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Solve Your Child's Sleep Problems: New, Revised, and Expanded Edition, by Richard Ferber
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The completely revised and updated edition of the all-time bestselling book on children’s sleep problems, with important new insights and solutions from Dr. Richard Ferber, the nation’s leading authority on children’s sleep problems.
Does your child have difficulty falling asleep? Wake in the middle of the night? Suffer sleep terrors, sleepwalking, or nighttime fears? Have difficulty waking for school or staying awake in class? Snore, wet the bed, or head bang?
In the first major revision of his bestselling, groundbreaking classic since it was published, Dr. Richard Ferber, the nation’s foremost authority on children’s sleep problems, delivers safe, sound ideas for helping your child fall and stay asleep at night and perform well during the day.
Incorporating new research, Dr. Ferber provides important basic information that all parents should know regarding the nature of sleep and the development of normal sleep and body rhythms throughout childhood. He discusses the causes of most sleep problems from birth to adolescence and recommends an array of proven solutions for each so that parents can choose the strategy that works best for them. Topics covered in detail include: Bedtime difficulties and nighttime wakings, effective strategies for naps, sleep schedule abnormalities, a balanced look at co-sleeping, new insights into the nature of sleep terrors and sleepwalking, problems in setting limits, and sleep apnea, narcolepsy, bed-wetting, and head banging.
Solve Your Child’s Sleep Problems offers priceless advice and concrete help for a whole new generation of anxious, frustrated, and overtired parents.
- Sales Rank: #4550 in Books
- Published on: 2006-05-23
- Released on: 2006-05-23
- Original language: English
- Number of items: 1
- Dimensions: 8.44" h x 1.10" w x 5.50" l, .95 pounds
- Binding: Paperback
- 464 pages
Review
"Booklist" A practical, informative and sensitive guide.
"Kirkus Reviews" Those wrestling with a persistent or more serious problem will find this a real boon.
T. Berry Brazelton, M.D. author of "Doctor and Child" Dr. Ferber is remarkably clear about a complex and common problem....Most parents will be able to use this book as a guide in helping them sort out theirs from the child's needs and will be able to follow his clear, practical directions to the relief of sleeping through the night.
"Publishers Weekly" Ferber is sound, sane and reassuring....Parents of the sleepless should have this one on the shelf for its facts and solid suggestions that work.
"Kirkus Reviews" Welcome news for exhausted parents.
About the Author
Richard Ferber, M.D., is an associate professor of neurology at the Harvard Medical School and director of the Center for Pediatric Sleep Disorders at Children's Hospital Boston. He lives in Newtonville, Massachusetts.
Excerpt. © Reprinted by permission. All rights reserved.
Chapter 1: At the End of Your Rope
The most frequent calls I receive at the Center for Pediatric Sleep Disorders at Children's Hospital Boston are from parents whose children are sleeping poorly. When the parent on the phone begins by saying "I am at the end of my rope" or "We are at our wits' end," I can almost always predict what will be said next.
Typically, the couple or single parent has a young child (often their first) who is between five months and four years old. The child does not fall asleep readily at night or wakes repeatedly during the night, or both. The parents are tired, frustrated, and often angry. Their own relationship has become tense, and they are wondering whether there is something inherently wrong with their child and whether they are unfit parents.
In most cases the parents have had lots of advice from friends, relatives, and even their pediatrician on how to handle the situation. "Let him cry; you're just spoiling him," they are told, or "That's just a phase; wait until she outgrows it." They don't want to wait, but they are beginning to wonder if they will have to, since despite all their efforts and strategies the sleep problem persists. Often, the more the parents do to try and solve the problem, the worse it gets. Sooner or later they ask themselves, "How long do I let my child cry -- all night?" And if the child gets up four, five, or six times a night, "Will this phase pass before we collapse from exhaustion?"
Everything seems pretty hopeless at first. If your child isn't sleeping well or has other problems that worry and frustrate you -- such as sleep terrors, bedwetting, nightmares, or loud snoring -- it won't take long for you to feel as if you're at the end of your rope, too.
Let me assure you that there is hope. With almost all of these children, we are able at least to reduce the sleep disturbance significantly, and usually we can eliminate the problem entirely. The information in this book will help you identify the type and cause of your child's particular disturbance, and it will give you a variety of practical ways of solving the problem.
When a family visits the Sleep Center, I meet with the parents and child together and learn all I can about the child's problem. How often does it arise, and how long has it lasted? What are the episodes like? How do the parents handle the child at bedtime and during the nighttime wakings? Is there a family history of sleep problems, and are there social factors that might be contributing to the problem? Given this detailed history, a physical examination, and, in certain cases, laboratory study, it is usually possible to identify the disorder and its causes. At that point I can begin to work with the family to help them solve their child's sleep problem.
