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Okay, so welcome back to the sleep edit.
I am Dr. Craig Canapari
And I'm Arielle Greenleaf.
And we are here to talk about what I feel is one of the thornier issues in
pediatric sleep and that is napping.
How to do it, when to do it, when to drop naps.
As a parent, I'd say this is a topic close to my heart because we
struggled with naps in our kids and in different ways with the two of them.
Mm-hmm.
and some of that is just 'cause napping is much more variable than nighttime sleep.
Like kids with terrible sleep.
They're still sleeping at night most of the time, but
napping is a whole other animal.
it sure is.
yeah.
I can tell you with my older son, we had kind of crappy naps till he walked.
Really?
man.
just like little 20 minute cat naps here and there.
with my younger son, it was easier except that he had to be
around our older kid schedule.
so that's another layer
That is so, so common.
I feel like my child was a textbook case, high sleep needs child,
and as soon as I was able to.
do any sort of sleep training with her.
The first day I wrote to my sleep consultant and I was like, it's
been like an hour and a half.
Should I wake her up?
What do I do?
And she was like, oh my goodness.
And Ashley really was like, you know, four hours, a daytime sleep, 12 plus
hours of overnight sleep as an infant.
It was kind of crazy.
What did you do differently that got you such a good result?
I didn't know what I was doing before I hired a sleep consultant, so I was
just kind of like napping her when she got fussy or just kind of winging it.
I don't even know.
I mean, maybe I was, look it, it's such a fog, honestly.
Her birthday is this weekend, she's turning 11, and I can tell you she
was not napping in a crib because.
I was too afraid, I thought.
And anytime she squeaked, I was like, uhoh.
she's never gonna be able to sleep in a crib.
And the first time I put her in the crib for a nap at the appropriate time, I think
she cried for five minutes and then fell asleep for, I woke her up after two hours.
It was like wizardry.
Just putting your kid in the crib.
Well, that, that's it.
People just put your kid in the crib.
That's, uh, I guess the episode's over.
Yep.
There we go.
All
done.
but you know, this does highlight, an important point.
That is you can't, when, if you're working as a provider, you don't make
assumptions about what people know because it's not like kids come with a manual.
And even if you read parenting books, it's not always clear what to do in the moment.
No.
And I think that's the number one thing that I deal with is people
just don't know what they don't know.
and I don't blame them, there's supposed information at our fingertips, right?
We have our phones and we look on Instagram and we look on Google and we
look at, well, what is this influencer saying about naps and how, you know,
what time should I be napping my child, and what are their weak windows?
And there's just so much stuff that they, you know, so many myths
that are pumped out about sleep through social media in particular.
And they come to me and they're like, well, isn't XY, z?
True?
And I laugh and I'm like, I'm really sorry that you were fed
that garbage because it is garbage.
there's no sleep education for parents.
They don't go home understanding anything when it comes to sleep.
So let's talk a little bit about what's in the medical literature around napping.
And, um, it is, uh, it, it's, it's limited and we'll get into the reasons why.
I think when we're talking about napping, we have to start by talking
about how much sleep kids need overall.
So in 2016, the American Academy of Sleep Medicine published a consensus
document, which is usually what is recognized as gold standard
guideline for sleep duration.
So I'm just gonna go through the kids numbers.
so according to that document, infants four months to 12 months of age
sleep, 12 to 16 hours per 24 hours.
Children one to two years of age should sleep 11 to 14 hours.
per 24 hours, children ages three to five should sleep 10 to 13 hours.
Six to 12, they say nine to 12 hours, and teenagers 13 to 18 years of age.
Eight to 10 hours.
And I'm just looking at this and I'm like, what do they say about
kids less than four months of age?
they didn't make any recommendations about children under four months of age.
oh, thanks for keeping me honest here.
Because I'm like, why didn't I put that here?
Yeah.
No, they, they, they didn't do any newborn, um,
and I think part of the reason is that it's a wide range, but to put a number
that, I'd say newborns are, it could be anywhere based on some other data
I've seen from like 14 to 20 hours.
I get nervous about, you know, so many people say newborns sleep
so much, they need so much sleep, they're gonna sleep 20 hours.
And then I have these clients who come to me after the newborn stage where they're
like, my child's sleeping 10 hours in a 24 hour period, and I'm losing my mind.
when ultimately there really is nothing wrong.
they either have lower sleep needs or their sleep hasn't quite yet
matured and things are happening and they improve as they get older.
