Sleep Challenges: Why It Happens, What to Do

Learn how to make sense of your infant or toddler’s sleep challenges, and find out how to appropriately address them.

Few parents get through the early years without struggling with some kind of sleep issue with their child. Consider some of the examples below. Do any of these sound familiar to you?

• Eight-week-old Tabitha falls asleep quickly as her mom rocks and sings to her. But the second her mom puts her down, Tabitha starts to cry until her mother picks her up again.
• Brian, 16 months, still wakes up 2–3 times a night and can’t go back to sleep unless his mom or dad pats his back for up to 30 minutes.
• Natasha, 33 months, refuses to go to sleep without a bedtime routine that seems to get longer each night. Even after “lights out,” she calls for her dad or grandmother many times for drinks of water and trips to the bathroom.

While there are no easy answers or one-size-fits-all approaches to solving sleep challenges, there is a lot you can do to help your child become a good sleeper. Trying the strategies below, modifying them to meet the needs of your child and family, is a first step. With sensitivity, patience, and consistency, hopefully you will all be sleeping better soon.

Think about:

Think about the following questions to help you adapt and apply the information and strategies below to meet the needs of your individual child and family:

• What do you find most challenging about your child’s sleep habits? Why?
• What do you think are the reason(s) for your child’s sleep challenge?
• What have you tried that has worked? Not worked? What can you learn from this?

Birth to 12 Months

Newborns usually don’t have trouble falling asleep, and they typically sleep a lot—anywhere from 8 to 16 hours—waking when they need something such as milk or a diaper change. They don’t yet know the difference between day and night, and they sleep for different lengths of time each day. An unpredictable sleeping pattern is normal in very young babies, which can be difficult for parents as they may be up a lot at night.

You can help your baby to sleep more at night by encouraging wakefulness during the day time. Try to spend some time outside each day. This provides good sunlight exposure and helps babies stay awake. Being outside also helps babies learn that daytime is when it’s bright out and they are active and social, and nighttime is when it’s dark and quiet.

By about 3–4 months of age, babies learn the difference between day and night. By about 6 months old, most healthy babies are capable of sleeping through the night. They are able to take in enough milk and other food during the day that they do not need to eat during the night. However, many babies are still waking up because they are used to falling asleep while being fed, rocked, or comforted in some other way. When they wake up—which we all do several times a night—they don’t know how to get themselves back to sleep on their own. Babies who have learned how to soothe themselves by, for example, sucking and getting their bodies into a comfortable position on their own (such as curling up in the corner of the crib) generally have an easier time putting themselves back to sleep. So it is a good idea to encourage self-soothing behaviors when your baby is distressed during the daytime.

12 to 36 Months

Most children this age sleep about 12–14 hours and take two naps a day. Between about 12–18 months, many children give up the morning nap and take one longer afternoon nap. However, as with all areas of development, there is wide variation in the amount of time children sleep. Like adults, some children need more sleep than others to function at their best.

Birth to 12 Months: Common Questions

1. My 3-week-old son wants to be held all of the time. I can’t put him down without him crying within a few minutes. He sleeps with me at night, but only naps during the day if someone is holding him. Any suggestions?

As tough as it can be for new parents who just want a few minutes to themselves, the fact is that very young babies often just want to be held. When you hold your baby, he feels your warm body and hears your heartbeat, a sound familiar from inside the womb. He smells your scent. When you cuddle him, he feels safe; it reminds him of the good old days back inside your belly. Plus, the closer he is, the more likely he is to receive your caresses and kisses.

It takes time for babies to learn to fall asleep on their own. Stay with him and rock him, sing, or stroke his face or hand until he settles down. Babies this young simply don’t have the ability to calm themselves yet, so it’s important not to let him cry it out. Helping him soothe himself during the daytime will help him calm himself at night when you put him down. So be patient, seek out help when you need it, and remember that these early days and months do fly by very quickly.

2. I have an 8-week-old. Her eating and sleeping habits are all over the map, and everyone keeps telling me to “put her on a schedule.” What does that mean and how do I do it?

Many parents feel exhausted and puzzled by their newborn’s seemingly random sleeping, waking, eating, and pooping schedule. This unpredictability is normal. The first 3–4 months of a baby’s life is a transition period, as infants learn to adapt to life outside of the womb. Getting used to being awake during the day and sleeping at night takes time and help from you.