At the Sleep Center, our methods of treatment for the "sleepless child" rarely include medication. Instead, I work with the family to set up new schedules, routines, and ways of handling their child. Often the child's biological rhythms may need normalizing, or at least his sleep-wake schedule may need to be changed. He may have to learn to associate new conditions with falling asleep or get used to fewer and smaller nighttime feedings. The family may have to learn how to set appropriate limits on the child's behavior, and the child may need an incentive to cooperate. And any anxiety in the child (or parent) must be taken into account. I always negotiate the specifics of the plan with the family. It is important that they agree with the approach and feel confident that they will be able to follow through consistently. As much as possible, I offer choices. The best solution frequently differs considerably from family to family, and from one culture or social group to another. If the child is old enough, we include him in the negotiations. Thus we use a consistent and firm but fair technique tailored to the particular sleep problem and to the needs and desires of the child and family.
Sleep problems are rarely the result of poor parenting. Nor (with a few exceptions) are they part of a "normal phase" that must be waited (and waited, and waited) out. Finally, there is usually nothing physically or mentally wrong with the child himself. Most parents are immensely reassured to know that sleep problems are common in all types of families and social environments, and that most children with such problems respond well to treatment.
In certain cases, such as in sleep apnea or, less often, in bedwetting, medical factors may be involved, and our intervention may include medication or surgery. Emotional factors may play a role in other instances, such as in the sleepiness of depression, recurrent nightmares in an anxious child, sleep terrors in the adolescent, and extreme nighttime fears. Here it is important to identify the source of these feelings and deal with them satisfactorily so the sleep problems can resolve. Sometimes professional counseling is recommended.
How well your child sleeps from the early months affects not only his behavior during the day but also your feelings about him. I have often heard parents say, "He is such a good baby. We even have to wake him for feedings." Although the parents are really just commenting on the baby's ability to sleep, they may start thinking that their baby is "good" in the moral sense.
It is easy to see how this distinction can influence the way you relate to your child. If your child does not sleep well, he may well be making your life miserable. It isn't hard to think of such a child as a "bad" baby. You will probably feel enormously frustrated, helpless, worried, and angry if you have to listen to crying every night, get up repeatedly, and lose a great deal of your own much-needed sleep. If your child's sleep disturbance is severe enough, your frustration and fatigue will carry over into your daytime activities, and you are bound to feel increasingly tense with your child, spouse, family, and friends. If this is the case in your home, you will be pleased to learn that your child is almost certainly capable of sleeping much better than he is now, letting you get a good night's sleep yourself. To make that happen, you need to learn how to identify your child's problem; then you can begin to solve it.
The case studies in this book are based on my experience at the Sleep Center. The discussions of these cases, along with descriptions of the underlying sleep disorders and explanations of the methods of solving them, will help you identify, understand, and deal with your own child's sleep problem.
CAN A CHILD JUST BE A "POOR SLEEPER"?
Parents often believe that if their child is a restless sleeper or can't seem to settle down at night, it's because he is by nature a poor sleeper or doesn't need as much sleep as other children of the same age. These beliefs are almost never true. Virtually all children without major medical or neurological disorders have the ability to sleep well. They can go to bed at an appropriate time, fall asleep within minutes, and stay asleep until a reasonable hour in the morning. And while it is normal for a child (or an adult) to wake briefly a few times during the night, these arousals should last only a few seconds or minutes and the child should go back to sleep easily on his own.
In fact, the mistaken belief that your child is unable to sleep normally can have a strong influence on how his sleep pattern develops from the day you bring him home from the hospital. I have seen many parents who were told by the nurse in the maternity ward, "Your baby hardly sleeps at all. You're in for trouble!" Because parents like these are led to believe their child is a poor sleeper and there isn't anything they can do about it, they allow him to develop poor sleep habits; they don't think it is possible for him to develop good ones. As a result, the whole family suffers terribly. Yet almost all of these children are potentially fine sleepers, and with just a little intervention they can learn to sleep well.
It is true that children differ in their ability to sleep. Some children are excellent sleepers from birth. In the early weeks they may have to be wakened for feedings. As they grow older, not only do they continue to sleep well, but it becomes difficult to wake them even if one tries. They sleep soundly at night in a variety of situations: bright or dark, quiet or noisy, calm or chaotic. They can tolerate an occasional disruption of their sleep schedules, and they sleep well even during periods of emotional stress.
