Your Toughest Sleep Problems Solved

Is putting your little one to bed a constant battle? Here, Parents advisory-board member Jodi Mindell, Ph.D., author of Sleeping Through the Night: How Infants, Toddlers, and Their Parents Can Get a Good Night's Sleep (HarperCollins, 1997), offers strategies for helping babies and big kids alike get the rest they need.

Q: My 6-month-old wakes up at least twice a night, and the only way he'll go back to sleep is if I nurse him. How can I break this routine?

A: I'm assuming that you also nurse your son to sleep at bedtime. If this is the case, you need to teach him how to fall asleep on his own. For the next week, feed him earlier in the evening and rock him to sleep instead. Once you've broken the association between nursing and slumber, put him in his crib while he's awake. Obviously, it isn't going to be easy -- it will probably take three to five nights before he learns to fall asleep this way. (Throughout this transition, feel free to nurse him back to sleep if he wakes during the night.) But whatever you do, don't give up. Once your baby has learned how to soothe himself at bedtime, he'll be able to fall back to sleep in the middle of the night without your help.

Q: My 3-year-old insists on sleeping with a light on in her room, but I've read that this may be harmful. What should I do?

A: A 1999 report did claim that night-lights hurt young children's vision. However, this conclusion has been strongly disputed, and there is no other evidence that sleeping with a light on is harmful in any way. As long as your daughter doesn't use the light to stay up and play, there's no problem with leaving it on.

Q: My 2-year-old has been sleeping with us since she was a baby. We've gotten her a bed, but she still insists on sleeping in ours. What should we do to make the transition easier?

A: It's difficult for a child who's used to sleeping with Mom and Dad to move into her own bed, so make the transition gradually. To start, lie down with your child in her bed at bedtime. After she gets comfortable falling asleep with you lying next to her, just sit on the bed. Once she gets used to this, sit in a chair at the foot of her bed, and then move progressively closer to the door. Eventually she'll be able to fall asleep alone. Keep in mind that every child is different -- some need only one night at each step; others need several.

Q: My child is 3 months old. Is it too early to let him "cry it out" and fall asleep on his own?

A: There is no set age to begin sleep training. Some children are ready as early as 3 months; others need a little more time. (I recommend starting before a child's sixth month -- the process becomes more difficult after he can pull himself up in his crib.) However, you should never just let your child "cry it out." Instead, check in on him frequently to make sure he's all right. This will not only reassure and help calm your baby but also ease your nerves. Finally, once you decide that the time is right for sleep training, start with bedtime. Only after your child has learned to fall asleep at night -- which usually takes about a week -- should you incorporate this method at naptime.

Q: My 4-year-old has sleep apnea. Our doctor thinks removing his tonsils -- which are enlarged -- will help him sleep better. Do you agree?

A: Obstructive sleep apnea is a breathing disorder in which a child repeatedly stops breathing during the night. Though it's usually thought of as an adult disorder, sleep apnea is actu-ally quite common in children, especially between the ages of 3 and 6. Symptoms include snoring, breathing pauses, noisy breathing, and sleepiness during the day. The condition is not life-threatening, however, as a child always wakes up when he needs to breathe. Because childhood sleep apnea is often caused by enlarged tonsils and adenoids, I agree with your doctor's recommendation. Removing them will most likely help your son have more restful nights and function better during the day.

Q: My 5-month-old refuses to nap! As soon as I put her in her crib, she starts crying, and she doesn't stop until I pick her up. I try to wait 15 minutes before going in to see her, but it doesn't seem to help. In fact, the only way she'll doze off is if I rock her. What should I do?

A:The one thing you shouldn't do is leave your baby to cry for 15 minutes and then rock her to sleep. This teaches her that if she cries long enough, you'll pick her up. You have two options: Either let her fuss until she learns to fall asleep on her own (while you frequently check in on her), or promptly pick her up after she starts fussing, play with her for five to ten minutes, then put her down again. Remember, your goal is to teach your baby to fall asleep on her own -- how you get there doesn't matter.

Q: Even though our 5-year-old has been using the potty for almost two years, he has started wetting the bed. What should we do?