Babies are not usually capable of maintaining any kind of consistent schedule until they’re 4–6 months old. So the first few months of your child’s life is not the time to work on setting up a rigid routine. For newborns, it is best that naps and feedings are on demand.

However, it can be helpful to develop some routines around sleeping and eating to lay the groundwork for establishing a schedule later on. For example, when you see that your baby is getting drowsy, you can sing her a lullaby, and then put her down to sleep. Over a period of time, the lullaby will become a cue for napping.

It’s also a good idea to look for patterns in your child’s behavior to help you develop routines. One mother, who was trying to get her 10-week-old to take two or three longer naps a day instead of six or seven catnaps, noticed that her child got very sleepy during feedings. So she decided to slowly adjust the feeding times to take place closer to when she wanted her baby to nap. She also started trying to keep her daughter awake a few minutes longer before each nap so that the baby would be awake for longer periods during the day, take longer and fewer naps, and sleep for longer stretches during the night.

To get into more of a routine for feedings, stretching out the time between feedings so they are longer and fewer, you can try a similar approach. See if you can delay a feeding for even just a few minutes when your baby is giving you signals that she’s hungry. If you continue to do this at each feeding, she is likely to eat a little more each time and will be able to wait longer between meals.

3. My daughter is 2 months old, and I’m wondering if this is too young for her to start sleeping in a crib in her own room. She’s been in ours since we brought her home, and she never sleeps through the night without waking at least a couple of times.

The American Academy of Pediatrics recommends that parents sleep in the same room as their baby – but not in the same bed as a baby – for at least the first six months, if possible. Once your child is old enough, here is one approach to managing the transition to her own room sensitively. First, help her prepare for the change by making her room a safe, familiar place. During her alert periods, make sure she spends some time in her room with you playing and reading. Use her bedroom for diapering and for bedtime and naptime routines. You might also want to gradually get her used to the crib by starting with naps during the daytime for a few weeks and then transitioning to using the crib at night. Nighttime sleep is often the more difficult transition. This incremental approach, while making these transitions warm and nurturing experiences, will help your baby learn to connect her room with cozy, safe feelings.

4. I am trying to train my 5-month-old to sleep through the night, but when I let him cry it out, he keeps waking up my 3-year-old. What can I do?

Many a parent has had the experience of waking up in the dead of night to a baby wailing and, shortly after, an older child calling out, “Mommy?”

Here are some ideas to help you make it through sleep training as well rested as possible:

Make noise. That is, provide white noise. The sounds will drown out middle-of-the-night crying for your older child. You can buy a white-noise machine, or simply run a fan in your older child’s room. Some families have found playing a relaxation CD works well.

Talk to your older child about what’s going on. Explain how her younger brother or sister is learning how to sleep through the night. Remind her that she knows how to get herself back to sleep when she wakes up. Make a plan together for what she can do if she’s awakened by her brother. For instance, she might closer her eyes, cuddle with her “lovey,” and think about the story you read together before bedtime.

Don’t linger. If your older child wakes you up because her younger sibling woke her, go in and explain (in whispers) that her brother is crying because he’s having trouble falling back asleep. Don’t turn on any lights or do anything that may make her more alert. Let her know you are working on helping him get back to sleep, and remind her about what she can do to get back to dreamland. Then give her a kiss and be on your way.

Be patient. You may have not one but two cranky children for a while until your youngest is sleeping through the night. If your older child is more irritable, whiny or clingy, you’ll know why. Just think how tough it is for you to make it through the day on little sleep—and you’re a grown-up who can order a cup of coffee! So hang in there, maintain a regular bedtime and naptime for your kids, and someday soon everybody in your home will be sleeping tight.

5. Since my 8-month-old was a tiny baby, I have had a regular bedtime routine: bath, quiet play, books, bed. It worked like a charm. But now, after we’ve read our story, my son starts fussing and crying as I carry him to his room. What’s going on?

It is very common for babies around 8–9 months old to begin protesting at bedtime. Why? Because at this age babies are developing an understanding of “object permanence”—the concept that people and things exist even though they can’t be seen. So now, when you put your son to sleep and leave the room, he knows that you are still out there somewhere. He is also starting to understand that he can make things happen. He knows that if he fusses and cries, he will get more attention from and time with you. Who could blame him?

