At age 3, Amaya Jenkins had slept in her crib so seldom that her parents decided to give it away. "It was brand-new," said her mother, La-Shawn Jenkins, who lives near Baltimore. "We had to blow the dust off it."

After her exhausted parents repeatedly left her to cry herself to sleep, 6-month-old Catherine Lake of Ellicott City became hysterical when anyone tried to get her near her room, even in broad daylight. Her mother, Tisha, said the child would sleep only in her -- the mother's -- bed.

My husband, Ken, and I understood these parents' frustration. Approaching his second birthday, our own son, Ilan, was a sunny, smiling easy baby, except at 12, 2, 4 and 6 a.m., when he awoke screaming, no matter what we tried.

Clearly, this couldn't go on. That it didn't, we owe to Kimble-Leigh West, the "Sleep Lady" of Severna Park.

A clinical social worker with a practice near Annapolis, the 38-year-old West has developed an unusual specialty, giving several hundred sleepy parents and sleepless babies a gentler alternative to the "cry it out" approach popularized by Richard Ferber, the Boston Children's Hospital sleep expert. She doesn't promise a tear-free transition to good sleep. But for parents emotionally or philosophically opposed to "Ferberizing" their babies, as well as for parents who have tried Ferber's technique and failed, West's "fewer tears" attitude is a relief.

"I am not going to suggest that you just close the door and let your child scream," she reassures new clients, who pay several hundred dollars each for her individualized plans. "I would never suggest anything that would make you feel like a horrible parent."

Instead West, who has two children of her own, coaches clients on how to help their babies and toddlers become more adept at self-soothing and putting themselves to sleep and how to give the tykes confidence that their parents are still nearby, attentive and responsive, even when they are out of sight.

And while some skeptics might wonder how parents too tenderhearted to hear their kids cry are going to weather the next 18 years or so of child-rearing crises, West enthusiasts would likely answer: On a full night's sleep.

Hard Lessons

Sleep researchers estimate about 20 to 25 percent of children under age 5 have sleep difficulties. In some cases, there are physical causes, such as apnea (a breathing disorder) or digestive problems. Sometimes, too, there are emotional issues -- anxiety or separation problems that go deeper than run-of-the-mill nightmares or monster-under-the-bed fears.

But often, according to Ferber and other experts in the field, the children just never learned to put themselves to sleep alone in their cribs.

"The need for sleep is biological, but the ability to sleep is learned," says Rafael Pelayo, director of pediatric sleep services at the Lucile Packard Children's Hospital at Stanford University and a member of a National Institutes of Health sleep research advisory board. "With babies, it's a learning issue, not a discipline issue."

Since the mid-'80s, pediatricians have recommended "Ferberizing," in which a baby is left alone to cry while the parent briefly reassures the infant at regular, but less and less frequent, intervals. The theory is that if a child learns to fall asleep on his own, without being rocked, nursed, stroked or serenaded, he will be able to go back to sleep on his own during the brief awakenings that almost everyone experiences every night and scarcely remembers the next morning.

Sleep researchers have shown that "Ferberizing" usually works, according to Jodi Mindell, associate director of the sleep clinic at Children's Hospital of Philadelphia. What may work still better, according to some studies, is a tactic known as "extinction" -- basically, letting the child cry and making no parental checks. But many parents, say researchers, can't turn off their ears and heartstrings long enough to tolerate it.

Whatever the reason, neither method works all the time. "It's not one-size-fits-all," Mindell says. That leaves room, she says, for alternative approaches such as West's. Pelayo agrees that gradual techniques like West's are often effective. "The question is," he says, "what are the parents comfortable with?"

Life Line

West accepts only four or five families at a time as clients. She works with each intensively, starting with a detailed sleep history and a 90-minute office consultation. Where separation issues are pronounced, West says, some clients may get partial insurance reimbursement. Follow-up involves 10- to 15-minute telephone calls almost every morning for the first week, several days a week for another two or three weeks and an occasional e-mail for three months.

Many clients say those morning phone calls{ndash} -- part pep talk, part fine-tuning -- are what helped them stick with the program, especially in the first, draining days.

"Having Kim call every morning was invaluable," said Cara O'Connor of Washington, who consulted West about her daughter Caitlin Shirvinski when the child was 11 months old. "You could rehash the night before, talk about what adjustments you need to make, whether it was great or whether you caved and did something you probably shouldn't have."

West's plans generally involve having the parent start out sitting next to the bed or crib and stroking or soothing the child, without picking the baby up. The parent can make calming "night-night" sounds, but does not converse. Every three days, the mother or father moves a little farther away, until the parent is sitting right outside the bedroom door, dimly lit and still in the child's view. Then the parent moves out of sight but still in earshot. Finally the parent is ready to leave the child for five-minute intervals, after telling the baby where she will be and what she will be doing.

