Establishing and Keeping Baby's Sleep Routine
When Good Sleepers Go Bad
Do your child's sleep habits follow a pattern of "one step forward and two steps back"? As Karen Werstein, a youth program coordinator and mother of 16-month-old Max, says, "Just when I feel like we're making progress on the sleeping front, Max gets sick or cuts a tooth and we're back to square one. It's driving me crazy!"
It's inevitable: You'll face setbacks as your child hones his sleep skills. Overall, however, if you have a base of good habits and an established bedtime routine, temporary problems don't have to permanently derail sleeping through the night. Typically, the biggest mistake is not getting back on a regular routine, says Judith A. Owens, MD, director of the Pediatric Sleep Disorders Clinic at Hasbro Children's Hospital, in Providence, Rhode Island, and coauthor of Take Charge of Your Child's Sleep (Marlowe & Company). "If something happens -- like a trip or the birth of a new sibling -- and things have to be changed temporarily, the priority should be to return to regular sleep habits and environments so the new behaviors don't become entrenched."
To ensure that sleep-robbing scenarios are just temporary, we talked to experts about six common sleep disruptions to find out what you can do to remedy matters and get your kids snoozing soundly again.
Baby Sleep While Traveling
C.J. Healy, a physical education teacher in San Rafael, California, is the mother of 2-year-old Jack, a great sleeper, and 13-month-old Mary, a not-so-great sleeper. The family took several trips in Mary's first year, and Mary didn't handle the change of scenery well. At home Healy would let Mary cry it out, but on the road she worried about the noise, so she'd breastfeed Mary and let her sleep in bed with her and her husband.
Experts agree that it's all right to have road rules like the Healys'. "Sleep does not go well when you're away -- and that's to be expected," says Jodi Mindell, PhD, associate director of the Sleep Disorders Center at Children's Hospital of Philadelphia. "It's okay to blow all the rules."
To help your child fall asleep in an unfamiliar setting, try sitting in the room with her, suggests Richard Ferber, MD, director of the Center for Pediatric Sleep Disorders at Children's Hospital Boston and author of the newly revised Solve Your Child's Sleep Problems (Fireside). Dr. Ferber suggests doing what you need to do to get your child to sleep -- such as rubbing her back or reading her an extra book -- bearing in mind that you'll have to undo what you did once you get home. "Once you're back on home territory, go back on home rules. It might mean extra enforcement for a few nights. But if the message is clear, you can quickly get back to the way things were."
While traveling, Liz and Joe Richards, of Portland, Oregon, kept encountering a frequent sleep complaint: A Pack n' Play is great for naps, but not for sleeping through the night. Instead of being awakened countless times by their 22-month-old son, Joey, identifying objects in a hotel room -- "light, light" -- the Richardses now put a crib in a separate room. Sure, booking a suite adds to your travel budget, but it's not as pricey as getting two rooms.
Two tips from Mindell, who is also the author of Sleeping Through the Night (HarperCollins): Do not have a night of transition when you get back home. (Yes, this means standing tough even if your child balks.) And, if possible, return from a trip in time for your child's regular bedtime. If the single daily JetBlue flight doesn't arrive until 11 p.m., however, just steel yourself preflight for a bumpy "landing" once you get home -- and again stand firm in the face of some tears or a tantrum. Example: While at Grandma's, tell your 4-year-old, "While we're here, you get to sleep in the same room with Mommy and Daddy, but when we get home, it's back to your own big-girl bed in your own room."
Switching from Crib to Bed
Two months after his third birthday, Cormac Duffy, of Portland, Oregon, asked his parents if he could start sleeping in the twin bed in his room instead of his crib; they had been waiting until he was at least 3, so this meshed with their plans. A previous "horrible sleeper," Cormac had become a "terrific sleeper" according to his parents, so they immediately put away the crib and moved Cormac -- and that's when things got bad again. "Once in his big-boy bed, it was easier for us to lie down with him to read books. He soon got used to this and wanted us to sleep with him 'for just five minutes,' but that really meant all night long," says Erin Duffy, Cormac's mom. "We went from putting Cormac down and having him fall asleep quickly to having bedtime be an hourlong process, at least."
One mistake the Duffys made was hurriedly putting away Cormac's crib: Even though he'd asked for the switch, he was not ready for it. "The transition to a bed is not all-or-nothing. Try it for a few days or weeks. If it isn't going well, there's really no problem in going back to the way things were," says Mindell. If you're considering the move to a bed because your little monkey is climbing out of the crib, she suggests a crib tent.