To help your baby cope better, start by doing his bedtime routine in his room. This can make the transition to bed easier and will help him think of his room as a place of comfort and security. If he is still fussing when you put him in his crib, leave the room and see if he calms on his own. If he doesn’t, go in every few minutes for a second or two to let him know you are still there. Don’t turn the lights on or pick him up as that will only get him more aroused and make it more difficult for him to soothe himself to sleep. If you are consistent and stick with the routine, after a few nights he will likely stop fussing and soothe himself to sleep on his own.

6. We are going to be visiting my parents’ house in a few weeks, where my 9-month-old will be sleeping in a portable crib. This is his first time away and his first time sleeping anywhere but in his own crib at home. Any tips on making the transition easier?

Begin by borrowing a safe, portable crib if you don’t have one of your own. Place it in a common room in the house and then move it to different rooms, including his bedroom, so he gets used to it in different places. Let your baby explore and play in it for limited periods each day so it becomes a familiar place for him. If you visit friends around naptime or in the evening, you might want to bring the portable crib along and have your baby sleep in it so that he will begin to associate his naptime routine and portable crib with sleep—regardless of where it is.

When you pack for your trip, be sure to bring with you the sheets you’ve been using for the portable crib at home as well as your baby’s “lovey” or other special objects that give him comfort. Because vacations can be very stimulating, especially if you’re visiting family, help your son wind down before nap or bedtime with a period of quiet time when the two of you spend time alone playing, cuddling, and reading books. Then do your usual bedtime routine.

But—there’s often a “but”—some protesting from your baby is normal and expected. Sleeping in a new place can make children feel insecure and fearful. Plus, at 9 months, children are learning about “object permanence”—the understanding that people and things still exist even though they can’t be seen. So protesting when you leave the room to try and get you to reappear is quite common. If your baby cries, peek your head in every few minutes to reassure him that you are still there and that he is safe.

Some parents understandably worry that for babies who had been sleeping through the night, the regression they see while on vacation will carry over when they return home. However, once babies are back in their own bed, after a few days they usually settle back into their normal sleep pattern.

12 to 36 Months: Common Questions

1. My 15-month-old son has just started child care full time (he was going 2 days per week before). All of a sudden, the child who has been sleeping through the night since he was 6 months old is waking up twice! I thought he was already adjusted to child care. After all, he’s been at the same center for a year now. What can I do?

Toddlers love their daily routines. Any change in their life (new house, new baby, new dog, new child care provider) creates some insecurity as they depend so much on predictability—knowing what to expect—to feel safe.

Because young toddlers can’t express their very strong and complex feelings in words, they “tell” us how they are feeling through their behaviors. Night waking is a very common reaction to changes or worries. It’s very effective as it results in contact with you that reassures your child that you will be there to comfort him and that all is right in his world.

So, what to do about the nighttime wake-ups?

Establish a bedtime routine: quiet play, bath, books, songs, lights out. This helps your child know what to expect and to prepare, emotionally, for separating from you.

When your toddler wakes in the middle of the night, go in and pat him on the back or kiss him on the cheek to provide the reassurance he needs, then return to bed. Don’t pick him up or interact—that’s likely to arouse him and make falling back asleep even more difficult.

Expect that he will protest and cry when you leave. If you keep returning to soothe him, he learns to keep crying out because it is so rewarding. He also doesn’t have the chance then to learn to soothe himself. If allowing him to cry makes you feel uncomfortable, peek in his room to let him know you are still there and reassure him that he is okay. But remember to limit interaction as much as possible as it will prolong the night wakings.

Keep in mind that research shows that letting a baby or toddler cry as they go to sleep does not have any long-term, damaging effects. A child who is well loved, nurtured, and responded to during the day will not be hurt by fussing a bit before bed in the evening. Remember: Crying at bedtime usually lasts for just a few days before your baby adapts and begins to put himself to sleep (provided you are consistent).

2. My 18-month-old son naps at child care like clockwork, every day from 12:30 p.m. to 2:30 pm. But on the weekends we can’t get him to go down for even 30 minutes! We do his nap routine, put him in his crib, but he screams until we give up and go get him. By 5 p.m. we’re all exhausted. Any suggestions?