Yeah, it's important to note that where you are on your sleep
requirements tends to be kind of fixed.
So if you have a baby that needs a lot of sleep, they're probably
gonna be on the higher end of those ranges at age three, ages six, ages
18, what have you, and vice versa.
That seems to be relatively fixed in people.
according to the authors, napping was considered biologically
appropriate under age seven, and quote, " naps may be important.
Missing one nap by preschoolers produces more negative emotional responses.
And nap provision improved toddler's performance on a generalization task
in grammatical language 24 hours later compared with non-AP groups."
So it's important to note that even in this document where they don't
deal with naps, they talk about naps being important for learning and mood.
some adults are that way.
Yeah.
and there was a study that came out of UMass that was looking at
the predictor of when kids sort of give up naps, shorten naps.
And it actually had more to do with hippocampal maturity.
So the hippocampus is a region in their brain that's associated with memory.
So for kids where this matures more quickly, they seem to
give up naps more quickly.
Which kind of makes sense.
Then there's an article by Staton et all from 2020, which
is a review article on napping.
Here's what they said.
infants less than 12 months of age on average, napped 3.1 hours kids,
one to two years of age, 2.3 hours, two to three years, 1.9 hours, and
three to four years, 1.7 hours.
And I feel like those are good ballpark numbers.
there is a huge amount of variability here.
Right?
But, I don't think they're crazy numbers, right?
No, I wouldn't say that they're astronomical, but I would say I get
very nervous about anything written in stone when it comes to sleep
totals, because parents really glom onto those things and then they think
there's something wrong with their child if they're below that number.
rarely do they think something's wrong if their child is above that number,
but if they're, below, a certain number or they're lower on a scale, they tend
to get, there's a lot of anxiety there.
Sure.
I just think it's good to kinda like level set for where we'll be.
in this article they say, across these articles they referenced 94%
of kids stopped laughing by age five.
I actually think that's a little bit high.
we know for example, in children whose family identify as African
American have prevalence at age 5.
Hmm.
Most kids in kindergarten, it actually may be a metric of kindergarten readiness.
If you have a five-year-old who's needing a long nap in the afternoon
and you have the luxury of not sending them to kindergarten that year, they
might have an easier time the next year.
Yeah.
Then, here's a graphic from, Iglowstein et all.
And this is just a percentage of kids who nap during the
first seven years after birth.
And in these bars, they just have the black bars represent two or
more naps, the light bars are just kids who are napping, one nap.
and then after age four, a dark bar means napping every day.
And a light bar means napping occasionally.
So what we see on this graphic, for those of you who are listening,
is that age one month, everybody's taking more than one nap.
Interestingly, at age three months, that look like there were about.
I don't know, just eyeballing that's maybe 5% of kids who are just taking one nap,
Is it one nap or two naps?
Dark bars represent two or more naps and light bars represent one nap per day.
So I'd say these kids are outliers.
for me,
Oh yeah.
This is just what parents were describing.
So we don't know the circumstances here.
what we do see is a clear progression in this graphic, from
more than one nap to one nap.
it looked like most of the kids by one and a half years of age
were napping once a day by age
four, only about 10% of kids were napping every day.
And by age seven, nobody was ever napping.
and I know little babies take multiple naps and then they give up those
naps and they're gonna go from say, three naps to two nap, to one nap.
The hard part is predicting when that's gonna happen and we'll get into that.
would you agree that it's fair to say that that's a typical progression?
Yes.
I was just looking at this next.
Oh, so the Galland review article, so again, this is another, I believe this is,
this one definitely looks more realistic than that other one.
So this was a study of about 900 families
normal sleep pattern in infants.
So this is, uh, uh, the Galland study.
This is From 2012.
This is, um, a systematic review.
So that meant they, they aggregated a bunch of different studies.
They had 34 different studies that they included in this.
And this is, this is actually a fairly interesting study.
So here's what these authors found.
for nap duration, fewer studies reported For zero to five months of age, they
found that the average amount of napping in that age group was 3.1 hours
Yeah, it is a little, but that makes sense.
Daytime naps, zero to five months, 3.1, six to 11 months, 2.21 to two years, 1.2.
All infants.
Those all seem very correct as far as like number of daytime naps by age.
Okay.
So
in this review article, they were looking at nap duration, the mean
nap duration for children, 0.5 months of age with 3.1 hours per day.
The lower limit was 1.2 hours.
The upper limit was five hours for six to 11 months.
It was 2.2 hours with 0.9 is the lower limit.
