Creating a Healthy Bedtime Ritual/Make a Bedtime Book

 

No family's sleep routine is exactly the same.

When I was growing up my mom was early to bed and early to rise. She loved getting up at dawn and having the quiet house to herself while the rest of us slept.

My dad was a night owl and was delighted if I stayed up with him to keep him company. I remember doing some odd projects together including translating physics from Russian to English or building a ‘heath kit’ color TV. Sometimes it was just watching the late news. I typically called it a night long before he did.

So when Sandy and I had kids, creating a firm bedtime was not at the top of my list. It was right up there for Sandy though; he was (and still is) a data hound. He had read how important sleep was. He was the one who did most of the sleep training when the kids were young and he was certainly the enforcer when it came to bedtime.

One evening, the kids may have been 3 and 6, Sandy was out of town on business. It turned out that several of my good friends were also playing single mom that week. We gathered at one of their homes with all the kids and ordered in Chinese food. The kids were running around and the moms were chatting. I wasn’t keeping close track of the time, but it was late and the kids were starting to get cranky.

“Hey girls, don’t get whiney, This was a special treat and I let you stay up”

“No, we are tired! It is past our bedtime. Daddy would have made sure we were home and in bed!”

Uh…way to throw me under the bus, I was NOT expecting this response.

But even when they don’t tell you as clearly as mine told me, kids do thrive from routine. Have you ever noticed how some kids go down for a nap like clockwork at daycare but fight it at home? If the schedule is wishy-washy, kids will push to see what kind of power they can exert. That’s their job!

Beyond making sure that your children feel safe, secure and comfortable, your job is to make sure that the rules are clear and the enforcement is consistent. Kids will ultimately follow them and thrive.

Have a set bedtime and try hard to stick to it.

Block out a reasonable amount of time for the process. It might vary from child to child but count on at least 30 minutes. Be present for this. Ideally this means keeping laptops and phones out of the room. Blink and your child will have outgrown these magic moments. Savor the sweetness.

The goal is for bedtime to be the time for deep connection rather than a battle. Sandy brought his guitar in and had a repertoire of oldies that he would sing. Make your own memories.

When you are establishing a firm, new routine, talking about it for the first time during the actual bedtime when your little one is tired is NOT the time to learn about new rules. This will work best if they are part of the team.

Have a conversation about this earlier in the day. Let them help create a routine that feels comfortable. Let them help negotiate how many songs/books etc. Discuss some rewards that they can earn for going right to sleep and not trying delay tactics

Some kids might do well with a simple sticker chart. They can earn stickers for easy bedtimes and a certain amount of stickers can turn into specific rewards.

Rewards can range from a special outing, to a few more minutes of screen time the following day. Find something that resonates with you.

Consequences for not cooperating need to make sense. These can simply be not earning that special outing, or cutting the allotment of screen time.

Problem Solve some common issues before they happen.

I am thirsty: okay to have a sippy cup or water bottle near the bed.

I want an extra yogurt pouch: Be clear on a reasonable window for getting a last minute snack. My grandson Elliot has learned to respect the “last call”. Once the teeth are brushed there is no more eating. “Tomorrow we will make sure to have a snack before you brush your teeth.” I know it breaks your heart to hear the “but I’m hungry”. Try not to cave.

I only want to wear my spider-man pajamas and they are dirty: Do your best to make sure you have options before you are in the midst of the bedtime chaos. If that favorite pair pjs or sheets aren’t going to be usable for another night, pop those in the laundry in the morning before you forget.

I am afraid there is a monster under my bed: “This house is safe. There are no monsters. If you like we can put a nightlight in here”. (Do not search for monsters. This would indicate that the possibility of a monster in the closet exists.)

I have to poop: This is a tough one, I would take them to the potty but do NOT engage or talk to them. Make it very businesslike.

Other considerations

• Avoid sugary foods, rough-housing and screen time in the period before bed.

• If possible make sure kids are exposed to natural daylight during the day.

• Start dimming lights and lowering the noise and energy level about 45 minutes before the actual bedtime. This is very impactful!

• A cooler room is more conducive to good sleep.

• Keep the bed for sleeping and napping. Do not use it for ‘time outs’ or playing.

• I have no issues with using a white or brown noise machine

• Model good behavior (sorry daddy, you were not such a good example in this one instance.)

• Try to keep the schedule the same every night. Weekends shouldn’t be different from school days.

• Illness or travel can completely derail a schedule. Do the best you can and just roll with it until you are home or everyone is feeling better.

• If you or your child are having consistent issues falling asleep, it is worth checking iron and Vitamin D levels. Low levels can be associated with insomnia.

If you are feeling more ambitious and have the bandwidth, another way to have a really clear routine is to make a Bedtime Book with your kids.