If your child is staying in her crib and seems happy there, don't rush to move her until between her third and fourth birthday -- otherwise you risk having a nighttime wanderer loose in your house. Think of it from your preschooler's perspective: The bars of the crib represent, in a way, her parents' authority. ("I can't get out of here; Mom and Dad put me in here.") It's only natural, then, that removing those bars creates a tremendous temptation to get up and explore. ("Freedom -- at long last!")
If your child has trouble staying in bed, Dr. Ferber offers a somewhat radical suggestion: Install a gate in the doorway of your child's bedroom to retain the "control" of the crib bars. "Nobody is locked out of the room, and the child can see out of the room. But the child is still confined to the room," he explains. Once you can get beyond the prison analogy, remind yourself that the worst thing that'll happen is your former midnight rambler will fall asleep on the floor -- in which case you can move her into her bed once she's sound asleep. Just remember to shut the gate on your way back to your own bed!
My older daughter, Phoebe, started sleeping through the night at exactly 8 weeks (don't hate me!), so it was startling when she started crying out in the middle of the night about two months later. The culprit? Phoebe had rolled onto her stomach in her sleep but then couldn't turn back over; I'd hurry to her crib to roll her onto her back before she got too worked up. Thankfully, after several nights, rolling over stopped waking her up.
"Around growth or motor milestones, like crawling or walking, your child may temporarily regress in her sleep habits," says Judith A. Owens, MD. Her advice? "It's best just to ride it out. These changes are very temporary."
For Daytime Only
You can take some action during the day to facilitate your child's sleep at night. Practicing the developmental habits during waking hours -- such as by helping your baby lie down from a seated position or helping her back down after standing -- is a daytime tactic that might help both of you. Once you know she's got the skill fairly well mastered, let her do it herself. Then, when she cries in the night because she's pulled herself up, you'll both know she's capable of lying back down again on her own. And until you're confident she's got the skill nailed (or if you're a worrier!), you can matter-of-factly go into her room, help her get down, assure her she's fine, and head out. The important thing: Don't make a fuss or be too intrusive. "At some point, though, it will be time for a parent to let the child figure it out on her own," reminds Mindell.
Effects of Illness or Cutting a Tooth
When Karen Werstein's son, Max, was 10 months old, he had a high fever; whenever his mom tried to put him down in his crib, he'd wake instantly and cry incessantly. Max's parents' solution? All sleep together. "We tried a lot of things, but it was just easier to bring him back to bed with us. We had to sleep, and I certainly can't sleep if he's wailing like that," says Werstein. Although Max was feverish for only two or three days, it was several weeks before Werstein and her husband could get him back to sleeping in his crib for extended chunks of time at night.
"The difficult thing is making the transition back," says Mindell. She suggests going to your child rather than bringing him to you; if there's no bed in his room, roll out a sleeping bag on his floor and camp there until he's well again. "Then things are consistent for your child, yet you can check on him quickly. At the end of the illness, it makes the transition easier for your child since he hasn't changed beds -- you have."
All the experts say not to do it, but if you can't resist bringing your child into bed with you, make sure he is truly ill and not just vying to bunk with you. Don't let the co-sleeping drag on unless that's your family's long-term choice: "This setup is fairly easily reversed if it's short-lived," says Dr. Owens. "The problem comes when sleeping arrangements don't return to normal once the illness is over. This can set up a behavior pattern that is difficult to undo."
Bad Dreams and Nighttime Fears
Things that go bump in the night can wreak havoc on a family's sleep, keeping your preschooler from falling asleep at night or waking your toddler at 3 a.m. One school of experts suggests "using something imaginary to battle something imaginary," says Mindell, who suggests putting some water in an empty squirt bottle, labeling it "Monster Spray," and then spraying it in your child's room when he fears a monster is lurking under his bed. Sheila Johnson, of Plainfield, Illinois, dubbed room freshener "Magic Spray" and found that spritzing it around the bedroom of her then-3-year-old daughter, Whitney, worked like a charm.
But others say parents have to strike a balance between recognizing common fears and giving in to them. "If you do something like Monster Spray or wave a baseball bat at invisible foes, your child might think, 'If Mommy is spending so much time doing this, then there must be something to this,'" says Dr. Owens. Her alternative? Provide a special stuffed toy to ease separation anxiety and fears.
