Episode 15: Napping Spectacular!

Episode Transcript
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(00:02):
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(00:27):
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Enjoy the show.
Okay, so welcome back to the sleep edit.

(01:12):
I am Dr. Craig Canapari
And I'm Arielle Greenleaf.
And we are here to talk about what Ifeel is one of the thornier issues in
pediatric sleep and that is napping.
How to do it, when to doit, when to drop naps.
As a parent, I'd say this is atopic close to my heart because we

(01:33):
struggled with naps in our kids and indifferent ways with the two of them.
Mm-hmm.
and some of that is just 'cause napping ismuch more variable than nighttime sleep.
Like kids with terrible sleep.
They're still sleeping atnight most of the time, but
napping is a whole other animal.
it sure is.
yeah.

(01:53):
I can tell you with my older son, wehad kind of crappy naps till he walked.
Really?
man.
just like little 20 minutecat naps here and there.
with my younger son, it waseasier except that he had to be
around our older kid schedule.
so that's another layer
That is so, so common.

(02:13):
I feel like my child was a textbookcase, 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 sleepconsultant 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.

(02:34):
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 differentlythat got you such a good result?
I didn't know what I was doing beforeI hired a sleep consultant, so I was
just kind of like napping her when shegot fussy or just kind of winging it.

(02:58):
I don't even know.
I mean, maybe I was, look it,it's such a fog, honestly.
Her birthday is this weekend, she'sturning 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 beable to sleep in a crib.
And the first time I put her in the cribfor a nap at the appropriate time, I think

(03:23):
she cried for five minutes and then fellasleep 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 doeshighlight, an important point.
That is you can't, when, if you'reworking as a provider, you don't make

(03:47):
assumptions about what people know becauseit's not like kids come with a manual.
And even if you read parenting books, it'snot always clear what to do in the moment.
No.
And I think that's the number onething that I deal with is people
just don't know what they don't know.
and I don't blame them, there's supposedinformation at our fingertips, right?

(04:08):
We have our phones and we look onInstagram and we look on Google and we
look at, well, what is this influencersaying about naps and how, you know,
what time should I be napping mychild, and what are their weak windows?
And there's just so much stuffthat they, you know, so many myths
that are pumped out about sleepthrough social media in particular.

(04:29):
And they come to me and they'relike, well, isn't XY, z?
True?
And I laugh and I'm like, I'mreally sorry that you were fed
that garbage because it is garbage.
there's no sleep education for parents.
They don't go home understandinganything when it comes to sleep.
So let's talk a little bit about what'sin the medical literature around napping.

(04:52):
And, um, it is, uh, it, it's, it's limitedand we'll get into the reasons why.
I think when we're talking aboutnapping, we have to start by talking
about how much sleep kids need overall.
So in 2016, the American Academy ofSleep Medicine published a consensus
document, which is usually whatis recognized as gold standard

(05:15):
guideline for sleep duration.
So I'm just gonna gothrough the kids numbers.
so according to that document, infantsfour months to 12 months of age
sleep, 12 to 16 hours per 24 hours.
Children one to two years ofage should sleep 11 to 14 hours.
per 24 hours, children ages threeto five should sleep 10 to 13 hours.

(05:41):
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 andI'm like, what do they say about
kids less than four months of age?
they didn't make any recommendationsabout children under four months of age.
oh, thanks for keeping me honest here.
Because I'm like, whydidn't I put that here?
Yeah.
No, they, they, theydidn't do any newborn, um,

(06:05):
and I think part of the reason is thatit's a wide range, but to put a number
that, I'd say newborns are, it couldbe 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 tome after the newborn stage where they're

(06:28):
like, my child's sleeping 10 hours in a24 hour period, and I'm losing my mind.
when ultimately therereally is nothing wrong.
they either have lower sleep needsor their sleep hasn't quite yet
matured and things are happeningand they improve as they get older.
Yeah, it's important to notethat where you are on your sleep
requirements tends to be kind of fixed.