Children love ritual and will enjoy reading their special book night after night. You will tire of it long before they do. Here is a step by step guide to making your own. Many children love helping you make the book by posing for the appropriate pictures. Of course this means you actually have to print some, rather than having them live exclusively on your phone.

Make your Bedtime book:

Get a binder. Bonus if it has an insert on the front so you can slide in a photo; this should not be too hard to find.

Put the pages into clear page protectors for a waterproof book that you can tweak over time by adding or subtracting pages. You may want to update it yearly with current photos and rituals.

Call it what you want; MY BEDTIME BOOK or add your child's name and age.

Start the book with photos of important people and introduce them.

Here is (parent) and if there are two of you, here is (parent),

Here is (sibling)

Here is (pet)

This is Me (or us if there is more than one child sharing the book)

For young kids, I would keep it to your immediate family members and pets, but you can be as inclusive as you want but keep in mind that unless you want to be reading for hours, this is not the time for the entire family tree

Next add a picture of your house with street sign and address:

This is where my family lives (great way for kids to learn their address)

Picture of bed.

Picture of a special blanket.

This is the safe comfy place where I sleep.

These are my special stuffed animals.

If your child has two homes you can take a picture of each room and make 2 copies of the book so there is one at each house. It is nice to have a ritual that is consistent in both places.

Take pictures of your nighttime rituals such as:

I get into Pajamas

Picture of a toothy smile - Before I go to sleep I brush my teeth. It is important to have clean and healthy teeth.

We get into bed and the lights get a little darker (picture of snuggling).

You can add some open-ended pages that allow the story to vary each night. Options include things like:

Pick several from this list:

We have read our (number that you have agreed on) stories/books

We have sung our (number that you have agreed on) songs

Let's talk about something I did today that I am proud of

Let's talk about something I did today that was kind

Let's talk about something I learned today

What was the silliest thing that happened today

Let's talk about something special that we can look forward to tomorrow

We send special goodnight "thought kisses" to people that we love

Finally, end with pages appropriate to winding down the good night process:

Getting good sleep is important. My body does a lot of growing when I am asleep.

My family is very proud of me when I stay in bed all night. If I get up too much they might get grumpy (photo of silly grumpy faces)

Now it is time to say good night and to turn off the light; maybe I will get a special massage (optional but what a nice way to end the day)

Good night!! See you tomorrow!!

Reading

Snuggles

Good Night kisses

This blog hit a milestone/ Half a million views!

 The majority of people reading my posts are the result of being on my email list. I used to send them via Constant Contact. Now I am happily on Substack.

I haven’t ever tried to calculate the actual number of emails opened and read. The one constant is that after I send the email, the posts get placed in my blog. This I can track and my little blog hit 500,000!

It motivated me to take a little trip down memory lane.

I can pinpoint when it started. Back in 2009 when I was working at Noe Valley Pediatrics there was an H1N1 flu epidemic. It feels like a lifetime ago. A vaccine was created fairly quickly, but there was a short supply. While many people are willing to wait in line for their own health care, trust me, that gets thrown on the window when it comes to their children.

The office phones were ringing off the hook and people tried to navigate getting their kids the shot as quickly as possible. There was no way to keep up with the demand for information. Continuous busy signals added to everyone’s stress.

The mother of one of our young patients suggested that I start a blog as a way to communicate any updates. I knew nothing about blogging, but it sounded reasonable. My blogging career was born.

Through the blog I was able to let people know quickly when we got the flu vaccine shipments and how we were managing the allocation.

Several months later, things had settled down from that scary flu season, but I now had a platform and I had thoughts on how to use it. I had come to recognize that many of my patients had the same questions (over and over and over). To minimize the need for frequent repetition, I started writing posts that addressed some of the more common issues.

The blog became an easy resource. At work if one of my callers had a question about a fever, a rash, strep throat etc, I would email a link to the related post and have them call me if they had any follow up questions. It was a great system.

I changed the name to Nurse Judy’s Approach. I got in the habit of sending out a weekly post on Friday mornings. I would often pick new topics based on what was going around. My patients also put in requests for things they wanted me to cover.

I confess to mixed feelings when I had my first moment of internet fame for my head lice post.

I loved writing and it felt so nice getting feedback about how my posts helped people get the information that they needed without freaking them out.

I also loved how much I learned along the way.

It’s time for some gratitude.

Thanks to my loyal readers who have stuck with me from the beginning, even as my subject matter has expanded and your children have grown. Welcome to all the newer readers who somehow found me.

Thanks to all of you who have shared the posts with others!

Thanks to the many doctors, specialists and experts in their fields who generously shared their wisdom with me when I would do a deep dive into a topic.

Thanks to Dr. Ted for encouraging me to keep the habit going. Collaborating with him while we update the old posts and create new ones is so much fun. No one can go down rabbit holes quite like the pair of us.

