a store, your child sees Elmo on the display shelf and cries because she wantsDear Mr.THAT Smith Elmo. Do you buy another Elmo just to calm her down and get her to stop crying? If you do, we have a lot more to talk about than just sleep. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et Manydolore parents magna aliquyam tell me about erat, sed the diam difﬁculties voluptua. they At vero have eos getting et accusam their et child justo to duo sleep dolores while et ea admitting rebum. Stet that clita otherkasd gubergren,caretakers no or sea daycare takimata centers sanctus seem est Lorem to have ipsum no troubledolor sit gettingamet. Lorem the child ipsum to dolor sleep sit independently. amet, consetetur Thissadipscing example elitr, demonstrates sed diam nonumy how eirmoda child tempor can be invidunt conditioned ut labore to etrespond dolore magnato different aliquyam people erat, differently.sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata I sanctusonce worked est Lorem with ipsum the dolorparent sit of amet. a 22-month-old Lorem ipsum dolorwho “required”sit amet, consetetur a two-hour sadipscing bedtime elitr, routine sed diam involving nonumy readingeirmod temporbooks, invidunt soft music, ut labore massage, et dolore cuddling, magna aliquyam and being erat, rocked sed diam to sleepvoluptua. before At vero being eos able et accusam to be placed et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. in a crib for bedtime. I asked how the child napped. The parent told me that naps were equally tough and longDuis on autem the velweekends eum iriure at dolorhome. in When hendrerit I asked in vulputate about velitweekdays, esse molestie the parent consequat, admitted vel illum that dolorethose eunaps feugiat were handlednulla facilisis by the at child’svero eros day et accumsancare, where et iusto naps odio came dignissim like clockwork qui blandit at praesent 12:30PM luptatum every zzril day, delenit with augueno book, duis nodolore rocking, te feugait no massage, nulla facilisi. music Lorem or cuddling.ipsum dolor The sit amet,parent consectetuer was at a loss adipiscing to explain elit, sedwhy diam this nonummy occurred. nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. I Utcouldn’t wisi enim help ad myself.minim veniam, quis nostrud exerci tation ullamcorper suscipit lobortis nisl ut aliquip ex ea commodo consequat. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel “Well,illum dolore clearly,” eu feugiat I said, nulla “the facilisis daycare at hasvero the eros Magic et accumsan Cot.” et iusto odio dignissim qui blandit praesent luptatum zzril delenit augue duis dolore te feugait nulla facilisi. Nam liber tempor cum soluta nobis eleifend option congue Thenihil parent’s imperdiet eyes doming widened id quod with mazim excitement. placerat facer possim assum. Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi “What’senim ad minima Magic veniam, Cot?!” quis nostrud exerci tation ullamcorper suscipit lobortis nisl ut aliquip ex ea commodo consequat. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel illum dolore I eulaughed, feugiat nullaand thenfacilisis. explained the joke.

ThereConsetetur are, ofsadipscing course, elitr,no Magic sed diam Cots. nonumy But there eirmod are tempor regular, invidunt predictable, ut labore consistent et dolore magna routines. aliquyam The kindserat, sed of routines,diam voluptua. and prevailing At vero eos nap et accusam rules, that et justo kids duo are dolores more thanet ea willingrebum. Stetto comply clita kasd with gubergren, when they no sea learn takimata that sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy they have no other choice. Without those routines, and without the enforcement of those rules, kids eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et know that they’re the ones calling the shots. justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et Day cares understand this, and they create an atmosphere that allows – and expects – a child to self- dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita settle for naps. What providers do at day care, you can do at home. kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet.

TSincerely,RAINING & RE-CONDITIONING

WeChad all Hermann condition our children. Sometimes, we have to recondition them. Communications Director When your 9-month-old crawls toward the electrical outlet, you move her away and say, No. When she immediately starts to crawl back toward the outlet, you pick her up, move her, and say No even louder. The baby looks at you, the boo-boo lip comes out, and she begins to wail – as she heads back toward the outlet. At no point, no matter how often or loudly she cries, do you consider letting her make it to the

