Nicole Keller, D.O.
Recently I’ve had a lot of families come to the office with sleep woes. Whether it is the six-month old who is still waking up every 2 to 3 hours, the nine-month old with sleep regression, or the toddler who doesn’t want to stay asleep, all of these situations can run a family ragged! I myself didn’t get a full night’s sleep until my son was 10- months old (and that was just until 3 to 4 a.m.!) and didn’t sleep until past 4 a.m. until he was 14-months old. So, I have full appreciation for how hard it is when your child isn’t sleeping. Some kids are just not good sleepers to start – but that doesn’t mean that they (or you) won’t ever get good sleep! Beyond this, there is no “one size fits all” for sleep – every family and household is different. If you ask me, getting good sleep is finding a set of healthy and safe routines that works in YOUR house for YOUR family and YOUR schedule. Below are some tips and tricks that hopefully you can make work for your unique child and family.
- Get a good routine. This is key! By keeping a consistent routine, your child will start to associate the SAME book, the SAME sounds, the SAME lullaby, (etc) with sleep. This can take time, so, don’t get discouraged. Make sure you put them to bed at roughly the same time of day each night as well. Good bed times to shoot for are: 0-2 months: 8-9 p.m., 3-6 months: 7-8 p.m., 7-12 months: 6:30-8 p.m., older than 1 year: 7-8 p.m. This routine will serve you well when life gets hectic too. For example when you are on vacation, when your child is sick, or at hectic times of the year. Your kids will already be programmed to be ready for sleep no matter their location, illness, or busy day. My son’s sleep routine goes as follows (feel free to use this if it works for you!): 5:30 p.m. dinner, 6:30 p.m. bath and brush teeth, 7 p.m. read same 3 to 4 books, turn on his fan, say goodnight
and turn off lights together, “I love you” and down in his crib (by 7:15ish) with his horsey thumbie blanket. He’s so used to this that once we are getting towards the end of the last books he is pointing to his crib. He even puts his arms out to hold his thumbie blanket after being put down – it is so sweet! *Of note, no stuffed toys, blankets or pillows should be in your child’s bed until they are 9 to 15 months old. Safe sleep first!* - Put your child down drowsy, but awake. This is a hard rule to follow. Let me explain why this is important. If you put your little one down asleep (after nursing, bottle, rocking, etc), they learn to need you to fall asleep. If they are put down awake (but drowsy), they then teach themselves to fall asleep on their own. Sometimes this involves a little crying (which is really hard to hear!), but, try to think of it as you teaching them to learn to fall asleep. You don’t ever have to let your child cry it out, but, I do feel that sometimes those short periods of crying are helpful in giving your child the opportunity to figure things out for themselves. In addition, try to not have feeding be the last thing you do before putting your child down. Rearrange the bedtime routine to have feeding be at the beginning followed by bath, book, then bed. This way they don’t associate needing a bottle or nursing with bedtime – it will really help you wean off bottles and nursing when the time comes!
- Keep visits during middle of the night wakings non-existent or as short as possible. Kids are smart. They know if they cry for mommy, mommy will come. They then expect this. If they get fed, their body learns to be hungry. Considering this, try to keep the middle of the night visits short and boring. After four months old, babies can self soothe. You can allow them to fuss/whine/cry in their crib for a little to see if they’ll fall asleep on their own. If you have to go to them, try to keep them in their crib, offer a short pat on the back and be gone within a minute. If you are already feeding them when they wake up, wean that slowly – one minute at a time every 3 to 5 days. That way you know hunger isn’t the reason they are waking. Most of these middle of the night waking are behavioral – a bad habit really. It’s no one’s fault that they began, but, you can work to slowly eliminate them to help you and your little one get more restful sleep at night. Plus, the older they get, the harder it is to stop these frequent night time disturbances.
These tips are brief but I feel are the most important when trying to get sleep back on track in your household. There will always be good nights and “less good” nights too…but hopefully by getting some good habits in place you’ll be able to get more good nights on a regular basis. If you need more help, you can always look to a sleep book, sleep consultants, or of course your pediatrician. There are lots of different ways to work sleep – you just need to find what works for you! Many times it is a blending of several sleep styles and recommendations.
Here are some of the references I found helpful and I hope that help you too:
Healthy Sleep Habits, Happy Child (By Dr. Marc Weissbluth)
The Happiest Baby: Guide to Great Sleep (By Dr. Harvey Karp)
The Sleep Sense Program (online program by Dana Obleman)
I wish you all lots of zzz’s! Cheers! Thanks for reading!