Other children seem inherently more susceptible to having their sleep patterns disrupted. Any change in bedtime routines -- an illness, a hospitalization, or the presence of houseguests -- can cause their sleep patterns to worsen. Even when these children have always been considered "non-sleepers," we usually find that they, too, can sleep quite satisfactorily once we have made appropriate changes in their routines, schedules, surroundings, or interactions within the family. Such children may still have occasional nights of poor sleep, but if the new routines are followed consistently, normal patterns will return quickly.
There are, of course, children who sleep very poorly for reasons we have as yet been unable to identify; however, these problems are extremely uncommon and account for only a tiny percentage of the children we see with difficulty sleeping. For these few, our usual behavioral treatments may help very little or not at all, and medication may even be required. If your child is up a great deal in the night, it may be tempting to assume that he is one of these genuinely poor sleepers. But that is almost certainly not the case. Such instances of truly poor sleep ability are quite rare among otherwise normal young children. In all probability your child's sleep problem can be solved. He almost certainly has a normal inherent ability to fall asleep and remain asleep. This is true even if he has a sleep disturbance such as sleepwalking or bedwetting. Thes...
Most helpful customer reviews
41 of 42 people found the following review helpful.
Works amazingly with a few key factors to consider
By CAB
First of all: Ferber is not a monster who lets babies cry themselves to sleep. If you give this book a chance you will see that. Since being born and after 12 months of dealing with our baby waking up every 1 to 2 hours and not knowing how to fall back asleep on their own, we tried the techniques in this book and saw results from the very first night to the tune of our baby sleeping for 10 hours straight for the first time since he was born! And the results just kept getting better and the crying almost completely went away. For those on the fence about Ferber, there are however several keys to successfully implementing his techniques. The first and most important is both husband and wife need to be on board for keeping discipline to practice the techniques in the book. If one or the other can't take baby crying as they adjust to new sleeping conditions that do not require help from Mom or Dad, this book won't be of any help and will be the source of heated arguments putting unnecessary pressure on your marriage. The second key is consistency. If you do this for a few weeks and think your baby's sleep troubles are solved, it's likely your baby will regress back to the "easier" conditions that baby formerly preferred to sleep under (i.e. conditions where someone needs to wake up whenever baby wakes up to satisfy whatever condition(s) baby has been trained to think they need to fall back asleep). This will lead to no one in the house being happy. The final key which combines both the above keys is maintaining the same schedule every day to the best of everyone's ability. It's easy to fall out any routine, but if you slip on baby's routine, this will directly affect their ability to sleep. I'm sorry to say while my wife and I maintained discipline for the first 3 weeks on this book and our baby was sleeping through the night for 9 to 10 hours without our help, after 3 weeks my wife who had been struggling with how quickly our baby showed he did not need anyone's help reverted to going in at the sound of any whimper and after 3 or 4 days of this she's back to sleeping on the floor every night with our baby who again is waking up every hour or two and needing her to cuddle him back to sleep. While this is the exact type of sleeping arrangement I thought we were trying to avoid, this is proof to me that while the techniques in this book work, if both Mom & Dad are not on board your baby will revert back to whatever conditions they formerly fell asleep under and you'll have to start all over again. I hope my advice can be of help to others. Good luck!
15 of 15 people found the following review helpful.
Only Falls Asleep While Breastfeeding (6 Month Old)
By Lou
***3 MONTH UPDATE***
We are CONSISTENTLY SLEEPING THROUGH THE NIGHT!!! My baby is almost 9 months old now and we started this at 6 months. We went at our own pace and started with *just naps* as my pediatrician suggested. I continued to go nurse her at night if she cried (at first) - until I realized that just wasn't going to work. At her age, she absolutely doesn't need the night time feedings - so - we let her cry at night too.
It was rough for about a week. She would wake and cry for an hour in the middle of the night. So we still weren't sleeping great at first, but now, she sleeps from about 8pm - 6am every night - straight through - no crying (but she still *does* cry when we put her in the crib). She also still screams when I put her down for a nap. But end result: she naps in the day and sleeps at night. I hate it, but crying has been the ONLY solution for her.
She is also napping MUCH more consistently - and for longer amounts of time. Finally! Crying it out was so worth it. I can finally enjoy motherhood now. And my baby is getting the sleep she needs. Side note - my baby had eczema from almost head to toe. That was a nightmare. I am convinced that the eczema was a big factor for her not sleeping well. That's a whole other story, but - I used Tubby Todd ointment (along with prescription hydrocortisone) just in case you were curious. I slathered every ointment on her that you could think of.
Main point: when you are ready to face your fear of letting your baby cry --- GO FOR IT! We are all much happier now!
----------------------
I have never felt so physically, emotionally, mentally DRAINED in my life - so in my desperation, I bought this book.