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June 10, 2010 outlet. And you never, not even for a moment, no matter how often or loudly she cries, consider letting her stick her finger in that outlet. To you, it’s clear: Outlet=Electricity, Electricity=Danger, and Danger=No.Dear Mr. Smith Even if she cries more, you resist. Your stance is as firm and unyielding as a brick wall. She learns that no matter what she does, no matter how often or loudly she cries, she will not be allowed to touchLorem the ipsum outlet. dolor Eventually sit amet, consetetur she learns sadipscing that if she elitr, tries sed again, diam nonumy she will eirmod fail. Eventuallytempor invidunt she utjust labore stops et trying.dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur Conditioningsadipscing elitr, works sed diam best nonumy when the eirmod process tempor is clear invidunt and ut consistent. labore et dolore You magnaknow that,aliquyam and erat,you sedprovide diam that clarityvoluptua. and At consistency, vero eos et accusam when your et justo child duo is dolores crawling et ea toward rebum. anStet electrical clita kasd outlet.gubergren, You no need sea takimatato know it, and yousanctus need est to Lorem do the ipsum same dolor thing, sit whenamet. Loremshe’s notipsum self-settling dolor sit amet, in bed. consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. GoingDuis autem to Sleep vel eum is Tough.iriure dolor And in Learned.hendrerit in vulputate velit esse molestie consequat, vel illum dolore eu feugiat nulla facilisis at vero eros et accumsan et iusto odio dignissim qui blandit praesent luptatum zzril delenit augue duis Think about it. Going to sleep is tough! dolore te feugait nulla facilisi. Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Sure, a nice cozy bed or crib seems like a fine place to relax and drift off. But don’t forget that the primitiveUt wisi enim predecessors ad minim veniam, from which quis nostrud we’ve exerci evolved tation lived ullamcorper in much suscipit less safe lobortis surroundings. nisl ut aliquip Going ex ea to sleep meantcommodo – and consequat. still, in Duissome autem ways, vel means eum iriure – putting dolor indown hendrerit ALL in your vulputate defenses. velit esseIf an molestie invading consequat, tribe or vel hungryillum dolore bear eucame feugiat across nulla your facilisis sleeping at vero behind, eros et accumsanyou weren’t et iusto likely odio to dignissim fare very qui well. blandit We praesent mammals luptatum are hard-wiredzzril delenit thisaugue way. duis dolore te feugait nulla facilisi. Nam liber tempor cum soluta nobis eleifend option congue nihil imperdiet doming id quod mazim placerat facer possim assum. Lorem ipsum dolor sit amet, consectetuer Everadipiscing see a elit,dog sed prepare diam nonummyto go to sleep? nibh euismod Watch tinciduntthe ut laoreet dolore magna aliquam erat volutpat. Ut wisi geneticallyenim ad minim programmed veniam, quis instinct. nostrud Theexerci dog tation chooses ullamcorper a suscipit lobortis nisl ut aliquip ex ea commodo strategicconsequat. spot, Duis typically autem vel with eum airiure good dolor view in ofhendrerit the area, in vulputate velit esse molestie consequat, vel illum dolore theneu feugiat circles nulla round facilisis. and round and plops down, curled inConsetetur a ball, its sadipscing back against elitr, a sed wall diam or nonumyother barrier. eirmod Only tempor invidunt ut labore et dolore magna aliquyam erat, sed thendiam does voluptua. it slowly At vero drift eos off et accusamto sleep, et with justo one duo eye dolores et ea rebum. Stet clita kasd gubergren, no sea takimata neversanctus quite est Lorem seeming ipsum to closedolor sitall amet. the way. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et Wejusto humans duo dolores don’t et have ea rebum. quite Stet that clita much kasd of gubergren, an on-guard no sea takimata sanctus est Lorem ipsum dolor sit amet. modeLorem when ipsum we dolor go sitto amet,sleep consetetur– though sadipscingsome maladapted elitr, sed diam nonumy eirmod tempor invidunt ut labore et sleepdolore routines magna aliquyam can retain erat, this sed on-guard diam voluptua. characteristic. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita Modernkasd gubergren, humans no in sea safe takimata settings sanctus have est Lorem ipsum dolor sit amet. learned to suppress this vigilance. But this ability to loosen up and let it all hang is not necessarily the Default mode in our Genetic Factory Setting. Sincerely, Some infants while appropriately nursed, rocked, held, kissed and cuddled to sleep don’t spontaneously transition to self-sufficient sleep automatically. Sometimes as a parent, you have to move your cursor to theChad lower Hermann left corner of the screen, click on the Start button, open the Control Panel, and manually click offCommunications the “On Guard” Director mode and click on the “Self-Settle” mode.

Of course, it isn’t that easy. But would you be surprised if I told you it’s almost that easy? And that it’s almost always much easier than parents thought it would be?

