“Good” Parents #2

May 24, 2012

I would like to summarize some of the comments from the previous Post and ask some more questions.
1. Good parents are sensitive, kind, caring, compassionate , patient, and understanding. Can anyone imagine a situation where this is a problem?

2. Good parents are attentive; they take an interest in what interests their child. When might an excessive interest such as “helicopter” parents be harmful?

3. Good parents put their child’s well-being first. I think this, #1, and #2 are candidates for being true for all cultures.

4. Good parents have consistent routines. Well, you know I am biased here.

5. Good parents set boundaries, set limits, say “no,” and use age-appropriate discipline. When might excessive control limit personal growth, inquisitiveness, development of independence in a culture that promotes individualism or teach mindless conformity in a culture that promotes fitting in for the common good?

6. Good parents teach respect for people, property, and authority. I have a problem with this as written because should respect for people refer to all people or only people that we value? Should respect for authority refer to all authority or only the authority that we value? You can imagine culture clashes such as any religious opposition to an established authority. How can #5 and # 6 be modified to be more applicable for all value systems and all cultures?

7. Good parents build confidence, self-esteem by praising effort, achievement, or participating. I am not sure if this is only a fad. Some psychologists think that the “self-esteem” movement is bogus. They think that putting forth effort to help the family (think chores) creates respect, value, and a sense of belonging that is more important than prizes, ribbons, or praise at outside events. Other psychologists say that praising achievement is wrong because it fosters a “perfectionist” attitude in the child and therefore it is better to praise effort.

8. Did anyone say that “good” parents teach skills. I may have missed it. That’s OK. My personal belief is that having family dinners where family events, values, religious ceremonies are shared build character and this is more important than hiring coaches and tutors for skills and lessons. This is similar to the comments in #7 referring to the family.

I am surprised that the list above is this short and I would like to hear from all of you for additional comments on what constitutes a “good” parent. Also, I would appreciate your replies to my comments in the list.
Marc

“Good” Parents?

May 23, 2012

How do you define a “good” parent? I have seen many parents over close to 40 years of pediatric practice and I think that it is a mistake to judge parents by focusing on their children because children come with their own genetic endowments. Perhaps you have heard of having a “good fit” between parenting and the child’s temperament but in actual practice, I am not sure how this leads to parenting guidelines except in a superficial sense. Perhaps you have also thought about what it means to be a “competent” parent but here again, I am not sure exactly what this means. It appears to me that it is easier to define a “bad” parent (abusive or negligent) than a “good” parent. Different cultures have different values (for example, fostering independence versus fitting in to society) so I am interested in your thoughts regarding what constitutes being a “good” parent that is not culturally dependent. For starters, I think there would be little disagreement that a “good” parent provides shelter, food, and safety but these might be trivial answers because they are embedded in the notion of parenting.
What are your thoughts?
Marc

A Question.

May 21, 2012

Some mothers of babies in the range of 3-4 months have observed that a “nap” occurs around 5-5:30pm and around 7ish the baby is up. Surprisingly, if the baby is quickly changed. fed, and briefly soothed, she goes back to sleep within 30-45 minutes. Previously, the “bedtime” was later at 8-9pm and the baby was kept up to that time. Naps improved when they made the interval of wakefulness around 7PM briefer.

My view is that the baby’s night sleep rhythm was kicking in around 5-5:30pm and the increased total net “night” sleep helped naps. Any other observations or opinions?
Marc

Sleep Consult: Our Audiobook has Arrived!

May 11, 2012

If you are too tired to read, here is our audiobook link for “Sleep Consult”
Check it out:
Sleep Consult Audiobook

Marc and Dan

Drowsy Signs?

May 7, 2012

Drowsy signs might be absent if your child is often somewhat sleep-deprived. He might appear to be full of energy much of the time (second wind) and then quickly crashes into an over-tired state before a sleep period without going through a drowsy phase. Is it also possible that drowsy signs might be absent in a well-rested child whose parent knows when to begin the soothing based on clock times? in this scenario, there is a synchrony between soothing to sleep and the early emergence of sleep rhythms so mom or dad do not see “drowsy signs.” If this is true, then the presence of drowsy signs before sleep times might suggest that sometimes the interval of wakefulness before sleep times is a little too long and the child is slightly sleep deprived because very well-rested children do not exhibit them. Maybe drowsy signs indicate slight sleep deprivation and are something that we try to avoid by soothing our children to sleep before they have a chance to surface. Please share your observations and thoughts.
Marc
Sleep Consult for iPad
Six Sleep Problems and Solutions
Infant Nap App for iPhone/iPad

Why Some Parents Allow Their Child to Become Sleep-Derived

April 23, 2012

“Chronic sleep deprivation degrades one’s ability to recognize the impairments induced by sleep loss,” N Eng J Med 363:27, December 30, 2010.
If a parent is chronically sleep deprived, (s)he might not recognize the symptoms of sleep deprivation in their older child who might have frequent tantrums, outbursts, or melt-downs near the end of the day.
What are your thoughts?
Marc
Sleep Consult for iPad
Six Sleep Problems and Solutions
Infant Nap App for iPhone/iPad

How maternal depression and disturbed child’s sleep are associated.

