CHILDREN; Non-sleeping sickness

If you believe your baby won't sleep, it probably won't. Leaving a child to cry is counter-intuitive; many parents give up
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The Independent Culture
SIT HALF a dozen parents of pre-school children round a dinner table, and sooner or later one topic will arise. Sleep - or lack of it - is a concern to all parents, and an obsession to many. How to get your child to sleep and how long it remains in that state are questions that keep conversation turning until the baby-sitters call time.

Those still searching for an answer will derive little comfort from the findings of a study presented last month to the British Psychological Society. David Messer and his team at the University of Hertfordshire found that babies' sleeping habits were determined by the pre-natal assumptions of the mother. Expect to get up nine times a night, it seems, and you probably will. Such a conclusion is of little practical use to parents, but it is a rare insight into a complex and neglected area.

"Given the impact it has on so many lives," says Messer, "and how much emotion the topic engenders, little research has been done on infant sleep. He is conducting a second, larger-scale study and believes it will be relevant to many. His research shows that up to a third of pre-school children have sleeping difficulties.

Fashions in child-rearing come and go: toilet training in the Sixties, bottle feeding in the Seventies. But sleep is the issue for today's parents, says Messer. "There are more parents than ever who really need the sleep, because so many mothers work and people's lives have become busier."

Desperation drives many to the doctor; sleep difficulties now occupy more surgery time than any other problem among under-fives. Experts agree sedatives are not the answer, but there the consensus ends. Martin Richards, a zoologist-turned-psychologist who runs the Centre for Family Research at Cambridge University, says homespun theories abound. "The majority of methods have never been studied. There was one significant study that showed that ignoring children was effective, but over half the parents involved abandoned it."

Faced with a screeching baby, most people take action: rocking, singing, feeding, cooing, cuddling, swearing. The post-natal follow-up to Messer's study confirmed observations by child therapists that such "responsive strategies" only reward the waking, and so perpetuate it. "The parents' behaviour was the key. Working mothers had less of a problem because, by force of circumstance, they attended to the child less in the night."

The "reward" theory is gaining currency - but it has a curiously adult logic, says Deborah Jackson, author of Three in a Bed. She, of course, slept with her babies - the biggest reward you can give a child, and a cardinal sin in the eyes of sleep experts. Yet three-quarters of adults do so to some extent, if only because they have exhausted themselves and all other options.

In this muddle of academic theories and survival strategies, one man says he has the answer. "I give parents a guarantee that the problem will be solved in three nights," says John Pearce, professor of child psychiatry at Queens Medical Centre in Nottingham. The building blocks of his technique, though not entirely original, are the culmination of years of challenging work with children with learning difficulties.

The resulting method, which he calls "rapid settling", takes as its axis a shift in focus from sleep patterns to the bedtime routine. Babies are born with a sleep/wake cycle of 20 minutes, compared with an adult's three- hour cycle, and so are biologically programmed to drift into light sleep very frequently. "There is absolutely nothing you can do to control that," says Pearce, "so parents need to concentrate on what they can influence."

The magic formula takes an hour to enact each night, and involves a wind- down period, a regular bedtime, saying goodnight, and leaving the child if it cries. It sounds such a time-honoured ritual that most parents must have tried it - but details are often missed, says Pearce.

"The time of going to bed is important, because if you stick to it the child's sleep pattern will become programmed. Saying goodnight using exactly the same words acts like a hypnotic suggestion." In the dark the chemicals in the brain alter, conditioning it for sleep, so leaving the light on or a door open isn't a good idea.

The secret is sticking to the whole package, and doing it every night. Pearce admits it is stressful, and is in regular telephone contact with his patients. "Leaving a child to cry is counter-intuitive, which is why most parents give up. But men find it easier than women, so they can help."

None of this is likely to work until the baby is six months old, at which age he or she will be able to distinguish clearly between night and day, and the sleep cycle will have lengthened to 40 minutes.

It may be because adults' own lives are increasingly less routine that sleeping problems are becoming more common. Parents are not only busier, but more demanding of themselves. "They think they should be the child's carer, friend, playmate, teacher and provider," says Pearce. "When they fail to fulfil all their roles, they feel guilty and end up being indulgent to their children."

So are your child's nocturnal pranks of your own making? The suggestion infuriates Sally Baines, founder of the now-defunct National Association for Parents of Sleepless Children. "Babies are just small human beings," she says, "and some don't need much sleep, just like us. I started the association because people needed help - they had expected their babies would sleep, but found they were being blamed when they didn't. We helped change that; people became more sympathetic and the association disbanded. Now the pendulum has swung back. People think babies do as it says in the books - but babies don't read books."

Adults do, and there has been a proliferation of "how-to" sleep literature in recent times. But, as Messer's research indicates, parents' conscious behaviour is only part of the story - and if a mother can unconsciously influence her baby's sleeping behaviour before it is born, how much more can she do so afterwards?

Dilys Dawes, a child psychotherapist at London's Tavistock Clinic and author of Through the Night, works with parents on a range of problems. She has noticed an increase in those relating to sleep. Many derive from the parents' own anxieties, she says. "A lot of parents of babies with sleep problems have had some kind of loss - a miscarriage, stillbirth, cot death, or the death or divorce of their own parents." Their anxiety about loss is turned into fear of losing the baby at night.

"Some people will actually prod the baby until it moves or makes a noise," says Dawes, "to check it's alive. If the baby wakes, it picks up on the parent's night-time anxiety. At the very least it gets used to waking at night." With first-time parents getting older, the conditions for this kind of anxiety are becoming more common. Recent publicity about cot death may also have accentuated it, she says.

The answer is not to be found in any sleep manual, but in sharing these fears. "Talking about past events can uncover anxieties and help resolve them. I find that, by the time parents get referred to me, things are already improving because they've talked to the health visitor or doctor." Many callers to the Tavistock Under-Fives Counselling Service seek a sleep cure, and all are seen within two weeks.

Infant sleeplessness is popularly seen to be a problem for the parents, not the baby; the baby just makes up for lost time the next day. But an increasing body of opinion suggests children who sleep badly develop behavioural problems. "The personal and psychological effects of disturbed sleep can be very severe. They are underestimated in adults but even worse in children," says Dr Greg Stores, head of child and adolescent psychiatry at Oxford University. He is planning to examine the factors that can predict sleep problems.

Meanwhile, parents who can but dream of sleeping well should heed the words of Sally Baines, two of whose five children were terrible sleepers. "They do grow out of it, and you do forget," she says. "If I hadn't written it down at the time, I'd be saying now that my children didn't sleep too badly." Take heart: she now sleeps like a log. !

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