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June 10, 2010 My thought is that sleep has a genetic/nature piece and learned/nurture piece. You may be naturally hard-wired to be a Night Owl (like me) – able to watch Letterman, read a couple of chapters of a book, andDear complete Mr. Smith all sorts of paperwork ‘til 3AM without any problems. Or you might be one of those 6am Bright Eyes (like my wife) who’s up and excited and ready to shine before the sun is. 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Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy Goingeirmod to tempor sleep inviduntis much ut more labore easily et dolore conditioned magna aliquyam or taught. erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. BecauseDuis autem going vel eumto sleep iriure is dolor a vulnerable in hendrerit time, in vulputate and because velit esse we molestiemay not consequat, innately chosevel illum to dolorego from eu fullfeugiat wakefulnessnulla facilisis toat sleepvero eros without et accumsan help and et iusto reassurance, odio dignissim children qui blanditin a tumultuous praesent luptatum setting zzril may delenit have auguea difficult duis timedolore switching te feugait out nulla of facilisi. vigilance Lorem mode ipsum at bedtime.dolor sit amet, Most consectetuer infants and adipiscing children, elit, however, sed diam are nonummy not typically nibh ineuismod a stressful tincidunt environment. ut laoreet dolore After magna6 or more aliquam months erat volutpat. of being assisted to sleep, many children readily makeUt wisi the enim switch ad minim to self-settle veniam, quismode nostrud with onlyexerci a tation gentle ullamcorper nudge. suscipit lobortis nisl ut aliquip ex ea commodo consequat. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel (Byillum the dolore way: eu if feugiatyou’re nulla the parentfacilisis of at onevero oferos those et accumsan babies who et iusto from odio the dignissim first night qui afterblandit birth praesent could luptatum self- settlezzril delenitand sleep augue through duis dolore the night,te feugait I have nulla a facilisi. question Nam and liber a recommendation. tempor cum soluta nobisFirst: eleifend why the option heck congue are you readingnihil imperdiet this? Second: doming iddon’t quod tell mazim anyone placerat else facer how possim well your assum. child Lorem sleeps, ipsum because dolor sit other amet, people consectetuer with kids ofadipiscing similar ageselit, sed will diam probably nonummy hate nibh you!) euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi enim ad minim veniam, quis nostrud exerci tation ullamcorper suscipit lobortis nisl ut aliquip ex ea commodo Whyconsequat. They DuisFailed: autem Just vel Do eum It iriure(Correctly) dolor in hendrerit in vulputate velit esse molestie consequat, vel illum dolore eu feugiat nulla facilisis. ParentsConsetetur often sadipscing tell me elitr,they sedhave diam “tried” nonumy to let eirmod their temporchild fall invidunt asleep ut onlabore their et doloreown prior magna to aliquyamseeing me, erat, but sed thatdiam it voluptua.just didn’t At work.vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy Manyeirmod families tempor inviduntthat do utfail, labore fail etfor dolore one ofmagna two aliquyamreasons: erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. 1)Lorem Their ipsum approach dolor issit sound,amet, consetetur but they sadipscingdon’t stick elitr, with sed it diamlong nonumyenough eirmodfor the tempor conditioning invidunt to ut takelabore effect. et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita 2) They don’t recognize a critical flaw in their approach. kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. In the first example, the infants have not been given ample opportunity to learn that there are new rules inSincerely, place to support self-settling. In the immortal words of Yoda, the grandest of all Jedi Masters: Do or do not; there is no “try.”

SoChad Jimmy Hermann is 6 months old, and his parents agree tonight Friday night is the night. They feed, clean, and cuddleCommunications Jimmy prior Director to bedtime, and place him in his crib wide awake. They follow a reasonable approach, but at some point, Jimmy’s crying reaches his parents’ threshold, they say enough is enough, and they go in to hold and rock him to sleep.

If Sleep Self-Settling is followed as outlined later in this handout, it’s extremely rare for a child to fail if conditioning is followed and appropriately completed.

Pleasant Hills 850 Clairton Blvd., Suite 1200 ■ Pittsburgh, PA 15236 ■ 412 466-5004 Squirrel Hill/Greenfield 4070 Beechwood Blvd. ■ Pittsburgh, PA 15217 ■ 412 521-6511 www.kidspluspgh.com 12