April 19, 2012

See http://thechart.blogs.cnn.com/2012/04/17/depression-and-baby-sleep-vicious-cycle/?hpt=hp_bn12
What are your thoghts?
Marc
Sleep Consult for iPad
Six Sleep Problems and Solutions
Infant Nap App for iPhone/iPad

“Lack of sleep is an insult to a child’s developing body and mind…”

April 18, 2012

See http://well.blogs.nytimes.com/2012/04/16/attention-problems-may-be-sleep-related/ for how ADHD and lack of sleep are associated.
Marc
Sleep Consult for iPad
Six Sleep Problems and Solutions
Infant Nap App for iPhone/iPad

Sleep Smarts #7

April 9, 2012

1. The single most important fact to remember is that the time when sleep occurs is more important than the duration of the sleep period. You can’t fight circadian rhythms! We all have internal clocks that are genetically controlled. These clocks create an internal timing mechanism for sleep. These clocks evolved from dark (night)/light (day) cues. This signal is very primitive because it is based on the rotation of the earth on its axis. Sleeping in synch with circadian rhythms is more restorative, of better quality, than sleeping out of synch with circadian rhythms. Jet-lag syndrome is an example of sleep not in synch with circadian rhythms.
Additionally, a bout of sleep that is continuous (consolidated) is much more restorative than a bout of sleep that in interrupted (fragmented).

2. The Myth of Total Sleep Duration
Some parents observe that their child is getting 12 hours of sleep (e.g. 9pm to 7am plus a 2 hour nap) and therefore they think that there is no problem. Sleep duration is probably less important than sleep quality (intensity, consolidated, and in phase with circadian rhythms).

3. When the Bedtime is Too Late
What occurs when children are allowed to fall asleep too late at night? They wake up short of sleep in the morning. When you are short on sleep, then, even without caffeine, you get “keyed up” because your body produces stimulating chemicals such as cortisol, adrenaline, and noradrenaline. Then, if you suddenly go on vacation, it takes you a few days to “unwind” or dissipate the effects of the stimulating chemicals. This burst of energy is a primitive biological adaptive response so that early man could fight harder, hunt longer, or flee faster for survival. It’s like a turbo boost that we often call a “second wind”. When present, you are in a state of higher neurological arousal. When the bedtime is too late, he wakes up in the morning in a state of higher neurological arousal which causes him to have difficulty or inability to nap well.
The consequences of not napping well means that by the end of the day his sleep tank is empty and he is in an even higher state of arousal so it becomes more difficult for him to easily fall asleep and stay asleep at night. Parents might not see bedtime battles, long latency to sleep, or night waking resulting from a bedtime that is too late. But of course, he eventually crashes late at night. But this is preceded by an unhealthy state for the child, stressful interactions with him, and stressful interactions as a couple, and stress for each parent as an individual.
Sometimes the naps are very long and late (e.g. 1-4pm) because the bedtime is too late and the child’s sleep deprivation is masked by parents returning home from work and playing with the child.

4. Healthy Sleep is Like Healthy Food
Consider the similarities between food and sleep. Let’s first think about food and food quality. Food is a biological need. Food is energy for the body. Poor quality food –junk food – damages the body by causing all manner of medical issues including malnutrition, anemia, diabetes, heart disease, and obesity. A little junk food is O.K., a lot is not.
Now let’s think about sleep and sleep quality. Quality sleep means consolidated sleep occurring in phase with circadian rhythms. Sleep is also a biological need. Sleep is energy for the brain; poor quality sleep harms the brain. Think of poor quality sleep as junk sleep. Junk sleep is just as bad for our children as junk food. Just as you read labels on food to determine quality, think of sleep quality for your child. You would not starve your child by withholding food; try to not let your child get short on sleep.
Junk sleep causes many problems. All of these points are based on peer-reviewed published research. These are not my opinions.
• Exhaustion, and we all know what that feels like!

• Impaired mood. Children become more irritable, angry, and easily upset; later on, junk sleep can cause or exacerbate depression and marijuana use in adolescents. Less able to regulate emotions.

