Although the last year or so, may be considered a sick season all of its own, I think due to the lockdown and limited social interaction and most certainly the closure of day care and baby groups, I noticed in my practise a distinct lack of common illnesses that normally derail sleep efforts. Now however, as we are learning to live through these Covid-19 times, we are back into day-care settings with more social exposure and although we are and will continue to practise social distancing, safe hygiene and etiquette, we are also heading into typical sick season and already I am seeing children with colds, coughs, virus and infections – that have an immediate impact on many children’s sleep.
So, I think that there are certain categories – children who are routinely sleeping well and that good sleep is unaffected by sickness – and of course children who sleep well, but there sleep is immediately impacted when they start to feel well. Of course, I am well aware that there is another cohort of children who don’t sleep well sickness or otherwise and in this category it is hard to see the wood for the trees- I would encourage, in this instance, a sleep learning exercise to help improve sleep tendency and then you will routinely experience sleep disturbance when there is sickness/teething/developmental leap brewing, rather than all of the time. For more information on this approach, do see my online courses or books to help you to create a plan to grow your child’s sleep,
For the child who’s sleep is affected by sickness and indeed teething, I will help you to develop a response plan to respectfully support your child when they don’t feel great and to also avoid creating tendencies during this period that mean the sleep challenges remain, long after the sick or teething period has passed.
In some cases the deterioration of your sleep is possibly the first symptom of sickness or teething brewing- it is not unusual for parents to report a sudden change in the sleeping pattern such as early waking, short naps, sleep resistance and uncharacteristic night wakes. This is normally a sure sign if nothing else has changed; something is undermining your child’s sleep.
It is helpful to avoid making adjustments despite the change- retain your typical bedtime and nap times and avoid having any knee jerks reactions that may involve making bedtime later or thinking that a nap transition is a-foot. If you feel your child would benefit from it- I will always encourage an earlier bed and nap time, but I definitely won’t go the other way. If your routinely decent sleeper starts waking and sleeping less, their overtired tank can quickly fill, so adjusting forward sleep times, can help, but adjusting sleep times later, will typically make things harder, due to increased overtiredness.
Again, as above if they seem very sleepy, I may allow for a slightly longer nap but I will also do my best to ensure that there is enough awake time to support your usual bedtime. Sometimes allowing a longer 1 nap can impact the 2nd nap, so if 2 or more naps are applicable, keep nap 1 as before and allow longer for nap 2 if you need it. Don’t stray too far off your typical routine as this can affect your child’s sleep adversely.
I trust that you will seek medical advice as appropriate and use pain medication and prescribed medication as directed. Never doubt yourself, trust your instincts and ask for a medical opinion so the the correct treatment is observed early on.
If it feel it is appropriate share the room with your baby- even if you don’t normally. It may help them if they have a felt-sense of your closeness. It may help you to observe their temperature and other symptoms and it may also help to prevent you changing the sleep environment and recreating a bed sharing relationship that you may ultimately not want to continue after the sick period has passed.
I do find that this can be one of the single, most undermining influences for sleep when you are managing sickness and teething. Perhaps to get more sleep and/or provide more comfort – you bring them into your bed but very quickly this expectation grows and post sickness the waking continues with baby seeking this activity. If this is not where you want your baby to sleep in general and that is a personal choice and decision. You could instead, camp out in their room during this period, and therefore in a perfect position to observe, comfort and support them, avoiding a mixed message.
I do acknowledge that managing a sick child is very challenging and I also accept that during this time, you will feel tired and want to sleep more yourself, but if you sit with this period, accepting the challenges then once they pass we can catch up on our sleep again.
During this time, you may report that your typically “sleep able” baby needs more support-again, lean into this- use my stay and support approach but you may find you need to hold more and help them get to sleep in your arms even and in this instance, meet your baby where there needs are at and then once they feel better, they will either not need you, or you can quickly move through my stages to sleep to return to where you were in the context of their sleep. Never leave your baby on their own distressed- they need you and will need you more than usual, when they don’t feel at their best.
If you are worried about fluids or solid food intake don’t be afraid of re-introducing night feeds, sometimes this can be done in s a dream feed capacity or sometimes, you may find that allowing them the opportunity to feed overnight is a comfort and as soon as they feel well again, the need diminishes.
Once your baby is on the mend- typical indications may be off their medication, restored appetite and improved mood-then you can assess the sleep needs one more time and then try to get back on track.
In my experience it can take 7-14 days post sickness to return to where you were. When necessary, lean once more on the stay and support approach together with all age relevant feeding and sleeping balances and suggestions, remembering to work through the stages to sleep one more time as required. This time you could move positions every 2 days.
Don’t under-estimate the importance of the bedtime routine, the nap gap dynamic and the time that bedtime happens at; as when appropriately aligned, better sleep can emerge and re-grow – and that can be wonderful to observe, allowing you to feel confident in your approach when sickness arises in your home.