About a year ago, nightmares descended on the Rath house in Highlands Ranch, Colorado, after then-3-year-old Ethan saw The Polar Express. "He wakes up screaming, crying, and sweating, talking about a train coming," says Ethan's mother, Bryn. Her solution: holding Ethan for a few minutes, assuring him everything is all right. This is a textbook case of an authentic nightmare (versus a plot to sleep with Mom and Dad!). According to Dr. Ferber, nightmares are typically a very occasional event, but when they do occur, it's usually in the second half of the night. Upon waking, your child will look agitated and should be able to describe a few details of the dream. "If you believe your child truly had a nightmare, the child needs to be handled like any child who is frightened, and you need to stay there with the child." Dr. Ferber says the message you give your child in such a situation is a good one: "You have your own room, but if something happens, we take care of you."
A New Sibling
Bedtime was sedate at Nancy Coulter-Parker's house in Boulder, Colorado -- her nearly-4-year-old daughter, Ellie, went to bed without much of a production -- until a baby brother, Kai, was born. Then Ellie would cry and yell loudly from her crib, demanding her parents rock her to sleep or rub her head until she fell asleep. These bedtime battles continued off and on for a year until Coulter-Parker and her husband, Jeff, moved their kids into one room. "Sharing a room made Ellie feel more relaxed at night -- she'd been feeling left out and lonely. Now she falls asleep within a few minutes," says Nancy Coulter-Parker.
Making a Plan, Setting Ground Rules
Experts advise that during times of transition, every family needs to figure out a plan that works best for them -- as long as there are ground rules. If room-sharing is what your family opts for, make sure your older child doesn't interact with the baby after lights out, for example.
One plan all sleep experts support is to maintain the bedtime routine during transitional or troubling times. If Mama usually reads Green Eggs and Ham, she should keep doing it while Papa takes care of the newest member of the family. Or you can swap normal bedtime duties several months before the baby arrives, says Mindell: "The more you can do to keep your child's life consistent at bedtime, the better off you are."
Repaying a Sleep Debt
Like a gallon of milk past its expiration date, has your good sleeper gone bad? A sleep debt -- caused by a later summertime bedtime or the phaseout of a regular nap -- might be to blame for your child's bedtime battles, says Marc Weissbluth, MD, a renowned Chicago pediatrician and author of Healthy Sleep Habits, Happy Child (Vermilion). "Losing 10 or 15 minutes of sleep a day has a cumulative effect: It might take a month or two before you see it; it sneaks up on you." Weissbluth offers these simple tips for repaying a sleep debt -- and getting your good sleeper back.
Put your child to bed earlier. If your toddler has just dropped his morning nap, making his bedtime an hour earlier might partially solve the problem. "Temporarily, bedtime might have to be super-early to help the child get back in the groove."
Establish naps. If your 15-month-old fluctuates between one and two naps a day, work on getting her solidly on one midday nap. "Once the nap is established, it'll enable your child to stay up a little later at night."
Look at your child, not at the clock. "Parents need to look carefully at a child's behavior at 4 or 5 p.m., asking themselves, 'Is my child adaptable, sweet, calm, engaging, pleasant to be around -- or fractious, easily frustrated, whiny, and short-tempered?'" If he's the latter, then you can conclude that he needs to go to bed earlier.
Baby's Silliest Sleep Objects
Forget a blankie? Here are some real-life "loveys" from tots around the country.
"One of my old jammy shirts is what allows my 3-year-old, Isabelle, to sleep through the night without me next to her."Emily, Newton, Connecticut
"My youngest son, Joey, who is 4, sleeps with a big, green, soft, round pillow from Wal-Mart. We went shopping together for a 'sleeping pal' that Joey thought would make him feel safe from the things that were causing him nightmares, and the pillow was his choice."Annie, Morris, Illinois
"Daniel, my 3-year-old son, loves to sleep with a white bodysuit that he's had since birth. He rubs the snaps on the bottom and calls the bodysuit his 'button.' It's falling apart, but he can't live without it!"Megan, Sparta, New Jersey
"When she sleeps, our future basketball fan, 21-month-old Chiara, loves to bite down on the folded corner of any freshly laundered white towel. She's the spitting image of Jerry Tarkanian of UNLV fame, especially by morning when it's soaked through!"Stephanie, San Francisco, California
Sarah Bowen Shea, a mother of three, is a writer based in Portland, Oregon.
Originally published in American Baby magazine, October 2006.
The information on this Web site is designed for educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health problems or illnesses without consulting your pediatrician or family doctor. Please consult a doctor with any questions or concerns you might have regarding your or your child's condition.