The Flaw in the System: Groggy, But Awake?! June 10, 2010 Remember that time when you were sitting in the back of class, or in a meeting, with your eyes closing and opening, your head bobbing, obviously falling asleep yet still able to hear the teacher or speaker? To yourDear amazement, Mr. Smith you were even able recall some of the words the speaker said while you were drifting inLorem and out. ipsum This dolor is becausesit amet, consetetureven though sadipscing you were elitr, sitting sed diam in classnonumy looking eirmod kind tempor of ‘awake,’invidunt ut you labore had et alreadydolore magna started aliquyam entering erat, into sed stages diam 1voluptua. and 2 of At sleep! vero eos If etI slapped accusam sensorset justo duofrom dolores an EEG et ea machine rebum. Stet to yourclita headkasd ingubergren, that drowsy no sea state, takimata your sanctus brain estwould Lorem be ipsumcategorized dolor sit as amet. “asleep.” Lorem And ipsum yet, dolor even sit inamet, stage consetetur 1 and 2 “light”sadipscing sleep, elitr, you sed can diam still nonumy commit eirmod things tempor to memory. invidunt (That’sut labore pretty et dolore cool, magna huh?) aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. 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She cries. (This isn’t rocket science, folks.) Ut wisi enim ad minim veniam, quis nostrud exerci tation ullamcorper suscipit lobortis nisl ut aliquip ex ea Iscommodo it really consequat.shocking Duisthat sheautem should vel eum cry? iriure First, dolor she in was hendrerit likely in freaked vulputate out velit by esse the molestiefact that consequat, she woke vel in a placeillum differentdolore eu fromfeugiat where nulla facilisisshe went at veroto sleep eros (theet accumsan Bedroom-to-Kitchen et iusto odio dignissim Phenomenon). qui blandit Second, praesent sheluptatum didn’t self-settlezzril delenit in augue the first duis place! dolore Wete feugait can’t nullaexpect facilisi. her to Nam awaken liber temporin the middlecum soluta of thenobis night, eleifend find option herself congue alone innihil a dark imperdiet and room doming with id quodout any mazim soothing placerat motion, facer possim and just assum. roll Lorem over andipsum go dolor back sit to amet, sleep. consectetuer adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi Anotherenim ad minimparental veniam, misconception: quis nostrud when exerci atation child ullamcorper is run ragged suscipit or skips lobortis naps nisl or ut in aliquip some ex way ea commodo becomes very tiredconsequat. and “worn Duis autem out” byvel evening,eum iriure then dolor they’ll in hendrerit sleep in better. vulputate This velit usually esse molestieis not the consequat, case. In vel general, illum dolore an overly-tiredeu feugiat nulla child facilisis. will sleep worse than usual. Consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed Whydiam teachvoluptua. a child At vero self-settling eos et accusam skills et to justo fall duo asleep dolores independently? et ea rebum. Stet Many clita reasons: kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy 1)eirmodThe childtempor gains invidunt security ut labore and etconfidence dolore magna related aliquyam erat, sed diam voluptua. At vero eos et accusam et justo to duosleep dolores with eachet ea rebum.successful Stet clitanight. kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et 2)dolore The childmagna enjoys aliquyam greater erat, sed quality diam ofvoluptua. sleep. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. 3) The child does not develop fears associated with going to sleep alone. Sincerely, 4) The family unit does not suffer from the stress of an unnecessary sleep problem. Chad Hermann 5)Communications Most lousy adult Director sleepers were lousy sleepers as kids.