(06:49):
So if you have a baby that needsa lot of sleep, they're probably
gonna be on the higher end of thoseranges at age three, ages six, ages
18, what have you, and vice versa.
That seems to berelatively fixed in people.
according to the authors, nappingwas considered biologically
appropriate under age seven, andquote, " naps may be important.

(07:09):
Missing one nap by preschoolers producesmore negative emotional responses.
And nap provision improved toddler'sperformance on a generalization task
in grammatical language 24 hourslater compared with non-AP groups."
So it's important to note that evenin this document where they don't
deal with naps, they talk about napsbeing important for learning and mood.
some adults are that way.

(07:29):
Yeah.
and there was a study that cameout of UMass that was looking at
the predictor of when kids sortof give up naps, shorten naps.
And it actually had more todo with hippocampal maturity.
So the hippocampus is a region in theirbrain that's associated with memory.
So for kids where this maturesmore quickly, they seem to
give up naps more quickly.

(07:51):
Which kind of makes sense.
Then there's an article byStaton et all from 2020, which
is a review article on napping.
Here's what they said.
infants less than 12 months of ageon 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 aregood ballpark numbers.

(08:14):
there is a huge amountof variability here.
Right?
But, I don't think they'recrazy numbers, right?
No, I wouldn't say that they'reastronomical, but I would say I get
very nervous about anything writtenin stone when it comes to sleep
totals, because parents really glomonto those things and then they think

(08:35):
there's something wrong with theirchild if they're below that number.
rarely do they think something's wrongif their child is above that number,
but if they're, below, a certain numberor 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 kindalike level set for where we'll be.

(08:56):
in this article they say, acrossthese 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 childrenwhose family identify as African
American have prevalence at age 5.
Hmm.
Most kids in kindergarten, it actuallymay be a metric of kindergarten readiness.

(09:18):
If you have a five-year-old who'sneeding a long nap in the afternoon
and you have the luxury of not sendingthem to kindergarten that year, they
might have an easier time the next year.
Yeah.
Then, here's a graphicfrom, Iglowstein et all.
And this is just a percentageof kids who nap during the
first seven years after birth.
And in these bars, they just havethe black bars represent two or

(09:42):
more naps, the light bars are justkids who are napping, one nap.
and then after age four, a darkbar means napping every day.
And a light bar meansnapping occasionally.
So what we see on this graphic,for those of you who are listening,
is that age one month, everybody'staking more than one nap.

(10:03):
Interestingly, at age three months,that look like there were about.
I don't know, just eyeballing that's maybe5% of kids who are just taking one nap,
Is it one nap or two naps?
Dark bars represent two or more naps andlight 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.

(10:23):
So we don't know the circumstances here.
what we do see is a clearprogression in this graphic, from
more than one nap to one nap.
it looked like most of the kidsby one and a half years of age
were napping once a day by age
four, only about 10% ofkids were napping every day.

(10:45):
And by age seven, nobody was ever napping.
and I know little babies take multiplenaps 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'sgonna happen and we'll get into that.

(11:06):
would you agree that it's fair to saythat that's a typical progression?
Yes.
I was just looking at this next.
Oh, so the Galland review article, soagain, this is another, I believe this is,
this one definitely looks morerealistic than that other one.
So this was a study of about 900 families

(11:28):
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 aggregateda bunch of different studies.
They had 34 different studiesthat they included in this.
And this is, this is actuallya fairly interesting study.

(11:51):
So here's what these authors found.
for nap duration, fewer studies reportedFor zero to five months of age, they
found that the average amount ofnapping 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.

(12:14):
All infants.
Those all seem very correct as far aslike number of daytime naps by age.
Okay.
So
in this review article, they werelooking at nap duration, the mean
nap duration for children, 0.5months of age with 3.1 hours per day.