A: Bed-wetting is a common problem for kids this age -- especially boys. Though most children outgrow it over time, some cases are caused by sleep apnea, so it's a good idea to check with your doctor. In the meantime, limit the amount of liquids your son has at night and have him go to the bathroom right before bedtime. If his problem persists, your son's physician may recommend getting a bed-wetting alarm.

Q: Almost every morning when she wakes up, my 4-year-old daughter says she has had bad dreams. Is this normal?

A: Yes. It's normal for 3- to 6-year-olds to have bad dreams because their imaginations are developing. However, if your daughter has suddenly begun reporting nightmares, you may want to look into the reason why. For example, are her dreams related to a recent change at home or school? Is she anxious about an upcoming event? During the day, try to get your daughter to tell you more about what is happening in her dreams, and see if you detect a pattern. (Some kids can learn to change the result of the night- mare and give it a happy ending.) The dreams should go away with time, but if they are upsetting your child, it's best to speak to her pediatrician.

Q: My 3-year-old wakes up in the middle of the night and climbs out of bed, looking for us. Why is he doing this, and how can we stop it?

A: Three-year-olds -- who are used to the physical boundaries of a crib, where they couldn't get up and move around -- will often get out of bed during the night simply because they can. They don't yet understand that beds have boundaries too (albeit invisible ones). Consistency is the key to success, so when your son gets up, immediately return him to his bed and tell him that he needs to go back to sleep. Creating a sticker chart that rewards him for staying in bed can also help. At first, let him earn a sticker for simply sleeping in his own bed, even if he comes looking for you. Once he has a little success under his belt, he'll be more willing to stay put.

Q: Every night, I put my 5-month-old to sleep on her back, but she's taken to rolling onto her tummy. Is this dangerous? I'm concerned about SIDS.

A: Many parents worry when their child starts rolling over at night, but once infants reach this stage of development, they are generally no longer at risk for SIDS. You don't have to keep rolling her back over, but do talk to your pediatrician to make sure your child doesn't have any other risk factors for SIDS. Also, avoid putting anything in the crib -- such as blankets or stuffed toys -- that she can roll onto.

Q: Why is our 2-year-old suddenly afraid to go to bed? He gets sick to his stomach and claims he's afraid of the dark. We've let him sleep in our bed the past few nights, but I don't want to make this a habit.

A: For one reason or another, your child is going through a tough time, so let him sleep with you until his anxiety subsides a bit. Reintroduce him to his crib by hiding favorite toys in it, and get him used to his room again by playing games there during the day. The first night you put him in his crib, stay with him until he is sound asleep. Over the next week, ease yourself out of the room. With any luck, he should adjust back to his old sleep routines. However, if he continues to suffer from anxiety, talk to his doctor.

Q: My 2 1/2-year-old has gotten into the habit of going to sleep at 8:30 p.m. and waking up at 11 p.m. She's wide-awake and up half the night. Help!

A: Start by looking at your daughter's schedule; she may be sleeping too much during the day. (Children her age should nap for only 1 1/2 to 3 hours a day.) Consider reducing the length of her naps to see how she responds. If she continues to wake up, consistently tell her that it's time to sleep, and don't let her leave her bed. This will be easier if you and your spouse do only "boring" things after her bedtime, such as reading, paying bills, or talking. She'll be more willing to go to sleep if she sees that she's not missing out on anything.

Q: Getting my 5-year-old to go to bed is a nightmare -- he won't listen to our repeated requests to get ready. What should we do?

A: You need to create -- and stick to -- a routine for the 20 to 30 minutes before your son goes to bed each night. First, make a bedtime chart, using pictures of items such as a toothbrush and pajamas to represent steps in the routine. This will help him keep track of everything he must do and give your nights more predictability. Second, make the last part of his routine a favorite activity, such as reading a book or playing with a toy. This will give him a reason to look forward to bedtime. I recently worked with a 4-year-old who refused to go to bed. But once his dad started playing with his toy soldiers with him, he couldn't wait for his nighttime routine to begin.

Copyright© 2004. Reprinted with permission from the February 2002 issue of Parents magazine.

All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.

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