• Impaired social and academic performance. Kids who are lacking sleep will be more hyperactive, oppositional, and aggressive. Less able to accurately recognize human emotional expressions

• Impaired cognitive development. Sleep incorporates learning into permanent memory, sleep causes memory consolidation, sleep enhances organizational skills, planning, multi-tasking, and executive functioning.

• Impaired personality. Children become fussy, more intense, more frightened, and less adaptable.

• Impaired hand-eye coordination (which impacts a whole host of functions like athletic performance and fine motor skills).

• Systemic inflammation, increased blood pressure, increased stress hormones, increased susceptibility to infections.

•Impaired glucose control which is a factor in diabetes, obesity.

•Maternal depression.

5. Sleep and Brain Development
Never Forget: Sleep Helps the Brain Develop
1. The sleeping brain is not a resting brain.
2. The sleeping brain functions in a different manner than the waking brain.
3. The activity and work of the sleeping brain are purposeful.
4. The process of falling asleep is learned.
5. Providing the growing brain with sufficient sleep is necessary for the ability to concentrate and an easier temperament.
Sleep is the power source that keeps your mind alert and calm. Every night and at every nap, sleep recharges the brain’s battery. Unlike a light bulb that shuts down completely when it is turned off, your child’s sleeping brain is active and purposeful. Providing your child’s growing brain with quality sleep is necessary for its development. Sleeping well increases brainpower just as weightlifting strengthens muscles. Sleeping well makes your child physically relaxed and mentally alert; he is at his personal best. Sleep is not a luxury, sleep is a biological necessity.
6. Updates
From Sleep, 2008-9: “Sleep deprivation-induced performance deterioration is more marked in some individuals than in others. These inter-individual differences in response to sleep deprivation have trait-like characteristics consistent with a genetic basis”, “Sleep problems at 8 years predicted symptoms of depression at 10 years”, “Paternal involvement in infant care may contribute significantly to the development of infant sleep”, “Nap deprivation impacts emotional responses in 2-3year-old children.”
From Science, 2009: “Sleep is important for memory consolidation”, “Sleep is universal, strictly regulated, and necessary for cognition…sleep consolidates memories whereas sleep deprivation interferes with memory acquisition.”
From Pediatrics, 2009: “Sleep problems in childhood predict neuropsychological functioning in adolescents”, “short sleep duration in 7-to 8-year-old children predicts hyperactivity/impulsivity”.
From Proc Natl Acad Sci, 2009: Naps with “REM sleep enhances the integration of unassociated information for creative problem solving…”
From Devel Psychobiol 2010: Children “with more fragmented sleep displayed higher awakening cortisol levels {which} were correlated with {more} internalizing behavior and negative emotionality.”
From Archives of Ped & Adol Med 2010: Short nighttime sleep under age 5 years causes obesity by ages 5-9. “Napping had no effects on the development of obesity and is not a substitute for sufficient nighttime sleep.”
7. Final Thoughts
Sleep is a natural process and there will usually be few difficulties if we are patient and don’t interfere with it. Timing is most important but there are genetically-controlled individual differences between children regarding when their sleep rhythms develop and how long they sleep so don’t compare your child with other children. Naps and night sleep are related and both need to be in place to avoid sleep problems. Our goal is to have well rested families. But always remember, the amount of sleep our children need is measured by mood, behavior, and performance…not hours on a clock. The best advice I can give is: Let your child’s natural sleep rhythms do their job without interference from parents!

“30 Lessons For Living” Behavioral Book Review #10

March 30, 2012

This book was an unintentional choice. I was reading “30 Lessons for Living” (Pillemer) and the premise is that the author gathers advice from the wisest (and oldest) Americans and he shares it with the reader. As I was reading advice about marriage and work, I stumbled upon a parenting section. This parenting advice was not from a developmental /behavioral psychologist but rather from people who have lived a long time. Their expertise in parenting comes from experience and time.
Here were the five lessons:

1. It’s all about time.
2. It’s normal to have favorites, but never show it.
3. Don’t hit your kids.
4. Avoid a rift at all costs.
5. Take a lifelong view of relationships with children.

Pretty interesting, right? Do you think there is a difference between “child-rearing” and “parenting” advice? The name of the parenting chapter is “Nobody’s Perfect.” The funny thing is that when I read another blog post comparing my father to a bully, I am reminded of hearing my father say, “Being a ‘perfect parent’ is doing the right thing 80% of the time.” Turns out he was in agreement with some very sage individuals!

“30 Lessons for Living” is a great book and I think many of our families would like it too.
-Daniel Weissbluth

Sleep Consult for iPad
Six Sleep Problems and Solutions
Infant Nap App for iPhone/iPad


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