Our article “5 Reasons Why Your Child Is Not Sleeping Through the Night!” featured in the inaugural edition of LADY SAVANT: The Little Black Book for the Savvy Mom
Spring will be upon us soon – before we know it buds will be forming on the arms of the trees and crocuses will be popping up out of the hardened ground. Many of us will embark on a massive spring-cleaning to rid our homes of the staleness of winter. While you are at it, why not do some housekeeping on your family’s sleep? If you have a child who is not sleeping well at night, put fixing it on your “to-do” list. To many a tired parent, sleeping though the night may sound like a luxury item or a far-fetched goal beyond their reach. But in reality, the fix is easier than you think. In my pediatric sleep practice, I have worked with hundreds of families and found that one (or a combo) of 5 things is always amiss when this milestone has not been met by a child who no longer requires a night time feed. Ensure these items are in check, apply them consistently, and you and your child will have mastered the art of healthy sleep and will sleep fitfully through the night.
- To Sleep Well at Night, Your Child Needs To Sleep Well During the Day:
To ensure good night time sleep, your child must also be getting healthy daytime sleep. Many parents assume that without naps their child will be more tired and therefore more apt to sleep at night, but it’s actually the opposite. As sleep is cyclical, quality naps need to be in place in order for your child to achieve a good night’s sleep. Without adequate daytime sleep, your child enters their night in an overtired and stimulated state that will not allow their body to sleep in long, restorative stretches. So how do you make sure great naps happen? By scheduling naps to happen in sync with their body clock or their circadian rhythms. We all have an internal clock that tells our bodies when we should be asleep and when we should be awake. If we sleep in-sync with these clocks, we have our easiest time falling asleep, staying asleep, and can actually get in our best quality sleep. So when do these magical sleep times occur? For a baby age 4-18 months who is on two naps a day, we want them falling asleep for their morning nap in the 8:30-9am window and for their afternoon nap in the 12:30-1pm window. For a toddler 14 months or older who is on just one nap a day, this nap needs to begin in the 12-1pm window.
The key to a good bedtime is that it happens before your child can become overtired. When we become overtired, our bodies release the stress hormones adrenaline, noradrenaline and cortisol in an effort to keep us going. As adults, we call this a second wind and often rejoice at its occurrence – whoo hoo we can keep on trekking without another double cappuccino and then easily drift off to sleep for the night. But for a baby, toddler or small child, these hormones act as a high dose of stimulants and make it very hard for them to fall asleep for the night. If going to bed overtired is a nightly occurrence, these hormones build up in the child’s blood stream. When their sleep cycles shift during the night, this build up is present in their blood stream and they fully wake up instead of rolling right into the next cycle. Therefore, it is critical to know how long your child can tolerate being awake before they become overtired and have them fast asleep for the night before these hormones rear their ugly heads. As your child ages, they can of course tolerate being awake longer. Every child is different, but use this chart to gauge your child’s ideal bedtime.
- Sleep Crutches:
A sleep crutch is something that your child relies on to fall asleep. When they wake briefly at night between sleep cycles, if their “crutch” is not present, they will not be able to go back to sleep on their own. For example, if you child only knows falling asleep at night with you rocking them to a sleeping state, when they wake at night they will expect that to occur to go back to sleep. All sleep crutches are not necessarily bad – if your child can use or recreate their crutch on their own, they will likely be proficient in falling asleep and staying asleep on their own. Take a pacifier for example, for an older baby or toddler who can find and replace it on his own – it should not be an issue (as long as there are rules in place against parental replacement). However, a pacifier likely poses an issue for an infant who does not yet have the motor skills to replace it on their own and instead requires a parent to replace it….all night long! A simple lovey that has mom or dad’s scent and that is involved in the child’s pre-sleep routine is a great tool for many babies and toddlers as it is simple for them to find and hold on to and is very comforting. The key is either allowing your child to soothe themselves completely on their own, or finding something that they can utilize without your assistance. Again, if your child relies on you or your presence to fall asleep at bedtime or naptime, they will rely on your when they wake at night. They need to learn to fall asleep on their own.
We want to create the ideal sleep environment so that there is no question as to why they are waking up. Basically, we want to take the “what ifs” away. Is my child awake because he is cold? Because it is too loud? Too bright? He lost his blanket? To alleviate any of those questions – let’s just make sure the set up is right from the beginning! Your child’s room should be as dark as possible for all sleep – yes for naps too. Only use a night-light if it is truly necessary (please note, your child isn’t capable of being afraid of the dark until he reaches age two) and tuck it behind a piece of furniture so that it emits a glow and is not in direct view. His crib should be clear of any mobiles, toys, stuffed animals and distractions. For a baby older than one, a blanket is ok if he can replace it on his own or will not be cold if it is kicked off – otherwise use a wearable blanket to ensure his comfort. The ideal temperature for sleep is 65-70 degrees depending on how your child is dressed. Music is ok during the pre-sleep routine, but should be turned off before your child falls asleep, as music during sleep doesn’t allow the brain to enter deep sleep given that it is actively trying to listen. Instead, use white noise to block out ambient household and street noises. White noise should only be as loud as a running shower and should be at least 4 feet from your child’s head.
Consistency is key when it comes to teaching a child your expectations. If one day you expect them to fall asleep on their own and the next day you rock them to sleep – they will be very confused as to their sleep routine. Or if at bedtime your child has to sleep in their crib, but in the middle of the night it is ok to sleep in your bed – they will expect that they can always sleep in your bed (because babies and young children can’t tell time!). So you must come up with a consistent plan for your child’s sleep, which includes a consistent pre-sleep routine, a consistent sleeping location, and a consistent set of expectations for how they will fall asleep and stay asleep. Having this in place and sticking with your expectations will make it easiest for your child to understand that they have the skills to sleep on their own and that they should do so.
The Take away:
Sleep is a work in progress, as a child’s sleep overall needs will require alterations as they grow. If the five components above are in check, you will always have healthy sleep regimen is in place that will only require minor adjustments or small tweaks to insure that your child is always getting their best sleep and no major issues will ensue. As my husband likes to say – sleep is a marathon and not a sprint, there will be ups and downs but if healthy framework is in place, your child will always make it to finish line.
Amy Lage is a graduate of the University of Massachusetts Amherst and a Family Sleep Institute certified Pediatric Sleep Consultant. She is founder of Well Rested Baby (www.wellrestedbaby.com). She offers a host of services including in person, phone, email and Skype/FaceTime consultations that can be tailored to meet any family’s needs and schedule. Amy, her husband Jeff, their 4 year old Stella, their 2 year old Harley, and their two dogs Jackson and Cody live in Beverly Farms, Massachusetts. Please email her at firstname.lastname@example.org with any questions. Be sure to follow WRB on Facebook too more great sleep tips!