(12:40):
The lower limit was 1.2 hours.
The upper limit was fivehours for six to 11 months.
It was 2.2 hours with0.9 is the lower limit.
3.5 is the upper limit.
One to two years of age was 1.2hours a day with a lower limit
of 0.4, upper limit of 2.1.
they actually did scatter plots of thereported sleep duration and the number

(13:05):
of daytime naps by month actually hasa very nice, I guess the technical term
we would have would be a line of fit.
So you can look at this data over timeand it looks like what they found is
around two months of age, 3.5 per daywas typical and over time, that drops
this graphic ends at 24 months of age.

(13:27):
When.
one nap is typical.
So it looks like this is a fairlylinear progression, meaning
that it's somewhat predictable.
I think the challenge we have hereis it's not like your child goes from
having 3.5 naps a day to three naps to2.5 in a very clean incremental pattern.
They go from like four naps tothree naps, to two naps, to one nap.

(13:52):
And those transitions are really tricky.
So again, we know that it'spredictable giving up naps, but this
data doesn't tell us much for anindividual parent sitting the exam
room or consulting with a Arielle.
When can we predict thenap's gonna go away?
So like this is kind of like thefrustration here for parents and honestly

(14:17):
for providers as well, is we know thatthe sleep is gonna go down over time.
If somebody comes in and islike, my kids' naps are crappy.
Like, what do we do about it?
I am gonna be more of the sort of, theinterlocutor here because this is more
the art of napping versus the science ofit, which is a domain in which, Arielle
who unfortunately didn't have accessto when my kids were horrible nappers.

(14:41):
Neither did I.
I thought we would, kind of go throughthis and start with some just general
questions about napping and then maybeget into some cases as well, I think
if a parent is struggling, they shouldseek help from, you know, check in
with your pediatrician, make sure thatthere's no medical problem going on.
working with somebody who'sexperienced in troubleshooting child

(15:03):
and infant sleep problems can bevery helpful if you're struggling.
understanding a little bit howexpert may solve these problems
can be very helpful I think.
absolutely.
So let's start, what is the relationshipbetween napping and nighttime sleep?
So I think you just went over, a littlebit of the sleep science and the point
of napping and the fact that nappingserves a purpose for younger children.

(15:27):
And, there is that body of evidence rightnow that shows that once the, hippocampus
or whatever, is that what it's called?
Hippocampus,
Hippocampus is matured and memorysort of, matures, that napping.
So the sooner that happens,napping starts to go away.
So there are, there'sreal reason for naps.
As children grow, I don't want anybodyto get caught up on the fact that their

(15:50):
child is a bad napper and think thatbecause they're a bad napper, their
child isn't gonna be smart or won'thave good memory or things like that.
when I go to solve a nap problem andI'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 AmericanAcademy of Sleep Science recommendations.

(16:11):
Right?
So you said for infants fourmonths to 11 months, that's 12
to 16 hours in a 24 hour period.
Now a child that needs 12 hours ofsleep is gonna have, much less daytime
sleep than a child that needs 16hours of sleep in a 24 hour period.
But I have to look at each childindividually and start to determine,

(16:32):
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 dohave data, we can see.
Okay, your six month old is nappingfor six hours during the day and

(16:53):
then only sleeping five hoursovernight, six hours overnight.
we would hope that a childthat age is sleeping somewhere
between 10 to 12 hours overnight.
Overnight sleep is the mostrestorative 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

(17:15):
hours into the overnight hours?
but then it becomes a delicate dancebecause, 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

(17:35):
time that they need, to, in order toachieve whatever that 12 to 16 hours is.
So I have to look at nighttime anddaytime and balance that appropriately.
so that's where I start basically.
But I will talk about, I thinkI put in here, some children are
just very sensitive to timingand when they're being put down.

(18:02):
And so I actually have a quote from a mom.
I got permission to use this Thiswas when we first worked together.
So this was probably back in, I don'tknow, 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 lookingat 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 abit too far, he tends to take an

(18:25):
hour and five to an hour and 10minute nap, then he will wake up.
He did that this morning forhis 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.

(18:48):
So I think the biggest nuance forfiguring out daytime sleep is how
do you balance awake time with sleeptime 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.