3.5 is the upper limit.
One to two years of age was 1.2 hours a day with a lower limit
of 0.4, upper limit of 2.1.
they actually did scatter plots of the reported sleep duration and the number
of daytime naps by month actually has a very nice, I guess the technical term
we would have would be a line of fit.
So you can look at this data over time and it looks like what they found is
around two months of age, 3.5 per day was typical and over time, that drops
this graphic ends at 24 months of age.
When.
one nap is typical.
So it looks like this is a fairly linear progression, meaning
that it's somewhat predictable.
I think the challenge we have here is it's not like your child goes from
having 3.5 naps a day to three naps to 2.5 in a very clean incremental pattern.
They go from like four naps to three naps, to two naps, to one nap.
And those transitions are really tricky.
So again, we know that it's predictable giving up naps, but this
data doesn't tell us much for an individual parent sitting the exam
room or consulting with a Arielle.
When can we predict the nap's gonna go away?
So like this is kind of like the frustration here for parents and honestly
for providers as well, is we know that the sleep is gonna go down over time.
If somebody comes in and is like, my kids' naps are crappy.
Like, what do we do about it?
I am gonna be more of the sort of, the interlocutor here because this is more
the art of napping versus the science of it, which is a domain in which, Arielle
who unfortunately didn't have access to when my kids were horrible nappers.
Neither did I.
I thought we would, kind of go through this and start with some just general
questions about napping and then maybe get into some cases as well, I think
if a parent is struggling, they should seek help from, you know, check in
with your pediatrician, make sure that there's no medical problem going on.
working with somebody who's experienced in troubleshooting child
and infant sleep problems can be very helpful if you're struggling.
understanding a little bit how expert may solve these problems
can be very helpful I think.
absolutely.
So let's start, what is the relationship between napping and nighttime sleep?
So I think you just went over, a little bit of the sleep science and the point
of napping and the fact that napping serves a purpose for younger children.
And, there is that body of evidence right now that shows that once the, hippocampus
or whatever, is that what it's called?
Hippocampus,
Hippocampus is matured and memory sort of, matures, that napping.
So the sooner that happens, napping starts to go away.
So there are, there's real reason for naps.
As children grow, I don't want anybody to get caught up on the fact that their
child is a bad napper and think that because they're a bad napper, their
child isn't gonna be smart or won't have good memory or things like that.
when I go to solve a nap problem and I'm looking at naps versus nighttime
sleep, I have to look at 24 hours sleep.
And what is 24 hours sleep?
We go back to look at those American Academy of Sleep Science recommendations.
Right?
So you said for infants four months to 11 months, that's 12
to 16 hours in a 24 hour period.
Now a child that needs 12 hours of sleep is gonna have, much less daytime
sleep than a child that needs 16 hours of sleep in a 24 hour period.
But I have to look at each child individually and start to determine,
okay, What are their 24 hour sleep needs?
A lot of times when they come to me, we don't have a great handle on that
because things are so all over the place.
But sometimes if they do have data, we can see.
Okay, your six month old is napping for six hours during the day and
then only sleeping five hours overnight, six hours overnight.
we would hope that a child that age is sleeping somewhere
between 10 to 12 hours overnight.
Overnight sleep is the most restorative sleep a child can
get or a human can get, really.
So we wanna maximize that sleep.
So what I would do is say, okay, how are we gonna shift some of these
hours into the overnight hours?
but then it becomes a delicate dance because, you know, do we have a child
that's super sensitive to wake times?
Because as much as I hate wake windows, every child have a specific amount
of sleep that they need, but in turn, they also have an amount of awake
time that they need, to, in order to achieve whatever that 12 to 16 hours is.
So I have to look at nighttime and daytime and balance that appropriately.
so that's where I start basically.
But I will talk about, I think I put in here, some children are
just very sensitive to timing and when they're being put down.
And so I actually have a quote from a mom.
I got permission to use this This was when we first worked together.
So this was probably back in, I don't know, he was five or six months old.
So she says to me, she's actually a doctor.
and she says to me, 'cause she's looking at the data that we have and I have all my
clients log all their sleep naps nights.
we've noticed is if we push him a bit too far, he tends to take an
hour and five to an hour and 10 minute nap, then he will wake up.
He did that this morning for his first nap, but was able
to settle back pretty quickly.
Not sure if I'm over analyzing.
Sometimes when we push him way too far, then he does have like a 27 minute nap
and cannot get himself back down to sleep.
