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Positive relationships: Ask the expert ... Good night?

Who or what should determine how much sleep an infant has? Dr Maria Robinson considers a sensitive point in practitioners dealing with parents.

I found out that one of our eight-month-old babies had been taken to a dinner party and was really late home. He was exhausted. The parents feel that the baby "needs to" get used to being with other people. I am in a dilemma, as I cannot undermine the parents and need to work with them, but this type of situation worries me!'

There are two issues in this query - the baby being exhausted through disrupted sleep, and the parents' wish that the baby 'needs to' get used to other people.

First, we need to consider the importance of peaceful sleep for babies - indeed, for all of us! - and the impact of disrupted sleep on the baby. Second, why are the parents anxious about the baby's sociability? Ascertain whether the dinner party was a one-off or a regular social occurrence.

Necessity of sleep

We all need to sleep. Although the reason for sleep itself remains a mystery, it appears vital for the functioning of all living things and as necessary for survival as food and water. It is said to be the 'primary activity of the brain during early development', and at the age of two years, we will have spent more time asleep than awake.

The National Sleep Foundation (USA) states that sleep is especially important for children, as it directly impacts on 'mental and physical development'. Our bodies are governed by the 'sleep/wake' cycle, which is influenced by light and darkness. This rhythm takes time to develop, which is why very young babies have such irregular sleep patterns, but by around three to six months a more regular pattern is emerging.

There are two alternating types of sleep: rapid eye movement (REM) and non rapid eye movement (NREM). Sleep research indicates that it is not just getting the right amount of sleep that is important, but also getting the 'right mix' of REM and NREM sleep, which includes shallow(1) and deep sleep. In normal sleep patterns, these 'mixes' alternate in regular cycles. This is why, if we awaken in the night, the way we respond may depend on which point in this cycle we have woken up. If woken in deep sleep, some children can suffer 'night terrors', bedwetting or sleepwalking.

Sleep influences a wide range of psychological and physical well-being. During sleep, there seems to be greater activity in the production of proteins, which are the essential building blocks for development. Disrupted or poor sleep appears to negatively affect memory, attention, motor control and emotions. Growth hormone is secreted during sleep and the sleep cycle affects the secretion of hormones influencing appetite and weight. It is also suggested that sleep, or lack of it, influences our immune systems.

In this particular case, it may be crucial to explore with the parents what they understand about their child's need for sleep, find out whether they have a regular routine in order to help positive sleeping patterns and also support them in considering how developmental changes may influence the amount of support the child may need. For example, at eight months there are enormous shifts in skills and abilities, coupled with a surge in brain activity overall. This means there might be disruptions in the baby's previous sleep patterns, and so more soothing, quiet and gentle routines could be needed.

A need to socialise?

Is there a concern about the baby being 'sociable' and able to relate to people generally? For example, the parents may have noticed that their previously cheerful baby appeared to be more distressed in company, but may not realise this is 'normal' at this age. Children often develop 'stranger anxiety' around eight months old. What may be supportive to the parents is to help them understand this normal phase and explain that their baby needs reassurance, comfort and calming responses to their anxieties. It may be helpful to sensitively suggest that during this phase, taking baby to a dinner party where several unfamiliar people may be present could be too much sensory input for their immature brain!

It might also be useful to consider with parents how far they have thought about their baby's own personality and whether it reflects either parent's style of relating to others.

Sometimes even the most loving and caring of parents can forget that their baby has its own personality, likes and dislikes, which also need to be respected. The needs of babies change according to their mood and circumstance and vary according to their phase of development. The eight- month phase, when the concepts of object permanence are firming up, also links with stranger anxiety and 'feeds in' to the need for the baby to learn the constancy of their adult carers as well as actual physical objects. It is the time when attachment formation to their parents is also becoming firmly established.

It may be helpful for parents to realise that everyday circumstances such as going to the shops, a walk in the park or visiting a playgroup are all valid ways of 'socialising' without putting the baby's immature emotional and sensory systems under too much pressure. All these can be done at varying degrees. An outgoing baby will enjoy more company, another less. It seems obvious, but it does depend on the adults being able to think about the baby's actual needs rather than what they feel they want for the baby.

Another reason these parents may want their child to get used to being with other people is that they are thinking about daycare. Again, it would be necessary to get to the root of their anxiety. The parents need support in thinking about what might be best for their child and what kind of person their child would find easiest to relate to and the type of context they would prefer - rather than the onus of adjusting being on the child.

Babies are vulnerable to the needs, attitudes, beliefs and ideals of their parents. Because of this vulnerability, it is the responsibility of all of us to help parents to see the world through the eyes of their child.

Maria Robinson is an early years consultant and author of From Birth to One and Child Development from Birth to Eight: A journey through the early years (Open University Press). Her Nursery World series on child development can be bought online at: www.nurseryworld.co.uk/Books

REFERENCES

- Graves, L, Pack, A, Abel, T, (2001) 'Sleep and memory: a molecular perspective', in Trends in Neurosciences, vol 24, no.4, April

- Hobson, JA, (2002) Dreaming. Oxford University Press

- Minard, KL, Freudigman, K, Thoman, EB, (1999) 'Sleep rhythmicity in infants: index of stress or maturation' in Behavioural Processes 47, 189-203

- Robinson, M (2008) Child Development from Birth to Eight: A journey through the early years. Buckingham: Open University Press

- Robinson, M, (2003) From Birth to One. Buckingham, Open University Press

- Sunderland, M, (2006) The Science of Parenting. London: Dorling Kindersley

- (1) Shallow sleep is when we feel drowsy and also when we can experience those rather horrible jerky muscle movements that can also follow feelings of falling.