(19:09):
Do you have a set amount or proportionin your mind for like, say a infant,
what's the minimum amount of sleep youthink they should be getting at night
at night, minimum 10 hours.
And I will tell you anecdotally that
it's extremely rare forme not to achieve that.
it is extremely rare for menot to get to at least 10 hours

(19:32):
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 monthshe's taking 5, 5, 1 hour naps and
He's going to bed at 11 and he iswaking up at five in the morning
and then taking five one hour naps

(19:55):
I think one of the really importantpoints here is that babies
don't deprive themselves, right?
they're gonna get their whateverhours of sleep they need.
there are probably some neurologicalbenefits to having longer sleep
periods at night for kids.
There are definitelyneurological benefits to parents.
Um, and that part of the reason we dothis is like, again, even kids that whose

(20:20):
parents are struggling, they still usuallysleep the normal amount every 24 hours.
One of our goals is to getthem 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'remostly talking about situations where

(20:44):
people have the luxury of moving thingsaround, which is not always that case.
I think we'll talk later about thingslike childcare or kids who aren't the
first kid, where there are other kidsin the house and it gets even harder.
But I think it's stillmore important for people.
Right now we're talking about if underoptimal conditions, what do you do?

(21:05):
Yeah, and I would say underoptimal conditions, when I go,
what is my goal for, let's sayan infant, four to 12 months-ish.
My goals are at least two naps eachnap, one hour each minimum, and then a
minimum of 10 hours of overnight sleep.

(21:25):
sorry, what age is that?
so that's a very wide range there.
So that's for an infant.
some even young infants don'tlike to take a third nap.
But let's say, you know, that's at thevery 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 forme to see an infant that only needs

(21:49):
twelve hours, especially a younginfant, although it's not unheard of.
it's, there's so many nuances toall of it, and I think that's why
it's frustrating to see so muchnap 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 mychild can sleep more than 30 minutes,

(22:12):
or, you know, whatever it may be.
And it's because it is so nuancedand it would just be nearly
impossible to help every singleparent with their nap struggles,
Like in speaking in generalizations.
Yes.
No, I agree.
I'm curious when you're saying highneed versus low need sleep babies,
do you have numbers in your head?
I would say a high need sleep baby issomewhere from like 14 and a half to

(22:36):
16 hours in a 24 hour period, and thenlower is closer to like 12 to below 14.
Yeah.
And, I, in my world, my clinic is full oflittle kids who don't need a lot of sleep
and big kids who need a lot of sleep.
Like if you're thinking about thehealthy kids that come in, right?

(22:57):
Like the kids that don't haveneurodevelopmental disorders, whatever.
often I'll see liketoddlers 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 napanymore even though they're two.
They can't always do it if it's a secondkid or in the, they're in childcare.
Yeah.
Because they're like, oh yeah, peoplebe like, oh, my neighbor's kid is

(23:18):
like taking three, two hour naps aday and sleeping 12 hours a night.
And I'm like, well, my18 hours of sleep a day.
And that's highly unusual.
I also find that I feel likeeverybody is always doing so
much better than everybody else.
You know?
And also, I don't trust whatother people are saying based on
the stuff that my clients say.

(23:39):
You always fixate on.
It's like, look, the cliche isthe grass is always greener.
like in our world, the clicheis someone's kid is always
sleeping better than your kid.
Right?
Like, their child might bestruggling with something else.
so let's talk about nap routinesversus bedtime routines.
I don't see them as allthat much different.
really it just needs to be a regularflow of steps that you go through

(24:02):
to prepare your child for bed,whether that be naps or bedtime.
Obviously I find that bedtime isusually longer in that there's
often, a bath involved or, morecuddling with mom or dad beforehand.
Whereas a nap is, not necessary togo through that big longer process.
but I think just having some sort ofconsistency with, okay, we're gonna

(24:26):
go change you, change your diaper,change into a sleep sack, read a book,
cuddle for a little bit, and thenit'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 understandthat what's coming at the end is sleep.