And that's when I think he's overtired 'cause we've pushed him too far.
So I think the biggest nuance for figuring out daytime sleep is how
do you balance awake time with sleep time and then, making sure that you're
prioritizing overnight sleep, but also, making sure that the child is well
rested throughout the day as well.
So let's talk concretely here.
Yeah.
Do you have a set amount or proportion in your mind for like, say a infant,
what's the minimum amount of sleep you think they should be getting at night
at night, minimum 10 hours.
And I will tell you anecdotally that
it's extremely rare for me not to achieve that.
it is extremely rare for me not to get to at least 10 hours
of overnight sleep for a baby.
So in the example where you've got, a six month old is taking five hours
a nap during the day, I assume, is that in two naps, three naps.
it really depends.
Sometimes it's, well, at six months he's taking 5, 5, 1 hour naps and
He's going to bed at 11 and he is waking up at five in the morning
and then taking five one hour naps
I think one of the really important points here is that babies
don't deprive themselves, right?
they're gonna get their whatever hours of sleep they need.
there are probably some neurological benefits to having longer sleep
periods at night for kids.
There are definitely neurological benefits to parents.
Um, and that part of the reason we do this is like, again, even kids that whose
parents are struggling, they still usually sleep the normal amount every 24 hours.
One of our goals is to get them to consolidate sleep
Yes.
I think we're helping the kids, but we're also helping the parents.
'cause if we help the parents, it also helps the kids.
Absolutely.
It's a family affair.
Yeah.
and I'll say that right now we're mostly talking about situations where
people have the luxury of moving things around, which is not always that case.
I think we'll talk later about things like childcare or kids who aren't the
first kid, where there are other kids in the house and it gets even harder.
But I think it's still more important for people.
Right now we're talking about if under optimal conditions, what do you do?
Yeah, and I would say under optimal conditions, when I go,
what is my goal for, let's say an infant, four to 12 months-ish.
My goals are at least two naps each nap, one hour each minimum, and then a
minimum of 10 hours of overnight sleep.
sorry, what age is that?
so that's a very wide range there.
So that's for an infant.
some even young infants don't like to take a third nap.
But let's say, you know, that's at the very minimum, I would say at that 12
hour mark, you know, 12 to 16 hours, two one hour naps and a 10 hour night.
it's usually not, it's very rare for me to see an infant that only needs
twelve hours, especially a young infant, although it's not unheard of.
it's, there's so many nuances to all of it, and I think that's why
it's frustrating to see so much nap advice out there because.
so many parents are like, I've done that.
I've tried that.
I've tried that schedule.
I've, you know, there's no way my child can sleep more than 30 minutes,
or, you know, whatever it may be.
And it's because it is so nuanced and it would just be nearly
impossible to help every single parent with their nap struggles,
Like in speaking in generalizations.
Yes.
No, I agree.
I'm curious when you're saying high need versus low need sleep babies,
do you have numbers in your head?
I would say a high need sleep baby is somewhere from like 14 and a half to
16 hours in a 24 hour period, and then lower is closer to like 12 to below 14.
Yeah.
And, I, in my world, my clinic is full of little kids who don't need a lot of sleep
and big kids who need a lot of sleep.
Like if you're thinking about the healthy kids that come in, right?
Like the kids that don't have neurodevelopmental disorders, whatever.
often I'll see like toddlers or preschools.
The parents are like, well, they nap.
They're up till like 10 o'clock at night.
I'm like, well, stop napping.
You know, they don't need the nap anymore even though they're two.
They can't always do it if it's a second kid or in the, they're in childcare.
Yeah.
Because they're like, oh yeah, people be like, oh, my neighbor's kid is
like taking three, two hour naps a day and sleeping 12 hours a night.
And I'm like, well, my 18 hours of sleep a day.
And that's highly unusual.
I also find that I feel like everybody is always doing so
much better than everybody else.
You know?
And also, I don't trust what other people are saying based on
the stuff that my clients say.
You always fixate on.
It's like, look, the cliche is the grass is always greener.
like in our world, the cliche is someone's kid is always
sleeping better than your kid.
Right?
Like, their child might be struggling with something else.
so let's talk about nap routines versus bedtime routines.
I don't see them as all that much different.
really it just needs to be a regular flow of steps that you go through
to prepare your child for bed, whether that be naps or bedtime.
Obviously I find that bedtime is usually longer in that there's
often, a bath involved or, more cuddling with mom or dad beforehand.
