Nightmares. Occasionally a child who is facing too many stressful situations during the day may relive them in her sleep through her subconscious by having nightmares. She will probably wake crying bitterly, not the way she does if she is thirsty, hungry or cold, which usually starts off as a niggly cry and builds up. If this happens, respond as quickly as possible and do your best to comfort your child, without making it into a party.
You should also try to pin-point the sources of stress and eliminate them if you can.
Some of the possible causes are the arrival of a new baby, a move to a new house, harsh discipline, forced toilet training, conflict between the parents, and unresolved fears. Your child may simply be overstimulated during the day because there is too much happening around her and there is not enough time to assimilate and digest all the stimuli that she is being bombarded with. Children cannot cope with constant chaos around them. As always, try to eliminate the problem if possible and bring order into her life.
Crying from pain. Around six months, and then perhaps in the middle of the second year, a child may wake from pain caused by teething. The area around the mouth is usually red because of dribbling and she will be restless and may wake often. If you suspect this to be the cause, buy a teething jelly from your chemist or doctor and rub it on the child’s gums.
Night waking from this cause should not last for more than a week or two, if it does it is probably due to something else. A common cause for waking during the night from pain is middle ear infection. If she suddenly starts screaming and seems to be relieved when you pick her up (the pressure in the ears changes in the upright position, easing the pain, a reaction that could lead you to think she is spoilt’ because she starts crying when you put her down), and if she is flushed and has a temperature or rubs her ears, she probably has otitis media. Give children’s aspirin or paracetamol and call a doctor in the morning.
Cold. Your child could also be waking because she is cold. If she kicks off her blankets you can try putting her in a special sleeping bag or sew tapes on the corners of the blankets and tie them round the bars of the cot. It is also possible to buy plastic clips which serve the same purpose. Remember that overheating her at night could also make her uncomfortable and wake her.
Worms. Although tiny, only about a centimetre long, threadworms cause intense itching in the anal area when they come out to lay their eggs, mainly at night. They may occasionally travel into the vagina and cause irritation which results in bed wetting – besides waking the child because of the terrible itching. These worms are extremely prevalent in children and are no reflection on the standard of hygiene since they are spread by microscopic eggs which can be dust-borne.
You can check to see whether your child is being worried by worms by looking at the anal area a few nights running about two hours after she has gone to bed. The whole family should then be treated with a suitable mixture from your pharmacist that is pleasant to take and needs only one initial dose and is repeated a few weeks later according to the instructions. (See p. 264.)
Getting into bed with you. Some children wake without crying and get into the parents’ bed. This can be the start of a habit that is very hard to break, presuming, of course, that you do not want to share your bed with a rather damp and restless toddler who is likely to hog most of the available space. If both you and your husband enjoy the company then you do not have a problem – there is a lot to be said for the family bed. However, you might not be able to get a good night’s sleep, and so feel tired and crotchety in the morning. It can also inhibit your sex life. But having to drag an unwilling toddler back to her room is also going to interrupt your sleep, so the best solution is to find the reasons for the problem and try to solve them.
The most likely cause is night fears and a basic sense of insecurity. If your child is waking for these reasons and you cannot resolve them during the day, she may be helped to overcome them sooner if you welcome her into your bed.
Children develop quickly and if you give her intensive care for as long as necessary – it may take weeks or months ” she will most likely return to the attractions of independence, which are also strong.
You could encourage her very gently by getting her a new night light or bed or cuddly toy. Don’t forget the value of a dimmer switch which turns the light down as low as you like – if you keep the passage light on she may feel more secure. On the other hand, if you are quite sure your marital bed could not cope with another addition, you will have to be firm the first time she tries to get into bed with you. It is no good allowing it once or twice, or sometimes; you will just frustrate and confuse her. Take her back to her bed in a reassuring but firmly confident way. Tuck her in and kiss her goodnight, assuring her that you will hear her if she needs you. If she turns up at your bedside again, go through the same procedure. If she has the least indication that there is any chance of sleeping with you, you will never persuade her back to her own bed.
One way of keeping a toddler from wandering in the night is to keep her in a cot with high sides for as long as possible. You will of course go to her at once if she is unhappy. Graduating to a bed is far easier from the latter half of the third year when the conflicts of the toddler stage are less troublesome.
Battles at bedtime. You may have a child who refuses to go to bed and ends up roaming the house when you and your husband should be unwinding and catching up on adult conversation. This kind of scenario usually starts insidiously without your realising that it is happening. There is no reason to suppose that your toddler will go to bed without protest if you have never had a stable and predictable routine. Children need and thrive on the kind of snug security they get from a regular pattern in their lives.
Keeping to a schedule means you will have to be adaptable and arrange your life so that you can go through a bedtime routine regularly. Give your child a basic pattern in her life, while being as flexible as possible in between.
This does not imply an arbitrary, insensitive approach. Ordering a toddler who has just started a game to come in for a bath is looking for trouble. It is up to you to keep an eye on the time and start winding her down slowly. Bedtime, too, should not be a kind of punishment; it should be the cosy conclusion to a full day. If you make it an unfailing rule to read or tell your child a story while she is tucked up in bed it will not be so hard for her to give up the day’s activities. For the system to work you will have to discipline yourself to keep to it. Remember too, that a toddler, unlike a tiny baby, is able to keep herself awake until she is beyond sleep. Overtiredness can keep a child up long past her natural sleep time, so don’t wait until she starts to get crabby before starting the bedtime routine.