(24:49):
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 doingthis three times a day.
I will say though, that when I thinkabout like toddlers in particular,
sometimes they need wind downtime transitions can be difficult.

(25:10):
Some children really strugglewith, okay, we're eating lunch
and now we're going for a nap.
It's like they need some timeto, settle and get into bed.
So sometimes in those situations, ifwe have the luxury of controlling that,
we may extend that a little bit justso that there's some wind down time.

(25:33):
Absolutely.
Yeah.
I think children benefit from routinesand if things are predictable.
Just like bedtime, you wouldn't have yourkid 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.

(25:54):
Okay.
So I mean, if you're, we talk aboutdaytime sleep and nighttime sleep.
I think it's important to understandthat 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?

(26:14):
I think those are the two mostessential pieces to figuring
out how to get longer naps.
so just to be clear, part one, knowinghow much sleep they actually need.
yeah, but they might notknow 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 howmuch sleep, your kid needs in 24 hours.
And that's like probably a minimumof three days of sleep diaries,

(26:37):
I would say three to fivedays is probably good.
and the second,
The second thing is that your child needsto know how to fall asleep independently.
I get a lot of people who.
their babies are, or theirchildren 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 methrough, okay, well how are

(27:01):
you putting your baby to sleep?
And it's like, I'm nursing him, he'sfalling asleep, and then, I'm putting him
in the crib and then he pops up 30 minuteslater and he won't go back to sleep.
But if I pick him up and he startsnursing again, he falls asleep again.
You know, things like that.
So, helping a child understandor learn the skill of falling

(27:22):
asleep independently is really thelinchpin to nighttime and daytime.
So if your child is dependent on anythingto fall asleep, then it's, it's gonna
limit your ability to extend naps.
some children know howto sleep independently.

(27:42):
They're on a great schedule andthey just don't like to nap.
they just aren't big nappers.
I think you have to set the bar low, andif you exceed that, then congratulations.
But I do think it is achievableto get more than a sleep cycle.
And a sleep cycle is typicallyanywhere from 30 to 45 minutes.
So I think anything beyond45 minutes is great.

(28:06):
for some kids, for thatone nap, it's enough.
so that, that's reallythe baseline that I'm at.
There were two studies of interventionsfor improving sleep in kids.
We usually, when we talk about formalsleep training, we've talked about
Cry it Out on an earlier podcast.
these real studies we'relooking at infants from like

(28:27):
three to four weeks of age.
And there were parentinterventions, to extend sleep,
and one is called the SAAF trial.
Another was, called the INSIGHTtrial, and this was all sort of
common sense stuff, but I think it'sworth enumerating the things that
these two protocols had in common.
So the first was avoiding feedingkids to sleep after a month of age,

(28:49):
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 infantdown for sleep, drowsy, but awake.
To me, that's four to six weeks ismaybe when it's worth the earliest
you'd consider doing it, and it's morelike, try it and see what happens.
Yeah, I mean, I think youcan try that right away.

(29:09):
it doesn't hurt, but as soonas 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 'emdown, see what happens.
They might be fine.
I've had clients that have babieslike that, and they're astonished, so
And another was, only feeding at nightif the infant actually seemed hungry.
not just fussy and sort of tryingto soothe them a little bit

(29:32):
first, actually pausing beforeyou go in the room for a moment.
for sure.
Taking a beat and thentrying calming techniques.
Shushing, white noise, gentle touch beforepicking them up, changing their diaper.
Like your baby doesn't necessarilyneed to have their diaper changed.
And this is the way you're taughtwhen you're in the hospital.
But you know, once you're likesix or eight weeks of age, I don't

(29:54):
think they necessarily need a diaperchange and feeding in the middle of
the night every time they wake up.
No.
So I think this is good stuff.
predictable bedtime routines, earlierbedtimes and, and I think this is
so important for napping, actually.
And I think Arielle, you taught methis, recognizing sleep cues, yawning
eye rubbing, or a fixed stare.
They said, put your babydown when they seem tired.