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June 10, 2010 While certainly not a primary reason for teaching a child self-settling, the chance for parents to regain normal patterns of sleep and intimacy does provide a significant benefit – both for the parents AND for theDear child. Mr. SmithThe parents’ reward is self-evident. The child’s reward comes from having well-rested parents. Tired parents are bad parents. Well-rested parents have more patience, better senses of humor, and a greaterLorem ipsumwillingness dolor sit to amet, engage consetetur their children sadipscing in elitr,play. sedOverall, diam nonumy they’re eirmodhappier tempor people. invidunt And betterut labore parents. et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita Reconditioningkasd gubergren, nois notsea takimatadifficult. sanctus At 6 to est 12 Lorem months, ipsum infants dolor sitrespond amet. Lorem to recurring ipsum dolorpatterns sit amet, AND consetetur learn rapidly.sadipscing If youelitr, and sed ALL diam caretakersnonumy eirmod are consistenttempor invidunt with utyour labore sleep et dolore conditioning magna aliquyam routine, erat, your sed child diam will likelyvoluptua. learn At withinvero eos a etweek accusam how et to justo fall duoasleep dolores on his et eaor rebum. her own. Stet Your clita kasdchild gubergren, will also nolearn sea howtakimata to put him-sanctus or herselfest Lorem back ipsum to sleepdolor sitwhen amet. waking Lorem inipsum the dolornight. sit Most amet, children, consetetur in sadipscing fact, will elitr, complete sed diam the nonumy majorityeirmod tempor of this invidunt learning ut laboreprocess et withindolore magna 2-3 days! aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. Now.Duis autemI must vel stress eum theiriure importance dolor in hendrerit of a CLEAR in vulputate and velitCONSISTENT esse molestie plan. consequat, The primaryvel illum reasondolore eufor feugiat failure tonulla resolve facilisis a sleep at vero problem eros et accumsanwith conditioning et iusto odio is dignissimthat the child qui blandit is given praesent mixed luptatum signals zzril from delenit one oraugue more duis caregivers.dolore te feugait I’ve nullahad many facilisi. parents Lorem comeipsum backdolor tosit meamet, and consectetuer state that adipiscingthey carried elit, out sed thediam plan nonummy I reviewed nibh witheuismod them, tincidunt and that ut laoreet“it didn’t dolore work.” magna But, aliquam except erat in volutpat. the rarest of cases, the failure almost always results fromUt wisi a lack enim of ad clarity minim orveniam, consistency quis nostrud on the exerci caretakers tation ullamcorper part. suscipit lobortis nisl ut aliquip ex ea commodo consequat. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel Soillum how dolore do you eu feugiatget that nulla clarity facilisis and at consistency? vero eros et accumsan et iusto odio dignissim qui blandit praesent luptatum zzril delenit augue duis dolore te feugait nulla facilisi. Nam liber tempor cum soluta nobis eleifend option congue Herenihil weimperdiet go… doming id quod mazim placerat facer possim assum. Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi Establishenim ad minim a Regular veniam, Bedtime quis nostrud Routine. exerci tation ullamcorper suscipit lobortis nisl ut aliquip ex ea commodo consequat. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel illum dolore Infantseu feugiat and nulla children facilisis. learn through repetition. A clear bedtime routine will let them learn to anticipate thatConsetetur bedtime sadipscing has arrived. elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata So,sanctus parents est Lorem often ask,ipsum what dolor time sit amet. should Lorem we ipsumchoose? dolor The sit goodamet, newsconsetetur is that sadipscing children elitr, can, sed within diam reason,nonumy easilyeirmod learn tempor to inviduntfall asleep ut labore at different et dolore times. magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. ChooseLorem ipsum a bedtime dolor thatsit amet, works consetetur for you sadipscing AND your elitr, baby. sed Ifdiam the nonumy time you eirmod choose tempor is greater invidunt than ut labore one to et two hoursdolore different magna aliquyam from the erat, time sed your diam childvoluptua. currently At vero falls eos etasleep, accusam your et justochild duo may dolores need etto ea have rebum. the Stetbedtime clita graduallykasd gubergren, adjusted. no sea (For takimata this approach, sanctus est you Lorem should ipsum talk dolor to sityour amet. doctor first.)

The idea behind the routine is to calm, or wind-down, your child. Obviously you want to avoid stimulatingSincerely, your child. This means avoiding loud noise, bright lights, rough play, and drinks with caffeine for at least 30-60 minutes prior to bedtime. The routine doesn’t need to last very long. 5 to 30 minutes is typical. Common bedtime routines can include: snack, bath, bedtime story, cuddling, talking, praying,Chad Hermann and toothbrushing. Communications Director The routine is NOT meant to get your child tired or to sleep. Your child must be awake and alert enough to recognize she is being placed in her crib. If she falls asleep during the routine, then she must be gently awakened prior to being put in the crib.

Pleasant Hills 850 Clairton Blvd., Suite 1200 ■ Pittsburgh, PA 15236 ■ 412 466-5004 Squirrel Hill/Greenfield 4070 Beechwood Blvd. ■ Pittsburgh, PA 15217 ■ 412 521-6511 www.kidspluspgh.com 14

June 10, 2010 I recommend the use of a Transitional Object to put in the crib with the baby. The child will typically bond with this object – a small teddy bear/teething toy, for example. Since this process usually occurs duringDear theMr. time Smith a child goes through teething, it’s helpful if the object can easily be chewed and withstand teething. Since your child will be presented with a new object for the sleep process, this is also an Loremideal time ipsum to dolor eliminate sit amet, a pacifier consetetur or sadipscingbottle. elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita Oncekasd the gubergren, bedtime no routine sea takimata is complete, sanctus yourest Lorem infant ipsum should dolor be sit placed amet. 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Ut wisi enim ad minim veniam, quis nostrud exerci tation ullamcorper suscipit lobortis nisl ut aliquip ex ea commodo Theconsequat. caretaker Duis should autem then vel immediatelyeum iriure dolor leave in hendrerit the infant’s in vulputate bedroom. velit Often esse molestie the infant consequat, will be vel crying illum anddolore eveneu standing.feugiat nulla You facilisis. should still leave the room. Staying to “calm” the infant or laying her back down is likely to condition her to expect these actions every time you put her in the crib. Consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed Thisdiam is alsovoluptua. why AtI don’t vero eosrecommend et accusam the et justouse ofduo a dolorespacifier; et ifea the rebum. pacifier Stet clitafalls kasd out gubergren,of the infant’s no sea mouth, takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy she’ll cry until you come back to put it back in her mouth. Some caretakers try to avert this problem by eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et buying several pacifiers and sprinkling them inside the crib, so if one falls out the infant might easily justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. find another on their own. (It’s true.) That approach, however, just continues, and perhaps even worsens, Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et the problem. It’s much easier to recondition the infant to self-sooth without additional items. dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. So you’ve left the infant in the crib awake and alone. If he cries what do you do?

