Cristina’s energetic ten-month-old, Olivia, is standing beside her mom's chair. As I walk into the room Olivia momentarily glances at her mom before reaching a chubby hand in my direction. She takes two wobbly steps toward the exam table, where she then begins to explore the chair, nearby drawer, and rolling stool. I seem to bore her right now.
Mom looks tired as she leans over, picks up and undresses her daughter for a check-up. Olivia twists and squirms on the table, communicating quite clearly that she was not done with her investigation of the room and her practice walking. Cristina describes a long weekend at her favorite family reunion. She explains that these reunions get bigger every year as sisters, cousins, and nieces become new moms. Last year Olivia was a newborn, and Cristina had enjoyed the extra attention she and her baby received, as well as the extra rest she enjoyed in this community of loved ones.
However, this year’s reunion was different. Olivia would go to bed as usual. Then she cried two or three times each night -- something the family members did not appreciate! Cristina would find Olivia standing in her crib "looking angry” because she could not figure out how to lie back down. Cristina has already appreciated that her girl was "strong willed” with “a mind of her own." But now her daughter seemed more out of sorts and did not call forth the same adoration from family members that Cristina had experienced the year before. "This reunion was more like 'work' than 'vacation'. I'm exhausted!"
The Science behind this child’s behavior
Olivia is experiencing a “Bumps in the Road” moment, and it is an opportunity for me to connect with Cristina. Remember that at times of a developmental surge children can become disorganized in their eating, sleeping or general behavior. A baby on the verge of walking is just too excited about the move from crawling to walking to settle into her comfortable routine. Couple this developmental activity with the exuberance of a family reunion, and it is no wonder Olivia can't sleep at night!
An “Ah-Ha” Moment for this Mother
Cristina is quickly reassured when I remind her how a leap in development impacts a child. She remembers seeing that kind of regression or disorganization when Olivia first rolled over at four months. "Even though I'm a bit exhausted," this mother says, "I love to hear how Olivia is growing and changing normally. Now give me some tips on what I should do!"
As I watch Olivia toddle around the room I reflect on her activity. "She has that wide-based gait of a new walker and hold her arms rather stiffly in order to keep her balance. She almost lunges from one hand hold to the next and doesn't mind a few tumbles to the floor,” I report. "She is such a determined little girl, and I can tell you are very proud of her.
I continue. "Here are some ideas about how to handle Olivia’s nighttime awakening. Since Olivia is no longer breastfeeding at night, we know she does not need more calories. So, let's skip adding a bottle then. You can help Olivia practice getting back down from standing during the day so that she will be more likely to do this at night. Then we discussed my "A, B, C" approach to nighttime parenting of the toddler. Offer Attention that is Boring and Caring," I explain to Cristina. "Go to her at night but maintain an unengaged appearance. Glance slightly to the side instead of looking directly at her. Limit your conversation as well. Olivia will feel your presence, but do not reinforce her nighttime activity.
Cristina laughs and rubs Olivia’s curly head as she promises me a follow-up call.
It does not surprise me, a week later, to hear from Cristina that Olivia has returned to sleeping through the night. Mother goes on to explain that she was identified as the family expert at their family brunch the following weekend. She told the other young moms how a surge in any baby's development will impact their behavior. Cristina explained how the "A, B, C" approach at night had helped Olivia return to her usual sleep routine. "Sometimes parenting is like a roller-coaster -- with thrilling "ups and downs. But, I'm glad for the ride!" she shares.