If resources are unlimited, go quickly and fix the twenty-four-hour schedule at once: bedtime battles, night waking, and fighting naps.
If your baby cries hard and vomits, consider changing sleep strategies to one that involves less crying.
Months Thirteen to Thirty-six
When your child starts to walk, babble, and show more personality, you will naturally begin to treat him less as an infant and more like a person. Please try to avoid the trap of endlessly explaining, negotiating, or threatening when it comes to sleep times. Save your breath; let your behavior do the talking.
Months Thirteen to Fifteen: One or Two Naps
At twelve months of age, 82 percent of children have two naps and 17 percent take only a single afternoon nap. But by fifteen months of age, 43 percent of children are taking two naps and 56 percent take a single afternoon nap. This is a dramatic change occurring over a short time period.
This transition, however, may not be smooth. You might have a few rough months when one nap is not enough but two are impossible. Here are some ideas for making the transition easier.
Move the bedtime earlier. The morning nap is always the first nap to disappear naturally. We do not know why. If the bed time is moved up a little, most parents will notice that the morning nap becomes briefer or turns into a quiet playtime without sleep. Most of these children do not appear to become very tired.
Other children take longer and longer morning naps and then appear to actively resist or be unable to take the second afternoon nap. Because this second nap was short anyway, many parents forget it. The result is a child who is tired late in the afternoon or early evening and who quickly becomes overtired by bedtime. One solution is an earlier bedtime because your child will wake up rested and take a briefer morning nap. In addition, you might want to shorten the nap by waking your child after about one or one and a half hours so she will be more tired around the midday nap time. Also, try to get out of the house immediately following the morning nap to provide intense stimulation but tone it down as you get to the middle of the day. Provide extra long and relaxing soothing to sleep for the midday nap. Maybe consider moving the midday nap to a slightly later hour so your child is a bit more tired. Sometimes your child continues to take a morning nap but none of the above causes her to take a midday nap, so here's another plan. At the time of the morning nap, delay its onset by ten or twenty minutes. This might require more intense and prolonged soothing to sleep. Slowly, over many days or weeks, continue to delay the morning nap until it is occurring near the middle of the day. During this transition, the bedtime might have to be temporarily ultra-early because your child gets pooped every afternoon. Some of these children appear to hate their bedroom in the afternoon and scream as you approach it. One mother solved this by doing all the prenap soothing in the living room and then quickly went into his room.
The earlier bedtime means that a working parent coming home late does not see the child then. If that is the case, that parent can get up extra early to have a longer morning playtime with the child before going off to work. Another solution is to declare some days as two-nap days and other days as one-nap days, depending on when the baby awakens, how long the morning nap lasts, scheduled group activities, or the time you want your baby to go to sleep at night. Flow with your child and arrange naps and bedtimes to coincide with his need to sleep as best you can. Be sensitive to the growing need for earlier bedtimes.
Here is one mother's account of how an early bedtime helped her child.
Sophie has always been inconsistent when it comes to napping. Some days she would sleep for half an hour, others she wouldn't sleep at all. And if I was lucky, she would take an occasional hour nap. I decided it was time to get help before the situation became worse.
Sophie was thirteen months old when I met with Dr. Weissbluth. She was sleeping for thirty minutes in the morning; her afternoon naps were unpredictable. At night, getting her to sleep was even more frustrating. Sophie had always been a great nighttime sleeper. Then, all of a sudden, she was waking up several times throughout the night. Not only was her mental state unbearable, but physically she did not look well. As for me, I was becoming mommy the monster. There were days when I thought I was going to lose it. I blamed myself for her sleeping disorder, even though I was doing everything right—putting her to bed early, keeping a consistent nap time, and putting her down in her crib for her naps instead of allowing her to sleep on the go.
After looking over Sophie's sleep log, Dr. Weissbluth gave me several options: try an earlier bedtime (5:00 P.M.), lots of stimulation when awake, and soothing her longer at night. The goal was to allow her to catch up on her sleep.
My husband and I put the plan to work. He supported the decision of an earlier bedtime, even though his time with her was already limited. Unfortunately, Sophie's sleeping did not improve. She continued to take one nap for thirty or forty-five minutes and then skip her afternoon nap. She and I were both exhausted and my frustration level was sky high at this point.
During our follow-up conversation, Dr. Weissbluth asked if I would consider dropping her morning nap. He recommended the continuation of an earlier bedtime (5:00 P.M.), which, surprisingly, she welcomed. Although I was hesitant to drop her morning nap, I was determined to get my happy child back.
So, I put plan B to work. For the first several days, Sophie could barely keep her eyes open past 10:30 A.M. I was able to keep her up until 11:00 A.M. and then 11:30 A.M. for the next several days. She continued to take thirty-minute naps. I called Dr. Weissbluth and he reminded me that she was still trying to catch up on sleep, that it would take several days for her to feel rested. After day four, she was staying awake until 12:30 and sleeping for an hour. And she was sleeping through the night—no more nighttime waking. By the end of the week, she was starting her nap at 12:30 and waking up at 2:00 P.M. And Sophie and mommy were happy.