After two weeks:
Two weeks into this, my 6 month old daughter has slept through the night a handful of times, but still tends to wake one time most nights. This is a HUGE improvement compared to being up 5+ times a night (or more)! I was desperate when I tried this and wasn't sure if I should let me baby cry, but I am glad I went for it. I am still reading the book - haven't had tons of free time to read ; ) I am very glad I used the Ferber Method.
More details:
My daughter REFUSES to take a bottle and - until using this method - would ONLY sleep if I nursed her to sleep and then snuck her into her crib ever so carefully. ALSO - the slightest thing would wake her up and.... she would cry for me to nurse her back to sleep. Again. And again. She was feeding so much at night that it was stimulating her metabolism and juuust as I had nursed her to sleep - she would poop! I would have to change her diaper (which woke her right up) - and we would start the WHOLE PROCESS OVER - nursing to sleep again. Lack of sleep brings out the worst in me and I was so on edge every single day. I am feeling much more like myself now and much more rested.
Hesitations on crying:
To make matters worse, I had not felt confident about letting her cry because she always had some issue going on (reflux, eczema, congestion, teething). If it wasn't one thing, it was another and it felt cruel to let her cry. Against my instincts, I let her cry a *little* at two months (because a friend told me I should) and she was sooo not ready. Should have listened to my gut - that was way too early. Then, at 4 months she suddenly refused to be nursed to sleep one night, so we suddenly tried to let her cry (without any preparation) and she cried for TWO HOURS. Insane and traumatic for us all. I felt so terrible. Again, she just wasn't ready/old enough/whatever - and we had absolutely no strategy. Then when we hit six months - it was time! I couldn't carry the burden anymore. She wasn't napping. She had bags under her eyes. I was falling apart myself. I debated about whether to buy this book versus a "no tears" book. My baby is so strong willed. I ultimately decided she was just going to have to cry a little.
How much crying?
There was actually less crying than I expected! Hallelujah! Most of the crying we deal with is during nap time. For naps, the book tells you not to let your child keep crying once you hit 30 minutes. We have unfortunately hit the 30 minute mark here a few times and she goes without a nap. Naps are harder, but still - she is napping much more consistently now. At night, my baby is quite tired and she has only cried about 15 minutes at the most. Most nights she still cries 5 - 10 minutes, however, some nights she is just too tired to cry and goes right to sleep. It is worth the tears! I feel such a weight lifted off of me.
This book gave me the confidence to let my baby cry and learn to sleep on her own. It went into detail on her specific issues (hers was a combination of sleep association and feeding issues). I feel like I have a much better understanding of how to handle my baby's sleep - and I will hopefully understand more when I finish the book. I skimmed through to the most critical information because - when you are sleep deprived and caring for a baby - you don't have time to read an entire book!
8 of 8 people found the following review helpful.
after expecting the worst, it really wasn't that bad
By KB
I have never reviewed anything on Amazon before, but my experience with this book combined with the controversy surrounding the book made me feel obligated to share my experience.
I was all about attachment parenting and never ever thought I would let my child cry it out. At 3 months, my little man would sleep through the night for a week at a time, and then spend a week getting up to eat once. This was totally manageable for me. At 5 months, though, things began to go downhill. He started waking up 2-3 times a night, and getting him to bed in the evening had become something I dreaded. He would only fall asleep while nursing and being rocked. Moving him into the crib had become a strategic minefield of squeaky floorboards, etc. I had become a walking zombie and started making mistakes at work because I was so very tired all the time.
When my son was 8 months old, I heard about the Ferber book from a friend with twins who also had reached her wit's end. And I have to say, after expecting the worst, it really wasn't that bad. The first night was no picnic--he cried off and on for about an hour in the middle of the night with me checking in periodically--but the second night he only cried for 12 minutes when I put him in the crib and then slept through the night! He would wake up in the middle of the night periodically and cry a few times for the rest of that week, but he always got himself back to sleep within 10 minutes. It has now been a month and he has been sleeping solidly through the night. I still nurse him to sleep in the evenings but then I wake him up enough so that he knows he is going into his crib--no more sneaking out of his room! Sometimes he fusses once he goes into his crib but only for a minute or two. Our entire house is now well rested and happy. My relationship with my husband, which was strained to say the least after so many sleepless nights, is so much better now.
I can honestly say that, though the first few nights were rough, this method worked quickly and overall involved significantly less crying than had we just continued doing what we were doing and letting the baby get up multiple times every night. You need sleep. Your child needs sleep. He just needs to learn how to go back to sleep on his own when he wakes up periodically in the night. This book helped my child do just that. I can't say that it's for everybody, but it was a lifesaver for me. Stick with it through the first few days and there will be light at the end of the tunnel.
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