I suggestSincerely, waiting 5 minutes, giving him time to possibly soothe himself to sleep. You must time this process with a watch or clock, because 30 seconds of crying will seem like an hour.

AfterChad 5 minutesHermann of crying, you can go to the baby’s crib and briefly, verbally reassure him. This does not involveCommunications picking, lying Director down, or even touching the infant. If the baby was happy and pleasant five minutes ago when you placed him in the crib, and he’s only crying since you left, it doesn’t take a specialist, or a rocket scientist (I told you!) to figure out what upset him.

He’s angry. He’s almost certainly NOT ill or in pain. (He was just ﬁne ﬁve minutes ago; it’s not like he

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June 10, 2010 suddenly developed tuberculosis after you left him!) So your brief visit at the 5-minute point is to condition him to expect that his crying will bring you to check on him. If he’s ok except for the crying,Dear Mr. you Smith leave the room again.

So,Lorem what ipsum is the dolor message sit amet, you’re consetetur giving sadipscing (conditioning elitr, sed) him? diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita Ifkasd I check gubergren, on you no in sea the takimata crib and sanctus everything est Lorem is ok,ipsum but dolor you aresit amet. upset Lorem at being ipsum put dolor in the sit amet,crib, conseteturI’m going to leavesadipscing after elitr,verbally sed diamreassuring nonumy you, eirmod because tempor I inviduntexpect you ut labore to soothe et dolore yourself magna to aliquyam sleep. erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata That’ssanctus a estlong Lorem message. ipsum Butdolor your sit amet. baby Lorem will getipsum it. Anddolor understandsit amet, consetetur it. sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. The question I most often get is: How long (after the 5 minute visit) do I let my child cry? The answer I typicallyDuis autem give vel is: eum As iriure long dolor as it intakes. hendrerit in vulputate velit esse molestie consequat, vel illum dolore eu feugiat nulla facilisis at vero eros et accumsan et iusto odio dignissim qui blandit praesent luptatum zzril delenit augue duis Somedolore caretakers te feugait nulla tell mefacilisi. they Lorem think ipsum this is dolor harsh. sit Onceamet, consectetueragain, my method adipiscing is elit,not sedthe diamonly nonummyapproach nibh– but whatevereuismod tincidunt you do isut goinglaoreet todolore condition magna youraliquam child erat to volutpat. expect the response again. Dr. Richard Ferber, probablyUt wisi enim the admost minim famous veniam, pediatric quis nostrud sleep exerci specialist, tation offersullamcorper a method suscipit essentially lobortis nisl the ut same aliquip as ex the ea one I’ve describedcommodo soconsequat. far, but Duisdiffers autem here. vel He eum suggests iriure dolor going in hendrerit back to ina cryingvulputate infant velit (olderesse molestie than 6 consequat, months) aftervel 10illum more dolore minutes, eu feugiat and nullathen facilisisagain after at vero 15 eros more et accumsanminutes – et each iusto time odio brieﬂy,dignissim verbally qui blandit reassuring praesent luptatumthe infant.zzril delenit I feel, augue however, duis dolore that each te feugait time nulla you facilisi.go back Nam into liber the temporroom, youcum disruptsoluta nobis or further eleifend delay option the congue self- soothingnihil imperdiet process. doming id quod mazim placerat facer possim assum. Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi (There’senim ad minimnothing veniam, wrong quis with nostrud Dr. Ferber’s exerci tation approach; ullamcorper it’s just suscipit different. lobortis If nisl you’re ut aliquip interested ex ea commodoin learning more,consequat. it’s clearly Duis autem explained, vel eum along iriure dolorwith somein hendrerit excellent in vulputate information velit esse about molestie pediatric consequat, sleep, vel in illumDr. Ferber’s dolore book,eu feugiat Solving nulla Your facilisis. Child’s Sleep Problems.)