Sophie continues to have thirty-minute naps every once in a while, and she looks forward to her nap time. She no longer cries; instead, she falls asleep quickly. As for me, I am feeling more confident. Sophie is not the only one who is sleeping better. I am spending more time enjoying her and less time being tired and frustrated.
Obviously, any combination of parents’ scheduling for their convenience and the baby's need to sleep can determine nap patterns. If you are a napper yourself, you may protect your child's nap schedule differently from the parent who does not customarily take naps.
Q: How long should my child nap ?
A: Does your child appear well rested? You be the judge. All of us have good days and bad days, but if you notice a progression toward more fussiness, brattiness, or tantrums, your child may need longer naps.
Months Sixteen to Twenty-one:
Morning Nap Disappears
The morning nap is on its way out. At eighteen months, 77 percent of children take a single afternoon nap; by twenty-one months, 88 percent sleep only in the afternoon. Sometimes the child is taking only the morning nap and the plan discussed above does not work because the general recommendation of an early bedtime backfires. You try an early bedtime and all you get is an earlier wake-up time, which makes your child more tired in the morning and makes him need the morning nap all the more. Under these circumstances, you might temporarily put your child to bed a little later at night with the hope that he will sleep in later. If you put him to bed much too late, he will have difficulty falling asleep and staying asleep, so this will require some patience and trial and error. Still, wake him, if he is asleep, at 7:00 A.M. and then proceed with one of the plans previously described to get an afternoon nap.
Q: What do I do if my child is healthy but cries at night, and the crying stops as soon as I pick him up?
A: Ask yourself if there is anything you can do to regularize the total sleep pattern, such as timing naps better or making the bedtime earlier. Was there anything that recently disrupted his schedule to cause him to become overtired? Does he snore or mouth-breathe during
sleep, or might he be starting to become ill? Look at the big picture, not just the night crying. In general, you will not want to attend to the night crying because you want to encourage consolidated sleep. If you go to your child, you will cause fragmented sleep, which is poor-quality sleep. If your head says that not going to your child is the right thing to do, but your heart won't let you do it, try some of these suggestions.
One parent tied a ribbon around her ankle and her husband's ankle so that she did not shift into autopilot mode at night and go to her child when he cried. Another mother waited for her husband to go away on business for a few days so she could ignore the crying without having her husband undercut the plan. Sleep temporarily farther away from your child; use earplugs, earphones, pillows over the head; take a shower. Do what is best for your child, but don't torture yourself.
Months Twenty-two to Thirty-six:
Only a Single Afternoon Nap
Naps
At twenty-four months of age, only 5 percent of children have two naps and 95 percent are taking a single afternoon nap. By thirty-six months of age, no children are taking two naps, 91 percent are taking a single nap in the afternoon, and 9 percent are not napping at all. A common problem occurs when the nap disappears but the child appears very tired during the day and really seems to need to nap. The closer the child is to his second birthday, the more likely you should try to reestablish the nap, because most probably it is biologically needed. But if he is almost three, you might not be as successful in reestablishing the nap because he might have outgrown the need for it.
Here are two plans to try to reestablish a nap. First, consider the situation where the bedtime is already quite early or you observe that when you moved the bedtime earlier it only caused your child to get up earlier in the morning. Try to slowly move the bedtime later by about twenty to thirty minutes each night with the hope that your child will sleep in later, wake up better rested, and be more able to take an afternoon nap. Second, if the bedtime is quite late, move the bedtime slowly earlier by about twenty to thirty minutes each night with the hope that your child will wake up better rested. In either case, try intensive stimulation in the morning, followed by a wind-down, then a prolonged prenap soothing routine, and try to nap him when he's tired but not too overtired. Consider lying down with your child in your bed temporarily, mother or father, to reestablish the nap routine. After five to seven days, reevaluate and make adjustments of bedtimes and nap times.
Between twenty-two and thirty-six months, most children still need to nap. The average amount of daytime sleep at thirty-six months is about two hours. But there is much individual variation; the range is from one to three and a half hours. If your child is at either extreme of this range, ask yourself if he appears well rested at all times.
The majority (80 percent) of children between the ages of two and three years have a nap length in a narrower band between one and a half to two and a half hours. Most children nap for about two hours. The model nap duration is two hours between the ages of two and six years. The stability of the two-hour nap over different ages is another argument for a strong biological influence over sleep, but it does not necessarily mean that your child needs a two-hour nap. Some children need less and some need more daytime sleep.
Q: When do I transition my child from a crib to a bed”?
A: As he approaches his third birthday, let the child ask for a big bed. If you move him too soon, he will not stay in his bed because he is curious and wants to see what's going on elsewhere in the house.