Whereas a nap is, not necessary to go through that big longer process.
but I think just having some sort of consistency with, okay, we're gonna
go change you, change your diaper, change into a sleep sack, read a book,
cuddle for a little bit, and then it's time for bed sort of situation.
It doesn't have to be overly complicated, just a predictable routine that a child
gets used to and gets to understand that what's coming at the end is sleep.
Sure.
Yeah.
And I think it's like, it can be shorter, right?
You know, you could do a story in a song,
Yes, Absolutely.
especially if you're doing this three times a day.
I will say though, that when I think about like toddlers in particular,
sometimes they need wind down time transitions can be difficult.
Some children really struggle with, okay, we're eating lunch
and now we're going for a nap.
It's like they need some time to, settle and get into bed.
So sometimes in those situations, if we have the luxury of controlling that,
we may extend that a little bit just so that there's some wind down time.
Absolutely.
Yeah.
I think children benefit from routines and if things are predictable.
Just like bedtime, you wouldn't have your kid going from bouncing on the trampoline
expecting to be sleeping in 16 minutes
exactly
that's true during the day as well.
Yes,
okay, now this is such a great question.
how to get longer naps.
Okay.
So I mean, if you're, we talk about daytime sleep and nighttime sleep.
I think it's important to understand that The same things are true for daytime
sleep, as they are for nighttime sleep.
If a child is struggling, you need to look at it all.
Are they falling asleep independently?
Are they on the right schedule?
I think those are the two most essential pieces to figuring
out how to get longer naps.
so just to be clear, part one, knowing how much sleep they actually need.
yeah, but they might not know that right away,
no.
but I still think it's fair.
Like, what are the things that you need?
First of all, you need to know how much sleep, your kid needs in 24 hours.
And that's like probably a minimum of three days of sleep diaries,
I would say three to five days is probably good.
and the second,
The second thing is that your child needs to know how to fall asleep independently.
I get a lot of people who.
their babies are, or their children are taking 30 minute naps.
A lot of times that's infants, like, they just cannot
consolidate their daytime sleep.
And I ask them to walk me through, okay, well how are
you putting your baby to sleep?
And it's like, I'm nursing him, he's falling asleep, and then, I'm putting him
in the crib and then he pops up 30 minutes later and he won't go back to sleep.
But if I pick him up and he starts nursing again, he falls asleep again.
You know, things like that.
So, helping a child understand or learn the skill of falling
asleep independently is really the linchpin to nighttime and daytime.
So if your child is dependent on anything to fall asleep, then it's, it's gonna
limit your ability to extend naps.
some children know how to sleep independently.
They're on a great schedule and they just don't like to nap.
they just aren't big nappers.
I think you have to set the bar low, and if you exceed that, then congratulations.
But I do think it is achievable to get more than a sleep cycle.
And a sleep cycle is typically anywhere from 30 to 45 minutes.
So I think anything beyond 45 minutes is great.
for some kids, for that one nap, it's enough.
so that, that's really the baseline that I'm at.
There were two studies of interventions for improving sleep in kids.
We usually, when we talk about formal sleep training, we've talked about
Cry it Out on an earlier podcast.
these real studies we're looking at infants from like
three to four weeks of age.
And there were parent interventions, to extend sleep,
and one is called the SAAF trial.
Another was, called the INSIGHT trial, and this was all sort of
common sense stuff, but I think it's worth enumerating the things that
these two protocols had in common.
So the first was avoiding feeding kids to sleep after a month of age,
which I think is very good advice.
It's great advice,
No, no,
different listeners.
but yeah, at least as a stated goal,
Absolutely.
It's a good goal.
the second was putting infant down for sleep, drowsy, but awake.
To me, that's four to six weeks is maybe when it's worth the earliest
you'd consider doing it, and it's more like, try it and see what happens.
Yeah, I mean, I think you can try that right away.
it doesn't hurt, but as soon as your newborn needs you, you
need to pick them up right away.
There's no like, put 'em down.
If they're crying, leave them.
It's like, try putting 'em down, see what happens.
They might be fine.
I've had clients that have babies like that, and they're astonished, so
And another was, only feeding at night if the infant actually seemed hungry.
not just fussy and sort of trying to soothe them a little bit
first, actually pausing before you go in the room for a moment.
for sure.
Taking a beat and then trying calming techniques.
Shushing, white noise, gentle touch before picking them up, changing their diaper.
Like your baby doesn't necessarily need to have their diaper changed.
And this is the way you're taught when you're in the hospital.