(30:16):
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 likeone of the ways that we struggle with
my kids is we were trying too muchto be on a schedule and sometimes
missing our windows for when ouropportunity to put our kids down.
You're talking about the art of napping,and that's part of it right there.

(30:39):
what is your child showing you.
So I think it's useful to have like anidea of when your kid's gonna nap, but
my colleague Monica Ordway had thisgreat thing, and this is more like for
older kids, like middle preschoolers,elementary school kids, the parents
were having these long, battles atbedtime and she's like, whenever your
kid starts to freak out, their bedtimeis probably 20 minutes before that.

(31:03):
Yeah,
I think there is something to be saidfor that when your baby is, I don't like
the term overtired 'cause I actuallydon't know what that means medically.
But like, if your child is,
where they can self-soothe and thenthey get too dysregulated and then
they can't soothe themselves anymore.
mm-hmm.
Yeah, it's kind of like what that parentsaid where we push him a little too far

(31:24):
and we only get 27 minute naps, you know?
But I would say one thing that I cautionparents about, when we talk about sleepy
cues after the newborn stage, it getstricky 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

(31:47):
not like nothing going on, they can startto rub their eyes or seem tired and.
You know, it's only, they'veonly been a week for an hour.
You put them down, they sleep for20 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 peoplestruggle so much because it's like,
just put 'em down when they seem tired.

(32:08):
No, just put 'em down at this time.
And with anybody that comesto me, it is such a balance.
It is such a nuanced balance for eachchild based on, so today, for instance,
I'm working with a, four and a halfmonth old where I was just so confused,
which is rare, but I just was, somethingjust felt off and it turned out well.

(32:30):
He was about to roll, so it wasa big gross motor development
situation that was disrupting him.
But he hadn't slept independently, ever.
And, has been held forall naps and co-sleeping.
last night was night four.
It was an incredible night.
he woke once to feed, he did wake alittle bit early this morning, but

(32:51):
I mean, he slept independently lastnight, 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 daybefore, 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 likewhen he woke up and what my witchy
magic was feeling in my head.

(33:13):
And he slept an hour and 45minutes for his first nap.
But like for his second nap, theysaid, 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.

(33:34):
And he was starting to fallasleep while I was feeding him.
And then he was kind of rubbinghis eyes and I was like, forget it.
Put him down in 10 minutes.
And they put him down in10 minutes and there we go.
So he fell asleep in a few minutes.
so point being is like, it's such abalance between all of those things.
And it can be very, I think it's verychallenging for a tired parent to decipher

(34:00):
all of the, like, to really put allthose things together to determine.
The right timing and all of that.
And that's where I come in and thenhelp 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 inthe first month, things are changing
every couple of days, right?

(34:21):
And then four to six weeks in maybe.
They're changing weekly and that rateof change slows down through childhood.
But it's just, you know, if you're reallystruggling parents, just wait a little
bit and it actually might get easier.
Absolutely.
so let's talk about sleep trainingcan you sleep train for naps

(34:41):
or not nights or vice versa?
So yeah, that's a tricky one.
Yeah, I'd say, first of all, it'syou shoot for the whole thing.
Yeah.
I think the thing that we need to comeback to is the idea of consistency
and your baby knows when it's lateand it's dark and their bodies get
used to a circadian rhythm, but theydon't understand why sometimes you're

(35:02):
holding them and sometimes you're not.
Sometimes you're feeding them tosleep 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 dayhe did not do well with naps, so we

(35:24):
continued to support them, but hedid so well last night that I felt
like I really don't wanna confuse thesituation and set us back at night.
So let's try at least that first.
But like, the goal is let's get themsleeping independently for all sleep so
that they get it and they're not confused.
Like sometimes you pick meup, sometimes you don't.