Some children need the comfort of a bottle, dummy or doo-doo’ to get off to sleep – don’t deny it to them.
Children who need little sleep. There are rare children who do not need a lot of sleep and these are usually very bright. They are the ones who wake early even if they go to bed late and do not fade during the day. Don’t confuse them with the child who likes to stay up late and wakes early but is grumpy and difficult during the day. The children who genuinely consistently need little sleep are bright-eyed and bushy-tailed on far less sleep than other children need. (See gifted children p. 297.)
These children should be allowed to play quietly in their rooms until they want to sleep and encouraged to stay in their rooms if they wake early. After all, you need your sleep to keep up! You can also see that the toddler’s cot has an interesting collection of toys at the foot for when she wakes up.
Habitual waking after sleeping through. One of the trickiest problems to sort out is the baby who wakes frequently at night after the first months. This usually starts around six months and can leave the parents exhausted. Go through all the possible causes listed previously and if there is no improvement, consider the following possibilities. It often seems as though the child is hungry because she takes a bottle eagerly. If she is having a good mixed diet and about 600 ml to a litre of milk a day she is probably not hungry. She takes the bottle because she is thirsty or needs the comfort of sucking. Try giving her a dummy instead. This means you have to get up when she loses it, but if you get up and pop it back at the first niggle you should not lose too much sleep. She may be over-full and feel uncomfortable but this should only happen in the first two hours after going to sleep. Studies have shown that some babies are extremely light sleepers and wake at the slightest sound. If she is sleeping near traffic try moving her to a quieter spot. It is also important to remember that tea and coffee contain stimulants and are unsuitable for a baby and can keep her awake. Never give them except for rooibos (red tea) which does not contain stimulants, although even this should not replace the milk she should be having.
Sedatives. There is a place for medication but it should never be used as a first resort. Only when all the other possibilities have been tried and investigated should you ask your doctor to prescribe a sedative to get your child to sleep. They have a place only if they help to break a cycle of overtiredness leading to wakefulness or if the mother’s health is endangered or she feels she cannot cope.
Head banging. Some children develop a habit of banging their heads hard against the side of the cot while rocking backwards and forwards rhythmically. It is far more common in boys than girls and usually begins at about six months. You should first pad the cot with thick plastic foam or buy a cot bumper made of plastic covered foam. If necessary use two cot bumpers for double padding. This will not stop the child but at least it will save her skull and deaden the noise. You should then ask yourself whether you have given the child enough tactile stimulation from birth by rocking her, hugging her and generally handling her. Although children who bang their heads do not appear to do themselves any serious physical harm, it can be a sign of frustration and lack of stimulation, and a review of the child’s general management is indicated.
Sucking, like rocking, has a soothing effect on infants and you may find that giving the child a dummy will ease the need to rock herself. Putting her in a camping cot’ with an aluminium frame and canvas sides can stop the actual banging though not the rocking. You will have to wedge the cot in somewhere or it will move about as she rocks.
Breath holding. Some children have a frightening tendency to force out all the air from their lungs while crying, and are then unable to breathe again for what seems an endless period. Their pulse slows down and they may pass out. But they soon regain consciousness with no harm done. It is difficult for a mother to stand by idly while her child goes blue in the face, and a sharp smack, holding her upside down or splashing her with cold water is often recommended. These measures will not help an attack and the best thing you can do is lie her on her side and ensure that her airway is not blocked. Luckily, children who hold their breath grow out of it, and until then their parents should cope with each attack as calmly as possible. It is worth checking to see if your child is anaemic as this often predisposes them to these attacks.
Hair washing and bathing fears. One of the most frequent household dramas in the early years centres on hair washing, with children screaming and mothers tearing their hair out (their own usually although they may be tempted to do it to the child). The fact is that children hate getting water in their faces unless they have been used to it from the beginning.
Playing with a hosepipe on a hot day and splashing her face with water from infancy may help make her more nonchalant about getting water in her eyes and face.
Always wash her hair with non-stinging shampoo and wrap her firmly in a towel, holding her backwards over the bath or basin. Most children dislike having their hair washed in the bath because the surrounding water makes them even more nervous. Plastic brims, like a hat with the crown cut out, are available and they help prevent water from running down her face. Otherwise you can let her lean over the bath and hold a face cloth to her face so that she does not have water running into her eyes.
Occasionally, a baby may become terrified of bathing and scream as soon as she sees the water. Infants have a very poor sense of relative size and she may fear being sucked down the plug hole. So don’t let the water out in her presence. You could give her sponge baths for a while, until she gets over it, without putting her in the water. First lie her on a towel and wash her. Or you can put her in a basin or bath (if she will get in) without water, and wash her that way, using a wet sponge and a jug of water to rinse her. Reintroduce her to the bath after a while using only a tiny bit of water, increasing it gradually over a period of time. Or put the baby bath in the big bath so that she does not feel insecure.
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