But you know, once you're like six or eight weeks of age, I don't
think they necessarily need a diaper change and feeding in the middle of
the night every time they wake up.
No.
So I think this is good stuff.
predictable bedtime routines, earlier bedtimes and, and I think this is
so important for napping, actually.
And I think Arielle, you taught me this, recognizing sleep cues, yawning
eye rubbing, or a fixed stare.
They said, put your baby down when they seem tired.
Mm.
and I think that you need a routine 'cause you need to know what to look for.
But the flip side is, I feel like one of the ways that we struggle with
my kids is we were trying too much to be on a schedule and sometimes
missing our windows for when our opportunity to put our kids down.
You're talking about the art of napping, and that's part of it right there.
what is your child showing you.
So I think it's useful to have like an idea of when your kid's gonna nap, but
my colleague Monica Ordway had this great thing, and this is more like for
older kids, like middle preschoolers, elementary school kids, the parents
were having these long, battles at bedtime and she's like, whenever your
kid starts to freak out, their bedtime is probably 20 minutes before that.
Yeah,
I think there is something to be said for that when your baby is, I don't like
the term overtired 'cause I actually don't know what that means medically.
But like, if your child is,
where they can self-soothe and then they get too dysregulated and then
they can't soothe themselves anymore.
mm-hmm.
Yeah, it's kind of like what that parent said where we push him a little too far
and we only get 27 minute naps, you know?
But I would say one thing that I caution parents about, when we talk about sleepy
cues after the newborn stage, it gets tricky because infants can seem, or
they can act tired if they're bored.
So if there's no stimulation going on, if they're just sitting there and there's
not like nothing going on, they can start to rub their eyes or seem tired and.
You know, it's only, they've only been a week for an hour.
You put them down, they sleep for 20 minutes 'cause they haven't
built enough sleep pressure.
So again, it's, it's such, this is why it's so hard.
Like, I think this is why people struggle so much because it's like,
just put 'em down when they seem tired.
No, just put 'em down at this time.
And with anybody that comes to me, it is such a balance.
It is such a nuanced balance for each child based on, so today, for instance,
I'm working with a, four and a half month old where I was just so confused,
which is rare, but I just was, something just felt off and it turned out well.
He was about to roll, so it was a big gross motor development
situation that was disrupting him.
But he hadn't slept independently, ever.
And, has been held for all naps and co-sleeping.
last night was night four.
It was an incredible night.
he woke once to feed, he did wake a little bit early this morning, but
I mean, he slept independently last night, which is just incredible.
So he did so well that I decided, let's try him for nap time today.
We did try nap time the day before, and it was a complete fail.
He cried and was unhappy for an hour.
But today he, I said, let's do it.
So we put him down, based on like when he woke up and what my witchy
magic was feeling in my head.
And he slept an hour and 45 minutes for his first nap.
But like for his second nap, they said, okay, so what time should
we put him down for the next nap?
And I was kind of had an idea in my head, but about 30 minutes before that time, I
wrote to them and I said, how's he doing?
Is he tired?
Is he okay?
And they said, well, I just fed him.
And he was starting to fall asleep while I was feeding him.
And then he was kind of rubbing his eyes and I was like, forget it.
Put him down in 10 minutes.
And they put him down in 10 minutes and there we go.
So he fell asleep in a few minutes.
so point being is like, it's such a balance between all of those things.
And it can be very, I think it's very challenging for a tired parent to decipher
all of the, like, to really put all those things together to determine.
The right timing and all of that.
And that's where I come in and then help you get to that place where you
feel confident and you understand
it's also gonna change.
Oh yeah.
It'll change soon.
I feel like the tempo of like in the first month, things are changing
every couple of days, right?
And then four to six weeks in maybe.
They're changing weekly and that rate of change slows down through childhood.
But it's just, you know, if you're really struggling parents, just wait a little
bit and it actually might get easier.
Absolutely.
so let's talk about sleep training can you sleep train for naps
or not nights or vice versa?
So yeah, that's a tricky one.
Yeah, I'd say, first of all, it's you shoot for the whole thing.
Yeah.
I think the thing that we need to come back to is the idea of consistency
and your baby knows when it's late and it's dark and their bodies get
used to a circadian rhythm, but they don't understand why sometimes you're
holding them and sometimes you're not.
Sometimes you're feeding them to sleep and sometimes you're just
putting them down in the crib.
I would say for some younger infants, even this baby I'm working with, right?
four and a half months, I said, let's just start with nighttime
and let's see how he does.