It can be tough to have a toddler up all day, especially one who is cranky and overtired. No nap means no break for mom and dad. It can feel pretty frustrating for parents to know that their child happily goes along with naptime at child care but won’t go down without a fight on the weekend. The comforting news is that this dilemma is pretty common. Here’s why.

First, child care providers are dealing with children in groups, so there is a greater need for rules and cooperation than there is at home. Young children learn very quickly what will and won’t fly in the different places they are cared for and are amazingly adaptable. Second, there is a difference in the nature of the adult–child relationships in child care versus home. A child care provider may care deeply about your child, but she does not have the same emotional connection to him as you do. This is why parents almost always find it more difficult than care providers to set and enforce limits. Parents sometimes get love and limits mixed up. Setting limits feels “mean” because children are often unhappy about and protest them.

As you begin to tackle this issue, keep in mind that you are being good parents by helping your child get the sleep he needs, even if he cries and complains. Start by talking with your child care provider to find out how she transitions the children to naptime. Is there a set routine that helps prepare the children for naptime: lunch, then diaper changing, then a story? Does she rub your child’s back? Play quiet music? Try to re-create the atmosphere and rituals as much as possible at home.

It can also help to try to maintain routines as much as possible on the weekends. Falling asleep in the car for 15 minutes here and there as you do errands means your child may not nap when you get home. If you let your child sleep later on a Saturday or Sunday morning, he may not go down at naptime.

If your child is 1 year or older, put a few soft toys or padded books in his crib. Some toddlers need time to wind down. Quiet play can often do the trick. (Note that soft objects in the crib can be a suffocation hazard for children under 12 months.)

If your son cries, go in to comfort him briefly—but don’t linger or take him out of the crib. Simply peek your head in and say something like, “It’s time to sleep. We’ll play when naptime is done.” You can decide if you’d like to go back in periodically (say, 5 minutes or 10 minutes later if he’s still crying) or not at all. The approach you choose depends on your child’s temperament and what you feel might work best for him. However, keep in mind that the going-in-periodically-to-soothe routine sometimes confuses children and can prolong the protesting as they keep waiting for you to come back in.

Remember, this is a learning process and takes time. Start out with a half hour as a goal. If he doesn’t fall asleep, go get him after 30 minutes. Wait a few days, then shoot for 45 minutes, then an hour. Soon you may find that he is learning to fall asleep on his own. Or, he may just rest and play quietly (remember, you can’t force a child to sleep), which also has benefits.

The most important thing is consistency. Going in and picking him up one day, then letting him cry it out the next is not likely to work and will only confuse your toddler. When you are consistent with his napping ritual, he will learn to adapt more easily and quickly.

3. My 2-year-old is loved and well cared for by my husband and me. She has not been abused or exposed to violence. So why does she have bad dreams? For some reason my daughter has had three nightmares in the past two months.

Just like adults, children work out confusing or difficult feelings and experiences through their dreams. At 2, children are active participants in the world around them and are taking in so much all of the time. We can’t know how they are processing all that they are exposed to. Naturally, some of what they see and experience is difficult for them to make sense of. This can be scary. For example, you might read a book together that has a picture of an animal that your child finds frightening. Or you may come across an object that you don’t find scary at all (like a tractor mowing the lawn at the park), but that your child finds terrifying. Later, these “characters” may find their way into your child’s dreams.

At age 2, children do not fully understand the difference between fantasy and reality, which can lead to an increase in fears. These sometimes get expressed through dreams and nightmares. It can help your child to describe what happened in the dream and how it made her feel. Talking about feelings helps your child understand and get control over them. But don’t be worried if your 2-year-old can’t verbalize or give a lot of detail about her dream—her language skills are still developing. Another way to help young children express and work through feelings is through pretend play. If you join your child in her play, and follow her lead, she will tell you a lot about what she is thinking and feeling through the stories she creates and acts out.

It can also be very helpful to give your child strategies for dealing with her fears of things that “go bump in the night.” You can do a room check to show her that no monsters are lurking in the closet or under the bed. You can give a good “anti-monster spray” to her room, or do a “no monsters” dance. You might help her make something that keeps the bad guys away that you can hang in her room, like a sign to put over her bed. Or see if she can come up with some ideas of her own. Avoid the temptation to tell her that monsters aren’t real, as they feel very real to her in her dreams. Negating her feelings is likely to lead to an increase, not a decrease, in her fears.

