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WHEN A TODDLER SUDDENLY DEVELOPS SLEEP PROBLEMS

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NEW YORK TIMES COLUMN:  FAMILIES TODAY:
WHEN A TODDLER SUDDENLY DEVELOPS SLEEP PROBLEMS
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. We have read “Touchoints” cover to cover. We keep our tattered and torn copy on the coffee table for easy access, but we are at a loss.

Up until a week ago, our 25-month-old daughter was the “perfect child” – our pediatrician often asks to adopt her if we tire of her! She has always has been able to self-soothe and go to sleep on her own. She is not having any problems at nap time (noon-2 p.m.) She eats fairly well, is active and well ahead of the curve in her language skills.

Last week, she started a pattern of not being able to/wanting to go to sleep in the evening (7:45-8 p.m.). We keep a very regular schedule and bedtime routine (bath, brush teeth, books in the rocking chair and then bed).

Now, we are having to actually get her into a sound sleep and when we finally get her to sleep, she experiences long spells of night waking – anywhere from one to four hours of screaming, crying, pleading with us to rock her, hold her, take her to our bed, stay in her room, rub her back, etc.

She’s not waking regularly at 10 p.m., 2 a.m. and 6 a.m., but rather wakes once and can not/will not go back to sleep. She repeatedly is crawling out of her crib. It is almost more than we can take to allow her to be in such a state.

A. At what time of night do these awakenings occur? Night terrors usually occur during the first few hours of sleep, while nightmares tend to occur in the last hours of sleep, in the early morning.

During night terrors, children are not really awake or conscious. They’ll suddenly sit bolt upright in bed and let out blood-curdling shrieks. Inconsolable, they often become more agitated when parents try to talk to them or comfort them. The best bet is to stay out of their way, if they are safe, and let them fall back to sleep on their own. They’ll have no memory for the event, since they never really were awake, even though it seems as if they are.

Nightmares, on the other hand, really are dreams, and children usually can remember them, and when they’re old enough to speak, talk about them.

Does your child really keep screaming for 4 hours even if you do hold her, stay with her, or bring her into your bed? It does sound as if she is conscious – not having night terrors – if she is pleading with you to stay with her and comfort her.

At 25 months, she is a little young to be having the kinds of nightmares that 3- and 4-year olds have when they begin to become aware of their own aggressive feelings and begin to scare themselves.

It sounds as if this has only been going on for about a week, but if it has persisted, we would suggest you consult with your pediatrician, who might refer you to a pediatric sleep expert.

Have there been any recent changes or stressors for your family? Her new resistance to going to bed, and her new demands for you to stay close during the night, raise the possibility that something has happened that has frightened her and makes her more hesitant to separate from you.

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton, prior to his passing, was the founder and head of the Brazelton Touchpoints Center, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is currently the Director of the Brazelton Touchpoints Center.  Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

WHEN A PARENT IS CALLED TO WAR

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From the NEW YORK TIMES COLUMN: FAMILIES TODAY

By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. My soldier son has just deployed to Iraq for his second tour of duty. His wife and three sons, ages 9 to 2 1/2, live at Ft. Hood, Texas. I want to add something that has helped our family: Web cams and computer speakers. We gave them to our daughter-in-law and our son during his last tour of duty and we have sent him a new set for this deployment. As soon as our son has his set up and running, they will be able to see and talk to each other via the Internet.

This makes a tremendous difference for spouses and children caught up in this war. The 2 1/2 year-old cries more for his dad that the others because he doesn’t understand what has happened. He just knows that his dad flew away in a plane with other soldiers. We tell him that his dad will come back. He does understand that.

A. Thank you for your great ideas and for the help they will be for all families with loved ones deployed overseas. Certainly Web cams and the Internet can be a great help in keeping families in touch. Maybe you can even record some of these special moments so that the children can go over and over them.

I have recommended leaving several DVDs or videotapes of parents reading bedtime stories so that children can be lulled to sleep by parents who are too far away to tuck them in. Your youngest grandchild may find comfort in a piece of Daddy’s clothing as a “lovey” to cuddle and to fall back on when he’s upset or frightened. Even his smell may be comforting at such a time. He is certainly old enough to sense the distress his mother must feel — another reason for his tears.

Of course a worried family member can’t hide such feelings. Instead they can be explained simply in terms that very young children can understand: “Mommy misses Daddy. I know you do too.”

The older children can be suffering because they do understand too well the separation issues as well as the dangers. Although they may seem under control on the surface, they deserve special times with their mother to unload their feelings, their questions, and to share her sadness. They also certainly need to have a chance for their own concerns to be heard. They will be relieved to speak openly but may also feel proud that through this sharing they are helping her. For the most mature children, and for adults, the terror of losing a military family member is all the worse with the current uncertainty about what this war could possibly accomplish and how it will ever end.

Family meals become even more important now. The family can pray together for their father’s safety and quick return. Then, too, they can share their feelings as a family, “We all miss him terribly and need to see his face and hear his voice.” Meanwhile, each of the boys will learn most from the mother’s strengths and her ability to share those — and her moments of vulnerability — with them.

If we can give anything to children who must suffer in this dreadful war, it will be the sense of having made it through the trauma of separation and loss and of learning how to be resilient. We pray with you that your son returns safely, and wish that all of our brave men and women could.

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton, prior to his passing, was the founder and head of the Brazelton Touchpoints Center, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is currently the Director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.