And then, like I said, the first day he did not do well with naps, so we
continued to support them, but he did so well last night that I felt
like I really don't wanna confuse the situation and set us back at night.
So let's try at least that first.
But like, the goal is let's get them sleeping independently for all sleep so
that they get it and they're not confused.
Like sometimes you pick me up, sometimes you don't.
and they're able to, be consistent for you because you're being consistent for them.
Well, if you think about this in behavioral terms, it's like intermittent
positive reinforcement, right?
you cry and fuss and every time you do it, you get a reward.
It's actually not as powerful as sometimes getting a reward.
So I think, again, it's not that it's always all about crying or screaming,
but parental consistency is so powerful in helping children form new
patterns, even really little kids.
yeah.
I had someone who really wanted to support naps and sleep train overnight
Our relationship didn't work out because it was just so clear that the, I mean,
this was an older baby, it was like a 10 month old, and it just, it was very
confusing to the child and therefore it made things a lot less consistent.
And, you know, it's a parent's choice.
Whatever they feel comfortable with, it's fine.
But, you know, if you want consistency, I always say if you
want consistency from your child, you need to give them consistency too.
well I also feel like every time you put your kid down, you have an opportunity
to put in place the pattern you want.
Absolutely.
So it's much more powerful to do your intervention saying a kid that's
napping three times a day, you could get in four reps a day instead of one.
Yeah.
When should my baby, and I guess we could say, kid, take a nap.
'cause I think this is, it is important, like recognizing this is a balance
between recognizing sleep cues, right?
Your kid really looks tired, you probably should put them down.
But also having some idea of like, well, around when would
you expect them to go to sleep?
A period during which your child should sleep.
I do think there's something to be said for knowing approximately when
your kid will be due for an nap.
Yeah.
So I'm gonna put this in such general terms.
I would say babies under six months, starting a nap anywhere between
eight and nine in the morning.
Eight is like very, very early.
I wouldn't stay there long unless your baby's like really
young and maybe on four naps.
'cause you can get into a problem where your naps are starting so early that
you're finishing your third nap by, you know, two 30 in the afternoon and then
your baby's not gonna stay awake for another five hours before it's bedtime.
So if your baby may be on four naps at that point, I would say a baby
on three naps, you really wanna be closer to 9:00 AM nine ish.
So that could be eight 30 and then that could be, depending
on, they can get older, like 10.
As they get older, they need more time to be awake.
So anywhere from 10 probably would be that morning nap for
like an infant over six months.
And then the afternoon is usually somewhere, for a
younger infant around 12, 12 30.
And then those can actually start.
To push out later as they get older.
So it can be anywhere from one to two and then as they're about to
transition to one nap, it can often be like two to three at the very latest,
but that's like at the very latest and capping it at an hour or so.
I would say there needs to be like a mid-morning nap between nine and 10 and
a mid-afternoon nap between one and two.
If you have a third nap somewhere happening between, I don't know,
three to 4:30, but finishing naps by a certain time is kind of important,
otherwise you kind of get into this zone of pushing into bedtime.
so like ending naps for younger infants by five and then sometimes
as they're getting older, ending them by four in order to get them down by
eight-ish is important because otherwise you're pushing bedtime way out.
Depending on how old they are.
So rarely do I see an eight or nine month old on three naps.
I rarely see the two to one transition before 12 months or later than 16 months.
Yeah.
And because, you know, in the medical literature, these are huge ranges, like
six to 15 months going down to, two naps.
But again, that's true, but most kids are gonna fall in the middle.
Okay.
how do I get my newborn on a good nap schedule or lengthen their naps?
I mean, if someone hires me for the newborn stage, I give
them no false information, and therefore I tell them that.
extending a newborn nap, your baby's either gonna do it or they're not.
it's totally normal to have a 20 minute nap or a two hour nap, but
extending a newborn's nap is kind of like trying to sleep, train a newborn,
and you can't sleep, train a newborn.
Their sleep is erratic.
Now you can, as we were talking about, you can practice, a couple of things.
You can practice trying to put them down, awake, at an early age and see
how they do if they're just kind of fussing, give them a little space and
see if they're not like screaming at the top of their lungs and they're just
kind of like kicking around or whatever.
You can sort of observe and see what they're doing.
If they get a little more fussy, you can try crib side soothing.
So, you know, going over and rubbing their belly or even picking them up.
Soothing and putting back down.
For some babies, that's gonna work.