Also keep in mind that nightmares may occur more frequently when children are experiencing some unusual stress or anxiety. Sometimes changes like the addition of a sibling, a new caregiver, or the move to a new house can create uncertainty in very young children that gets expressed through nightmares.

4. Recently, we switched my almost 3-year-old to a “big girl bed.” My one fear was that she’d start coming into our room in the middle of the night—and that is exactly what has happened. How do we nip this habit in the bud?

It is not at all unusual for toddlers—recently liberated from crib to bed—to start wandering at night. Fearless explorers that they are, they’re determined to exercise their newfound freedom and prolong their daytime fun.

Look at the situation from your child’s perspective: She may love her new bed and enjoy feeling like a “big girl.” But her bed is also new and unfamiliar, and perhaps not as cozy as her crib. When she wakes, as we all do in the middle of the night, she can’t rely on her old familiar crib to help her fall back asleep. There are no “walls” around her to make her feel contained, her blankets and sheets have changed, and the view is different too. When it’s nighttime and she feels unsure in her big girl bed, you’re the one she wants for reassurance. All she has to do is simply stroll down the hall to reach her goal—YOU.

If you want to put an end to these nighttime visits, the key is sensitivity plus consistency. At bedtime, acknowledge that it is a big change to be sleeping in a bed, but remind her that the rule is that she stays in her bed all through the night.

If she does get out of her bed during the night, gently take her by the hand and walk her back to her room. Tuck her in, but do not sing, rub her back, tell her a story, lay down with her, or do anything that would reward or prolong the interaction. Just warmly remind her: “It’s time to sleep. You need to stay in your bed. See you in the morning.” (In other words, make it a boring visit.)

The following strategies can help your child learn to soothe herself back to sleep during this transition:

• Talk about what she can do to help herself fall back asleep during the night. For example, cuddle her “lovey,” think about all of the fun things she did that day, listen to music.
• Make a tape of you and your child reading books and singing together. She can then listen to these at bedtime to help make the separation easier. Or you can borrow some children’s stories on tape or CDs from the library.
• Use bedrails. Bedrails give children the illusion of the walls they had when they were in the crib (and can give the bed a cozier feel) .
• Have her choose a stuffed animal to help her with the transition. Suggest your child choose a special stuffed animal that can be her “bedtime buddy.” Include her buddy in all of her bedtime routines like reading, singing lullabies, and tucking in at night—as well as at naptimes—so that she associates it with comfort and security.
• Try using a night light. When she wakes, she will be able to see her room, get her bearings, and hopefully feel secure enough to go back to sleep on her own.
• Give her lots of encouragement. When she does sleep through the night in her own bed, acknowledge this as the accomplishment it is,“You should be so proud of yourself—you were able to sleep all night in your own bed.”

5. My 2-year-old used to sleep soundly. But since we had a new baby, she has been getting up multiple times a night. This is driving me crazy. What can I do?

While a sibling is a gift to your older child, she doesn’t realize that now. Sharing your attention, your lap, and your love doesn’t seem like much of a gift. Because 2-year-olds don’t have the ability to reflect on and talk about their feelings, they “act out,” expressing their feelings through their behavior. Toddlers who are adjusting to a new baby in the family often regress, or move backward, in one area or another, be it sleep, potty training, or asking for a pacifier or bottle again. Waking at night provides the attention they miss during the day, and the reassurance that they’re still loved and cared for.

To let your toddler know she is still important, make sure both you and your partner each have some one-on-one time with her every day. Make her feel needed and included. Ask her to get diapers or pick out baby’s clothing. When you feed the baby, ask your daughter to pick out a book and turn the pages while you read to her.

At bedtime, be sure to have a very consistent routine for your older child so that she doesn’t become overtired and find it even more difficult to fall and stay asleep. While it’s challenging, avoid postponing bedtime, which often occurs as a family adjusts to having a newborn in the house again. Being overtired can actually make it harder to fall asleep.

When your child wakes at night, keep her in her room and gradually decrease the amount of support she needs to fall back asleep. Peek your head in, tell her everything is okay, and let her know it’s time to go back to sleep. After the second or third waking, call to her from the hallway: “Daddy’s here. Everything’s okay. I love you. Time to go back to sleep.” Decide how many times you’d like to repeat this, then let your child know you are going back to sleep yourself and stop responding. While this can be difficult to do, keep in mind that any attention your child gets for a behavior tends to reinforce that behavior. If you keep responding, she is likely to keep calling out for you, making it difficult for her to settle herself back to sleep.