"I wasn't just leaving my child in a dark room by herself to cry," said Pam Brooker, a Towson-area resident who consulted West last spring about her then 7-month-old daughter, Anna. "It helped me to be able to be in there and soothe her."

Nighttime awakenings taper off once the child learns to go to bed independently. Nighttime nursing schedules are adjusted or eliminated depending on the infant's size, age and nutritional needs.

Each case is a little different, though. Tisha Lake, for instance, spent two weeks just reintroducing Catherine to her dreaded room, putting in new toys and books before she tackled the sleep problem. She slept in Catherine's room for a few days to ease the transition. Amaya Jenkins has cystic fibrosis, and the choking and gagging characteristic of the disease affected her parents' willingness to leave her unattended. But West developed a routine that addressed the parents' anxiety about Amaya's health and still got the child happily sleeping in her "big girl" bed on her own and through the night in about two weeks.

Firetrucks and Night-Night

Ken and I first saw West in late August. Ilan was almost 2 and we were going through bedtime contortions involving tapes, books, big beds, small beds, rocking chairs, back-rubbing, head-stroking and hand-holding. It was hard to get him to sleep in the crib once he awoke, and he awoke almost every night, repeatedly. We usually surrendered and brought him into our bed, and while there is nothing sweeter than a little head of soft blond curls tucked next to my own cheek, he was not a peaceful sleeper, not even with us.

While Ilan retained his cheerfulness, my husband and I were losing ours. I was always grateful that somehow, as a seriously sleep-deprived working mother of two, I had managed to stumble through another day without falling asleep at the wheel, setting my house on fire or nodding off too conspicuously at a Capitol Hill press conference.

Even for someone whose livelihood involves tracking down information, finding help wasn't easy. I surfed the Web, scoured Montgomery County libraries, ordered books off Amazon, quizzed pediatricians and therapists, phoned all the sleep clinics in Washington and surrounding counties in Virginia and Maryland, only to be told that they did not treat very young children or they only treated children with sleep difficulties arising from breathing disorders. One day, Angela Gadsby, a Maryland pediatrician I know socially, mentioned Kim West. "I send about five families a year to see her," she told me. "They all sleep."

I suspected, and West agreed, that Ilan's sleep problems were an outgrowth of his reflux, a digestive disorder common in infants. He had outgrown the reflux but hadn't broken his poor sleep patterns.

Although he was young to switch from a crib to a bed, we knew he hated anything with bars. So we put a gate on the door, threw a mattress on the floor, found some glorious red firetruck sheets and made a huge deal about his new firetruck bed. Thrilled, he accepted the change and brought along several stuffed animal friends who he thought would like the firetruck bed, too.

With West's help, we tweaked his evening rituals. We began putting him to bed earlier after West helped us recognize his "sleep window" -- the natural wind-down before that lethal second wind of toddler energy kicks in. If my son rubs his eyes and asks for his special songs, I now know to get the bedtime routine moving quickly. If he starts leaping up and down shouting, "I jump on bed like monkey, Mommy!" I know I miscalculated.

I adapted a song he liked by tagging on a verse about firetruck beds, love and night-night, and sang it each night. He protested each time I moved the rocking chair farther away, but it was nothing either of us couldn't handle. By the time I left the room the first few nights, he was asleep. Then we had a few nights of tears until I realized that, while he resented my leaving him for work or household tasks, he was perfectly ready to share me with his big brother. "Go Zachy homework," he now says as I prepare to leave his room. "Ilan night-night."

We've had delaying tactics, but within normal 2-year-old realms. One week he came up with a series of pressing errands: "I fly kite." "I get e-mails." "I make coffee." But mostly he'll just lie down when told. We still have some bad nights and too-early mornings, but his sleep has improved significantly.

West reports some failures, but not many. She estimates that fewer than one in 20 cases show no progress, usually because of such complicating factors as marital problems, a physical disorder that had not been detected or an otherwise competent parent or caretaker who can't or won't get with the sleep program. But for the most part, patients speak about West with awe.

"I absolutely have my life back," said La-Shawn Jenkins, who was convinced that Amaya's illness would stymie West. "Our life does not revolve around getting our baby to sleep. We can talk about things other than what an awful night it was."


Joanne Kenen is a Washington-area writer.

"Sleep lady" Kimble-Leigh West coaches tired parents on how to get their babies to go to sleep at bedtime with fewer tears.Severna Park social worker Kim West (left) enjoys a session with 13-month-old Catherine Lake and her mom Tisha, who sought West's help with her daughter's sleep problems last summer.