So…Consetetur As long sadipscing as it takes elitr, is sed my diam professional nonumy eirmod opinion. tempor But inviduntwhy? ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy If the child discovers that you will come back into the room and maybe even pick him up if he cries eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et longer than 20 minutes, then you have just conditioned him to a new process. To get you back into his justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. room, all he has to do is cry for more than 20 minutes. And so he’ll do it. Just as he will if you come Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et back after 30, 40, or 60 minutes. Or longer. dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. A child will often cry for 30 minutes or longer. But she will almost always self-soothe and go to sleep if you don’t interfere. (Of course, if there’s a sudden change in the crying, or if something seems out of the ordinary,Sincerely, you should immediately go and check on her.) The worst effects of this long crying may be a hoarse voice, sore throat, or occasionally (if head-banging) a bruised head. None of these are serious.

SomeChad Hermannparents have asked me if the crying could cause a hernia, heart attack, or stroke. Unless the child hasCommunications a severe underlying Director medical problem, the answer is No. The most troublesome issue for parents is usually when their babies cry to the point that they gag and vomit. (Vomiting typically doesn’t occur in this process, with the exception of children with Gastroesophogeal Reﬂux, but it’s still worth mentioning here. Also worth mentioning: keep an extra pair of sheets and PJs handy in case they do vomit.)

How you respond to this is very important.

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June 10, 2010 To the child whose parent picks him up, apologizes, holds, rocks, and/or feeds him, there is likely to be a new conditioning: that if he’s awake in the crib, he should cry; if he cries and no one comes, he should cryDear harder; Mr. Smith if he cries long and hard enough, to the point of vomiting, then that Room Service response is finally going to come. (It may be bad room service, and it may be late, but it’s still room service.) Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et Ondolore the magnaother hand,aliquyam if you erat, go sed to diam him voluptua.and calmly, At vero verbally eos et reassureaccusam ethim justo while duo doloresyou clean et ea him, rebum. his Stet clothes, clita andkasd his gubergren, linens, then no sea immediately takimata sanctus put himest Lorem back ipsuminto the dolor crib, sit you’veamet. Lorem given ipsum a clear dolor and sit consistent amet, consetetur message,sadipscing conditioning elitr, sed diam him nonumy in a wayeirmod you tempor want: invidunt I will always ut labore check et dolore on you magna when aliquyam something erat, sed has diam happened,voluptua. At but vero once eos Iet address accusam the et justoproblem, duo dolores I expect et eayou rebum. to soothe Stet clita yourself kasd gubergren, and go to no sleep sea takimatain your crib. sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy Onceeirmod the tempor child invidunthas fallen ut labore asleep, et youdolore do magna not need aliquyam to go erat, back sed in diam his room. voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. IfDuis he awakensautem vel latereum iriurein the dolor night in or hendrerit early morning in vulputate – velit esse molestie consequat, vel illum dolore eu feugiat typicallynulla facilisis before at vero 6am eros – then et accumsan you should et iusto repeat odio the dignissim qui blandit praesent luptatum zzril delenit augue duis approachdolore te feugaitdescribed nulla above. facilisi. The Lorem one ipsum difference dolor sit is amet,that consectetuer adipiscing elit, sed diam nonummy nibh youeuismod may tinciduntnot have ut seen laoreet the dolore child magnafor hours, aliquam and erat the volutpat. awakeningUt wisi enim may ad minim have anveniam, obvious quis source nostrud that exerci requires tation ullamcorper suscipit lobortis nisl ut aliquip ex ea acommodo brief physical consequat. evaluation. Duis autem Problems vel eum like iriure teething dolor in or hendrerit in vulputate velit esse molestie consequat, vel aillum “dirty” dolore diaper eu feugiat can be nulla addressed facilisis withinat vero 2-3eros minutes,et accumsan et iusto odio dignissim qui blandit praesent luptatum allowingzzril delenit you augue to quickly duis dolore leave te thefeugait room. nulla (If facilisi. your childNam liber tempor cum soluta nobis eleifend option congue hasnihil a imperdietfever, you’ll doming have id toquod approach mazim placeratthat differently.) facer possim assum. Lorem ipsum dolor sit amet, consectetuer So,adipiscing in essence, elit, sed after diam 5 minutes nonummy of nibh crying, euismod you tinciduntmake a ut laoreet dolore magna aliquam erat volutpat. Ut wisi briefenim appearance, ad minim veniam, then quisleave nostrud and let exerci them tation go as ullamcorper long suscipit lobortis nisl ut aliquip ex ea commodo asconsequat. it takes. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel illum dolore eu feugiat nulla facilisis. Beware of the slippery slope here: 6am can become 5:50, which can become 5:35, which can become 5:15.Consetetur Pick asadipscing time. Draw elitr, a line.sed diam And nonumy then stick eirmod to it.tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy Naps should be similar. Infants 6-12 months old typically take about 2 naps per day. From 12 months to eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et about 4 years old, they usually take one nap. You should establish a pre-nap routine, just as you would justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. establish a pre-bedtime routine at night. You should put the child in her crib – ideally, with the same Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et setting as bedtime – awake, then leave. (You might consider using room-darkening shades for naps.) If dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita your child cries for more than five minutes, you should briefly return to check, then leave again. If the kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. crying lasts longer than an hour, then you should abort the nap attempt. (This, however, very rarely happens). Sincerely, I strongly suggest you begin the process with bedtime, not naps.