(35:47):
and they're able to, be consistent for youbecause you're being consistent for them.
Well, if you think about this inbehavioral terms, it's like intermittent
positive reinforcement, right?
you cry and fuss and every timeyou do it, you get a reward.
It's actually not as powerfulas sometimes getting a reward.
So I think, again, it's not that it'salways all about crying or screaming,

(36:07):
but parental consistency is sopowerful in helping children form new
patterns, even really little kids.
yeah.
I had someone who really wanted tosupport naps and sleep train overnight
Our relationship didn't work out becauseit was just so clear that the, I mean,
this was an older baby, it was like a10 month old, and it just, it was very

(36:31):
confusing to the child and thereforeit made things a lot less consistent.
And, you know, it's a parent's choice.
Whatever they feelcomfortable with, it's fine.
But, you know, if you wantconsistency, I always say if you
want consistency from your child, youneed to give them consistency too.
well I also feel like every time you putyour kid down, you have an opportunity

(36:54):
to put in place the pattern you want.
Absolutely.
So it's much more powerful to doyour intervention saying a kid that's
napping three times a day, you couldget in four reps a day instead of one.
Yeah.
When should my baby, and I guesswe could say, kid, take a nap.
'cause I think this is, it is important,like recognizing this is a balance

(37:16):
between recognizing sleep cues, right?
Your kid really looks tired, youprobably should put them down.
But also having some idea oflike, well, around when would
you expect them to go to sleep?
A period during whichyour child should sleep.
I do think there's something to besaid for knowing approximately when
your kid will be due for an nap.
Yeah.
So I'm gonna put thisin such general terms.

(37:38):
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 longunless your baby's like really
young and maybe on four naps.
'cause you can get into a problem whereyour naps are starting so early that

(37:59):
you're finishing your third nap by, youknow, two 30 in the afternoon and then
your baby's not gonna stay awake foranother five hours before it's bedtime.
So if your baby may be on four napsat that point, I would say a baby
on three naps, you really wannabe closer to 9:00 AM nine ish.
So that could be eight 30 andthen that could be, depending

(38:20):
on, they can get older, like 10.
As they get older, theyneed more time to be awake.
So anywhere from 10 probablywould be that morning nap for
like an infant over six months.
And then the afternoon isusually somewhere, for a
younger infant around 12, 12 30.

(38:41):
And then those can actually start.
To push out later as they get older.
So it can be anywhere from one totwo and then as they're about to
transition to one nap, it can often belike two to three at the very latest,
but that's like at the very latestand capping it at an hour or so.

(39:02):
I would say there needs to be like amid-morning nap between nine and 10 and
a mid-afternoon nap between one and two.
If you have a third nap somewherehappening between, I don't know,
three to 4:30, but finishing naps bya certain time is kind of important,
otherwise you kind of get intothis zone of pushing into bedtime.

(39:25):
so like ending naps for youngerinfants by five and then sometimes
as they're getting older, ending themby four in order to get them down by
eight-ish is important because otherwiseyou're pushing bedtime way out.
Depending on how old they are.
So rarely do I see an eight ornine month old on three naps.
I rarely see the two to one transitionbefore 12 months or later than 16 months.

(39:50):
Yeah.
And because, you know, in the medicalliterature, these are huge ranges, like
six to 15 months going down to, two naps.
But again, that's true, but mostkids are gonna fall in the middle.
Okay.
how do I get my newborn on a goodnap schedule or lengthen their naps?
I mean, if someone hires mefor the newborn stage, I give

(40:13):
them no false information, andtherefore I tell them that.
extending a newborn nap, your baby'seither gonna do it or they're not.
it's totally normal to have a 20minute nap or a two hour nap, but
extending a newborn's nap is kind oflike trying to sleep, train a newborn,
and you can't sleep, train a newborn.

(40:34):
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 themdown, awake, at an early age and see
how they do if they're just kind offussing, give them a little space and
see if they're not like screaming atthe top of their lungs and they're just
kind of like kicking around or whatever.

(40:55):
You can sort of observeand see what they're doing.
If they get a little more fussy,you can try crib side soothing.
So, you know, going over and rubbingtheir 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, falsenotion that you can extend a newborn's nap

(41:18):
or train them to be on a specific schedulebecause it goes against biology really.
I wanna take a quick sidebaron 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 bondingand also help with, milk supply.