Another strategy is to sit in her room with her until she falls asleep, but without talking, singing, or cuddling. Each night, move your chair further from her bed until you are completely out of the room. The idea is to let her know she is safe and loved, but not to make waking up at night a rewarding, fun experience.

6. My 2½-year-old daughter sleeps in our bed, and my second baby is due in a few months. I think four in one bed is a bit much, and I’d like to transition my daughter into her own bed in her own room. How do I do this without upsetting or scaring her?

The most important first step is to be sensitive to what this transition is like for your child, who has only known how to sleep up to this point in the comfort and security of your bed. She now has to learn to feel safe sleeping on her own, which takes time.

7. My 3-year-old son is suddenly afraid of the dark. He wants us to leave the light on when he goes to sleep, and if we turn it off after he’s nodded off, he awakens in the middle of the night screaming. What should I do?

Fear of the dark is quite common. In order to understand why this is happening and what you can do, consider the following factors. First, think about any recent changes in his world. A separation from a loved one, a new baby, a new babysitter, a recent move? Any change can cause a child to feel insecure and fearful.

Where he’s at developmentally is also a factor. Starting at around age 2½–3, children are engrossed in a world of pretend and imagination, but they don’t fully understand the difference between fantasy and reality. In their minds, anything can happen at night: the dragon from the bedtime story or the clown from the party might suddenly appear out of the shadows to scare them.

Finally, your child’s temperament is important. Children who are by nature more fearful and cautious, or who get overstimulated easily are more prone to develop fears. To help your child overcome his nighttime fears:

Don’t tease, even in good humor, or try to talk him out of it. This can prolong the fear as well as erode his trust in you.

Try to control any frustration you might feel. Expressing annoyance can increase your child’s distress. It also makes it more difficult for you to respond sensitively.

Make one of his special stuffed animals his “protector” and include it in his bedtime routine. During the day, act out stories in which the protector watches over others.

Let him sleep with a night light or leave the hallway light on with his bedroom door open. Using a dimmer may also help. Let your child decide when he’s ready to darken his bedroom.

If he wakes up in the middle of the night, resist the temptation to bring him into your room. This sends the message that he really is not safe alone in his room. Instead go to him to reassure him that the monsters aren’t real.

Most children outgrow these fears in a few weeks or months. Your best strategy for now is to be sensitive and patient with your son and know that this too shall pass.

First, sit down and talk to her about making this change. Listen to her concerns and let her know you understand that she may be scared at first, but that you’re confident she can learn to feel secure in her own bed. Remind her of other challenges she has faced and overcome. If she doesn’t have a “lovey,” help her attach to a stuffed animal or blanket she seems to especially like. Having a trusted “friend” in her new room with her can provide the sense of security and comfort she needs to substitute for when she can’t be with you.

After you’ve set the stage, pick a start date and end your child’s bedtime routine by lying down with her or next to her bed until she falls asleep. Then, incrementally move yourself out of her room. After a few days of lying beside her, sit a few feet away from her bed and move closer to the door each night until you’re sitting outside her room until she falls asleep.

If she awakens in the middle of the night and comes into your room, walk her back to her room and provide the comfort she needs there. Don’t revert to letting her sleep in your bed. This can cause her confusion about what the new rules are and make it more difficult for her to adapt.

8. My 3-year-old sometimes starts screaming in the middle of the night. When we go to him, he does not respond to us even though his eyes are open. He eventually stops, lies down, and goes back to sleep. He doesn’t seem to have any recollection of the event the next day. Are these night terrors? What should we do?

What you describe does indeed sound like night terrors, which usually don’t start until age 4 or older. Night terrors are different from nightmares. During a night terror, children often scream and may thrash about while remaining asleep throughout. While it can be very scary for parents to watch, children don’t have any memory of the incident, as you have observed, and there are no negative effects for the child. There is nothing you can do to stop the night terror. The best response is to just sit with your child and wait it out. Although tempting, it is best to avoid waking your child, as that can actually be distressing and disorienting to him.

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