MoreChad thanHermann 95% of children will learn to self-soothe within 7 days. Communications Director The majority of children will learn to self-soothe within 3-4 days.

The ﬁrst 1-3 days are the worst.

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June 10, 2010 Days 1 & 2 can typically have 30-90 minutes of crying and disruptions.

StartingDear Mr. on Smith a weekend or holiday helps.

IfLorem you have ipsum neighbors dolor sit amet, with consetetur a shared, sadipscing thin wall, elitr, you sedmight diam want nonumy to explain eirmod whattempor you’re invidunt doing ut labore in advance et ofdolore starting magna the aliquyam sleep training. erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur Ifsadipscing someone elitr, shares sed the diam infant’s nonumy room, eirmod you tempor should invidunt temporarily ut labore move et dolore her magnaout for aliquyam a couple erat, days. sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata Ifsanctus you feel est thatLorem this ipsum process dolor should sit amet. take Lorem place, ipsum but dolor you sithonestly amet, consetetur recognize sadipscing you’re not elitr, able sed to diam do it,nonumy you shouldeirmod gettempor close invidunt friends ut orlabore family et dolore to help magna and aliquyamleave for erat, a few sed hours. diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. PerhapsDuis autem most vel importantly... eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel illum dolore eu feugiat nulla facilisis at vero eros et accumsan et iusto odio dignissim qui blandit praesent luptatum zzril delenit augue duis ...Ifdolore you te start feugait this nulla process, facilisi. COMPLETE Lorem ipsum IT!dolor Stopping sit amet, andconsectetuer starting adipiscing send mixed elit, signals, sed diam which nonummy sabotage, nibh andeuismod greatly tincidunt prolong, ut laoreet the process. dolore magna aliquam erat volutpat. Ut wisi enim ad minim veniam, quis nostrud exerci tation ullamcorper suscipit lobortis nisl ut aliquip ex ea Ifcommodo the process consequat. doesn’t Duis seem autem to fit vel what eum I’veiriure described, dolor in hendrerit call our in office.vulputate And, velit as esse always, molestie if youconsequat, have anyvel questionsillum dolore at euall feugiatabout nullathe health facilisis and at verowellness eros etof accumsan your child, et iusto please odio let dignissim us know. qui We’re blandit here praesent to help. luptatum zzril delenit augue duis dolore te feugait nulla facilisi. Nam liber tempor cum soluta nobis eleifend option congue nihil imperdiet doming id quod mazim placerat facer possim assum. Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi Dr.enim Todd ad minim Wolynn, veniam, the President quis nostrud of exerciKids Plustation Pediatrics, ullamcorper has suscipit been lobortis a general nisl utpediatrician aliquip ex ea (Board commodo Certified)consequat. since Duis autem1995. velIn eum1997, iriure he becamedolor in hendreritinterested in invulputate pediatric velit sleep esse molestiedisorders consequat, and subsequently vel illum dolore completedeu feugiat nullatwo intensivefacilisis. courses at The School of Sleep Medicine in Palo Alto (which is associated with Stanford University). After completing the course in 1999, he helped to open the Mercy Hospital PediatricConsetetur Sleep sadipscing Disorder elitr, Program. sed diam nonumy He was eirmod the Medical tempor inviduntDirector ut of labore the program et dolore magnafrom 1998-2007. aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet.

Sincerely,

Pleasant Hills 850 Clairton Blvd., Suite 1200 ■ Pittsburgh, PA 15236 ■ 412 466-5004 Squirrel Hill/Greenfield 4070 Beechwood Blvd. ■ Pittsburgh, PA 15217 ■ 412 521-6511 www.kidspluspgh.com