Q: My 23 month old just stopped using a binky about 4 weeks ago. Ever since, he wakes up about 2 hours earlier every day and won't go back to sleep. He still rubs his eyes and looks exhausted but I don't want to give him a binky just to get him to sleep later again. I'm concerned he's not getting enough sleep now. What should I do?

A: First thing to do is to pat yourself on the back for being an excellent mother and not giving the pacifier back just to get more sleep. After the age of 1 year pacifiers are bad for children’s developing teeth. There are a number of steps you can try to get him back into the habit of sleeping later. First make sure the room remains as dark and quiet as possible as the light or other noise in the house may be awakening him and without his pacifier he may be having trouble returning to sleep. If he does awaken tell him that it is still “sleeping time” or whatever words you use to refer to sleep when you talk to him and take him back to his bed. In the same way that you would deal with a child getting out of bed at night, be consistent with the message that in your room is the only place to be until mommy or daddy comes to get you. You may need to remain in the room to frequently replace him in the bed when he gets up and slowly work your way back out the door as he understands the need to stay in the bed.

The alternative would be to put him in bed earlier in the evening to be sure he is getting the 10-12 hours of nighttime sleep he needs. My kids go to bed at 7pm (they are 5 and 7 years old) because they like to get up between 5 and 6 am. I tried unsuccessfully to keep them up later in hopes that they would sleep later and I just ended up with unhappy and tired children who still got up at sunrise every day. We have nowhere to be at that hour and I have learned to go to bed earlier myself and put off household tasks until the morning. It has turned out to be wonderful family time, we finish homework, read books, play board games and prepare for the day ahead.

Answered by Dr. Carrie M. Brown