Soothing Sick Kids in the Wee Hours

Why do kids often wait until the wee hours to wail for you? Solve your child’s 2 a.m. problems so everyone can get back to sleep.
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Forget the things that go bump in the night. We’re more terrified of the things that whimper and cry—also known as our kids. But just because awakenings are inevitable doesn’t mean they have to put a significant dent in your family’s shut-eye. The key is to create a plan, because let’s face it: When you’re ripped into consciousness by a sobbing kid, levelheaded strategies don’t come naturally. Consider this your cheat sheet for the bleary hours. 

You Hear Cries of Pain

Likely Culprits: Earache or teething 

What's Happening: Ear infections typically occur when a respiratory infection blocks the ear’s eustachian tube, causing infected fluid to accumulate. Lying down increases the pressure, making pain worse, says pediatrician Alan Greene, M.D., author of Raising Baby Green. If your child’s been sniffling or sneezing, there’s a good chance this could be the reason for her crying. When it comes to teething, a hormone is to blame: “Growth hormone is released shortly after a child falls asleep, which is why teething can be so disruptive at night,” says Lisa Meltzer, Ph.D., a pediatric-sleep specialist at National Jewish Health, in Denver. As new chompers inflame and break through the gums, the discomfort can rouse the steadiest sleeper. How to know if it’s teething? Drooling, swollen gums, and an increase in biting are signs—in addition to night wakings, of course.

Get Back To Bed: When you think your child is in pain, give her a pain reliever; acetaminophen and ibuprofen both can help if she is uncomfortable or cranky. “If your child starts to relax as the pain reliever kicks in (it takes about 20 minutes), you may be able to get her back down without much fuss,” says Jennifer Waldburger, a sleep consultant and coauthor of The Sleepeasy Solution. “If she’s still upset, try rocking her for a bit.”

You Hear Rustling Over the Baby Monitor

Likely Culprit: Motor milestones

What's Happening: Scientists aren’t sure exactly why learning to crawl or walk causes babies to wake more, but research has confirmed what tired parents everywhere have long suspected. One study tracked infants’ sleep patterns and crawling development for six months and discovered a link between the onset of the milestone and increased night waking.

Get Back To Bed: First, don’t worry: Most new skills affect sleep for just a few days. Second, resist the urge to check on your child. “Let him run his battery down and go to sleep on his own,” says Waldburger. Rustling turning into crying? The new skill he’s learning may have him feeling frustrated. For example, perhaps he has mastered standing but hasn’t yet figured out how to lie back down. Assist him in the moment; tomorrow, give him practice time. 

You Hear a Barky Cough

Likely Culprit: Croup

What's Happening: A kid with croup has a swollen larynx, or voice box— typically caused by a virus—and this creates a seal-bark cough. It’s usually worst at night, possibly because the body’s natural steroid levels fall, causing swelling to increase. 

Get Back To Bed: Cool air and steam can both ease swelling in the larynx and improve your child’s breathing quickly. A cool-air nebulizer (akin to an über-effective humidifier) works best, says Dr. Greene. If you don’t have one on hand, sitting in the bathroom with the door closed while a hot shower runs will relax your child’s vocal cords and make it easier to breathe. You can also try bundling your child up and standing outside in the chilly air—or in front of an open freezer door. As soon as the coughing starts to lessen, try putting your child back to sleep if she’s breathing comfortably. The majority of croup cases can be managed at home, but if your child is struggling to breathe, experiences stridor (a high-pitched sound when breathing in), or if you notice a blue tint in her lips, seek urgent medical attention. Otherwise, call your pediatrician in the morning. She may prescribe oral steroids to help your child breathe better the next evening. 

You Hear Screaming

Likely Culprit: Nightmares or night terrors

What's Happening: It depends on the time of night. In the first few hours after bedtime, most kids move seamlessly from deep, slow-wave sleep to lighter-stage sleep, but some children get stuck in a state of partial arousal known as a night terror. You’ll know this is the case if an hour or two after going to sleep, your child appears upset, doesn’t seem to recognize you, and is crying or screaming, says Parents advisor Jodi Mindell, Ph.D., associate director of the Sleep Center at the Children’s Hospital of Philadelphia. Nightmares are more common in the final third of the night. “With a nightmare, once the child’s awake, he can tell you about his dream,” says Dr. Mindell. Kids generally don’t recall night terrors. 

Get Back To Bed: It’s natural to want to wake your child when he’s having a night terror—but avoid it if you can. “Touching him may exacerbate the episode and make it last longer,” says Dr. Mindell, who is also the author of Sleeping Through the Night. Instead, walk into the room and stand there. If your child is awake, he will respond to you. If he is having a sleep terror, let it run its course. Night terrors seem to peak when kids are 3 or 4 and may overlap with bedwetting, Dr. Greene says. He’s found that sometimes, guiding kids to the bathroom can end the events more swiftly. If you sense it’s a nightmare, reassure your little one that he is safe and help him calm down with a back rub. Then reset the room for better dreams: “Try telling him to turn his pillow over. It’s like changing the channel on a TV,” says Dr. Mindell. 

You Hear “Uh-oh, Mama!”

Likely Culprit: Bedwetting

What's Happening: When the bladder is full, it signals the brain, and your kid runs to the potty. But at night, the sleeping brain may not be as receptive. Not all kids have the same arousal threshold, says Dr. Meltzer. 

Get Back To Bed: To minimize the disruption, keep extra pajamas and underwear in arm’s reach of the bed, suggests Waldburger. “You could also set up a sheet sandwich in advance: Make the bed with a sheet, then add a waterproof mattress pad and another sheet. If your child has an accident, strip off the top sheet and pad, and the bed will be ready for her.” To help her get back to a sleepy state, remind her that accidents aren’t a big deal. You may also find it useful to gently rouse your sleeping child before you go to bed and guide her to the bathroom for a quick pee.

Parents Magazine

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