Yes we are hard at work for the enormous sleep post that I promised….It is coming.

Thanks especially to my husband Sandy who decided that my grammar was horrible enough that it shouldn’t be allowed out in public; he started editing for me several years ago. (While my attitude was always that if someone really got annoyed by an errant comma, they could get their information someplace else; BTW, he found six errors in the draft of this post!)

Thanks Rebecca for getting me over the hump

And later that day…..

Thanks for reading!!!

July 4th Safety Tips

 Here are some tips that can help you all have a safe & healthy holiday weekend.

Posting it a day early. It might be more useful for planning purposes.

Fireworks

Not surprising that these are on the top of the list.

Please be very careful of fireworks. If you are skipping the organized shows and planning on setting them off yourself, make sure your kids don't have any access to the fireworks or matches ahead of time. Do an inventory and know exactly what you have on hand. Keep the kids at a safe distance during the actual fireworks. Have a bucket of water or a hose nearby.

The danger isn’t only personal injury. If you are living in an area where the fire danger is elevated, please don’t be a dumbass.

Fireworks are LOUD

Loud music and fireworks can be damaging to your child's sensitive ears. Consider getting some ear protection if you are going to be someplace that can put hearing at risk:

How loud is too loud?

Dogs and cats hate the 4th of July

Try to keep your pets indoors with windows closed. There are items such as the Thundershirt or medications that you can give them if you know your animal has a tough time with the booms of fireworks. There are also some noise canceling headphones for pets, newly on the market.

I know this first hand, my poor grand-dog, Bowie, who is an enormous fierce looking shepherd/husky mix, is absolutely terrified of fireworks. We were in Golden Gate park last year and some (^%$#) set off a firework just yards away. Poor Bowie, all 75 pounds of him, jumped into his daddy’s arms and needed to be carried to the car. ( Luckily Adam is a strong guy)

Also, pay attention. Stressed out animals need to be observed especially closely with any interactions with your children and babies.

Make sure that your animals are microchipped or have current tags on, in case they get out.

Going out in a crowd

Since some of the holiday festivities may involve large crowds, I have some recommendations for dealing with situations where you might find yourself in a throng of people. Dress your child in bright clothes that stand out from the pack. Take a photo of them before you set out, so if heaven forbid you get separated, you have a current picture to pass around that shows exactly what they are wearing. Another sensible and creative idea is to write your phone number on your child's wrist and cover it with liquid band-aid to make sure it doesn't wash off. Make sure all phones are fully charged.

Have a solid plan with your older children. What should they do if they lose sight of you? Where should you meet up? This is a good time for the : ‘What would you do if’ game

Protect from the sun and stay hydrated

If you are in San Francisco chances are you probably don't have to worry about the heat. When my kids were growing up, our July 4th fireworks watching usually included warm blankets, hot chocolate and lots of thick fog. I remember one year when Lauren was 3 or 4 and we were driving to a vantage point, she saw a traffic light through the fog. "Is that a firework? It's beautiful!" Ah, our San Francisco babies.

For those of you escaping the city…..

Get in the habit of doing a skin sun exposure check at least every 30 minutes (more frequently for fairer kids) to see if it is time to reapply the sunscreen. Be very wary about applying any of the aerosol sunscreens around a heat source (like a grill.) These are flammable and there are horror stories out there about terrible burns that have occurred.

Sunscreen post

Safe Grilling/food safety

Let's move our discussion over to grills. I was watching the news and a story came on about the hazards of metal bristles coming loose from utensils that are used to clean your grill. These metal strands may get lodged into pieces of food. People have been reporting mouth injuries and worse. Happily, that is one call that I have never gotten, but it seemed like a caution worth sharing. Check your utensil brushes to make sure there is nothing loose. While you are at it, check the grill surfaces to make sure there are no pieces of any foreign objects that can get stuck in the food.

Make sure your child can't get anywhere near any type of grill. The danger begins from the moment you light it and are waiting for it to be ready, until long after the cooking is done and you are certain it is completely cool.

If you are cooking meat, make sure that it is thoroughly and safely cooked. Food borne illnesses don't just love under-cooked meat; other foods can transfer the bacteria also. Pay attention to any picnic foods that will be out of refrigeration for several hours:

Outdoor woes

If your picnic/meal is outside and you will be spending time in grassy, wooded places, make sure you do a head to toe check for ticks once back inside:

Ticks are rampant right now. Finding them early before they have been attached for a couple of hours will vastly decrease any concern about disease transmission.

Tick Post

If you are doing any hiking, or have a dog who is tromping around in the bushes, then pay attention to the possibility of Poison Oak

No, it is not okay to keep your child in bubble wrap; that isn't my intent. Go forth and have a festive, fun and safe holiday. Happy 4th of July!