(41:41):
And then there's contact napping,which as I understand it, is a
less well-defined term, but it'slike holding your baby to sleep.
Right.
Yeah.
And I think that contact napping isone of those things where I, because
I've seen on Reddit and stuff, parentssaying, oh, my kid can only contact nap.
And I'm like, well, it's'cause it's the only way you've

(42:01):
offered to have them nap, right?
Like, and there's a safety concernfor small infants here too.
And the risk is if you yourself are tired.
Falling asleep while holding your babyis one of the riskiest things from a
suffocation or entrapment standpoint.

(42:22):
So if it's like eight or ninein the morning and you've had a
cup of coffee, that's one thing.
But if you are like really sleep deprivedand you're regularly holding your
baby for an entire nap, I really worryabout these babies getting injured.
I think that we need to be real aboutthat, especially in that newborn stage.
but yes, I think it's really importantto educate around it as well.

(42:43):
if you're too tired, I mean it wouldalmost be better for you to put
the baby in the bassinet and justhave your hand in the bassinet.
You know what I'm saying?
Like just to soothe thatway versus holding upright
Well, you know, there's alsothis period of purple crying,
Yep,
And it's this idea that there's thiswhole like dogma in pediatrics that

(43:05):
crying increases over time in the firstfour to six weeks and then falls off.
And this isn't really well understood.
It's attributed to the maturationof neurological and GI systems.
and it does seem like thisparticular flavor of crying, this
fussing of like a four week old,

(43:25):
Hmm.
what parents do does notinfluence how much kids cry.
Correct.
So I think that there's this desperationsometimes 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 weeksof age, crying age, 150 minutes a day.

(43:49):
Oh, yes.
it's important for parents torecognize you could be holding
your baby or not holding your baby.
Sometimes they're just going to cry.
Yeah.
And I'm not talking aboutsleep training here.
I am just talking about thereality of having a neurologically
immature little baby.
and you are so desperate to stopthem crying if you are holding

(44:11):
them to try to soothe them.
And you're so exhausted, you'regonna fall asleep holding them.
Or you are like losing it.
It is okay to put your dae downand go walk, go in the other
Yes.
put them in a safe place, put them flatin their back in case they do fall asleep.
You are not doing harmto your other child.
They're gonna cry that muchregardless of what you do.
Yeah.

(44:31):
And I have seen so much stuff onlinedirected at me and other people who talk
about things like sleep training, abouthow it is child abuse to let your kid cry.
I think it's actually this wholenarrative about you can't let your
kid cry is actually dangerous.
And you know, it's okay forbabies to cry sometimes.

(44:51):
Well, it's part of development,
they do.
it's not, somethingthat can be controlled.
Thanks so much forlistening to the Sleep edit.
You can find transcripts atthe web address Sleeped show.
You can also find video of theepisodes at that address as

(45:13):
well as in my YouTube channel.
You can find me at Dr. Craigcanna perry.com and on all social
media at D-R-C-A-N-A-P-A-R-I.
You can find Ariel atInstagram at Ariel Greenleaf.
That's A-R-I-E-L-L-E-G-R-E-E-N-L.

(45:37):
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 QualitySleep for babies, kids, and parents.
It's available whereverfine books are sold.
If you found this useful, pleasesubscribe at Spotify or Apple Podcast
and share it with your friends.
It really helps as we're tryingto get the show off the ground.

(45:58):
Thanks.
So this is part one ofour napping spectacular.
in part two we have cases, whichArielle has brought, which look great.
We are gonna talk about transitioningfrom three to two naps, two to one nap,
and one the dreaded one to zero nap.

(46:20):
and we're also gonna talk about someof the milestones, like how do you
know when these transitions occur?
how do you know when yourkid's ready to give up the nap?
And also finally, strategies for nappingaround 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

(46:40):
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 SleepEdit podcast@gmail.com.
Yeah, send us an email.

(47:01):
thanks for listening.
Take care.

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