And for others it's just not gonna work.
I don't try to give any sort of, false notion that you can extend a newborn's nap
or train them to be on a specific schedule because it goes against biology really.
I wanna take a quick sidebar on contact napping here too.
'cause this is.
Not something that's, you know, so there's, there's kangaroo
care that's skin to skin.
That's like when your baby is born, they put the baby on your chest to
try to, you know, help with bonding and also help with, milk supply.
And then there's contact napping, which as I understand it, is a
less well-defined term, but it's like holding your baby to sleep.
Right.
Yeah.
And I think that contact napping is one of those things where I, because
I've seen on Reddit and stuff, parents saying, oh, my kid can only contact nap.
And I'm like, well, it's 'cause it's the only way you've
offered to have them nap, right?
Like, and there's a safety concern for small infants here too.
And the risk is if you yourself are tired.
Falling asleep while holding your baby is one of the riskiest things from a
suffocation or entrapment standpoint.
So if it's like eight or nine in the morning and you've had a
cup of coffee, that's one thing.
But if you are like really sleep deprived and you're regularly holding your
baby for an entire nap, I really worry about these babies getting injured.
I think that we need to be real about that, especially in that newborn stage.
but yes, I think it's really important to educate around it as well.
if you're too tired, I mean it would almost be better for you to put
the baby in the bassinet and just have your hand in the bassinet.
You know what I'm saying?
Like just to soothe that way versus holding upright
Well, you know, there's also this period of purple crying,
Yep,
And it's this idea that there's this whole like dogma in pediatrics that
crying increases over time in the first four to six weeks and then falls off.
And this isn't really well understood.
It's attributed to the maturation of neurological and GI systems.
and it does seem like this particular flavor of crying, this
fussing of like a four week old,
Hmm.
what parents do does not influence how much kids cry.
Correct.
So I think that there's this desperation sometimes if your baby is crying and
some babies cry quite a a lot . I, I, you know, I'm just looking at, this
graphic I have here, which I'll throw in.
And it was like, kids are on four weeks of age, crying age, 150 minutes a day.
Oh, yes.
it's important for parents to recognize you could be holding
your baby or not holding your baby.
Sometimes they're just going to cry.
Yeah.
And I'm not talking about sleep training here.
I am just talking about the reality of having a neurologically
immature little baby.
and you are so desperate to stop them crying if you are holding
them to try to soothe them.
And you're so exhausted, you're gonna fall asleep holding them.
Or you are like losing it.
It is okay to put your dae down and go walk, go in the other
Yes.
put them in a safe place, put them flat in their back in case they do fall asleep.
You are not doing harm to your other child.
They're gonna cry that much regardless of what you do.
Yeah.
And I have seen so much stuff online directed at me and other people who talk
about things like sleep training, about how it is child abuse to let your kid cry.
I think it's actually this whole narrative about you can't let your
kid cry is actually dangerous.
And you know, it's okay for babies to cry sometimes.
Well, it's part of development,
they do.
it's not, something that can be controlled.
Thanks so much for listening to the Sleep edit.
You can find transcripts at the web address Sleeped show.
You can also find video of the episodes at that address as
well as in my YouTube channel.
You can find me at Dr. Craig canna perry.com and on all social
media at D-R-C-A-N-A-P-A-R-I.
You can find Ariel at Instagram at Ariel Greenleaf.
That's A-R-I-E-L-L-E-G-R-E-E-N-L.
If you like the flavor of the advice here.
Please check out my book.
It's Never Too Late to Sleep.
Train the Low Stress Way to high Quality Sleep for babies, kids, and parents.
It's available wherever fine books are sold.
If you found this useful, please subscribe at Spotify or Apple Podcast
and share it with your friends.
It really helps as we're trying to get the show off the ground.
Thanks.
So this is part one of our napping spectacular.
in part two we have cases, which Arielle has brought, which look great.
We are gonna talk about transitioning from three to two naps, two to one nap,
and one the dreaded one to zero nap.
and we're also gonna talk about some of the milestones, like how do you
know when these transitions occur?
how do you know when your kid's ready to give up the nap?
And also finally, strategies for napping around childcare and around older kids'
schedules, which are really complicated.
So we're gonna put a pin in it here, and we will be back hopefully in a
shorter interval than usual for part two.
Part two of the Napping Extravaganza.
Spectacular.
So, where can we find us?
You can find us at the Sleep Edit podcast@gmail.com.
Yeah, send us an email.
thanks for listening.
Take care.