Fears
Nightmares, monsters, fear of separation, fear of darkness, fear of death, fear of abandonment … don't fears cause disturbed sleep at this age? Many experts tell us that night fears are common among children between two and four years old. Thunderstorms, barking dogs, loud trucks, and many other events over which we have no control can frighten children. If your child has been a good sleeper up to now, you should expect any disturbed sleep triggered by these events to be shortlived.
Some child care experts believe severe sleep disturbances are caused by night fears. Usually, though, children with serious sleep problems did not sleep well at younger ages, and their current difficulty is simply misinterpreted as caused by an age-appropriate concern or “stage.”
Reassurance, frequent curtain calls, open doors, night-lights, or a longer bedtime routine will help your child get over his fears. My recommendation is to spend extra time soothing your child to sleep or go to him once for reassurance, but use a kitchen timer to control the duration of the extra time. The timer is set to the number of minutes you want to spend with your child and is then placed under a pillow or cushion to muffle the noise. Tell your child that when the buzzer or bell sounds, you will kiss him and leave. The child learns to associate the sound of the time with your departure and learns that this signals the end of your hugging, massage, or lullabies. This is called “stimulus control,” which is discussed further in Chapter 9. Just as when the final curtain call ends, you know the play is really over, or just as you know to slow down as the green light turns to yellow, your child learns to associate the sound with the end of your soothing effort. Because crying will not bring you back, the crying ends.
If your child has never been a good sleeper and now also appears during the day to be extremely frightened, withdrawn in new surroundings, shy, or fearful, then it is very difficult for parents to give less attention at night, even if the goal is to enhance consolidated sleep. If this is the case with your toddler, a child psychologist can give you good advice on where to draw the line between supporting the child and encouraging him to learn to overcome his fears.
Routines and Schedules
At about two to three years of age, although most children in my research survey go to sleep between 7:00 and 9:00 P.M. and awaken between 6:30 and 8:00 A.M., I think that an earlier bedtime is better. A single nap between one and three hours occurs in over 90 percent of children. Try to be reasonably regular about nap time and bedtime, and be consistent in your bedtime rituals. There are no absolute, rigid, or firm rules, because every day is somewhat different. Reasonable regularity and consistency implies reasonable flexibility. Be aware that your lifestyle helps or hinders your child's sleep patterns, and remember that there will be changes due to growth and rearrangements in relationships within the family.
How about scheduled, organized activities that take place when your child needs to take her afternoon nap? If she is unable to take her afternoon nap two or three times each week and you are able to get an extra-early bedtime on those days, then there may be no problem, as long as the child is sleeping well in general. For the child who is not sleeping well, for whatever reason, losing a few naps can be quite problematic. Also keep in mind that children are likely to pick up minor illnesses from each other in group settings, and not feeling well may disrupt your child's sleep and push her into an overtired state. In general, be cautious. Have fun with your child, but occasionally have what my wife called a “declared holiday.” Missing a swim class, gym class, or any other preschool event now and then because your child is tired and needs to nap, or leaving soon after you arrive because the other children look sick will notjeopardize your child's college plans!
A Regular Bed and the Arrival of a New Baby
One rearrangement is moving your child to a “big kid's” bed. There is no special age when you should make this change. As long as the crib is large enough, you should not feel that your child must be placed in a regular bed by a certain age. Many parents make the switch around the second or third birthday. Let your child ask for a big bed. One mother described how she felt that she had made the move too soon and the big bed must have seemed “oceanic” compared to the crib, because her son always slept curled up in one corner of the bed—that is, when he slept. He slept better when returned to his crib. Before she made the move back to the crib, his mother wondered whether this would cause a “regression” in her child. It did not. But it did result in a be
tter-rested family.
If the move to a regular bed is needed because of a new baby brother or sister, consider making the move when the newborn is about four months old. By then, the newborn has regular sleeping habits. Before the baby reaches this age, there is a constant shifting of household routines due to the infant's naturally irregular sleep pattern. This may cause confusion or insecurity in the older child because he does not know when mom or dad will be available, or why he has to wait when he wants to go outside and has been used to doing just that. When the newborn is four months old and her sleep pattern is stable, events in the house are much more predictable. The older child now becomes adjusted to the new family arrangements. The baby goes to the crib and the older child graduates with pride to the big bed for big kids. He does not feel displaced. Before the newborn is actually moved from the bassinet to the crib, feel free to leave the crib up and empty for a while with the understanding that if the older child gets out of bed once, then it's back to the crib.
Moving to a big bed too early, before the birth of the new baby, often invites a problem: The commotion and excitement surrounding the arrival of a new baby creates confusion or insecurity in the older child, who may call out or cry at night. The more difficult situation is when the older child starts to get up every night to visit his parents.
If the move to a regular bed prompts frequent nocturnal visits, curtain calls, calls for help going to the bathroom, or calls for a drink of water, think before you act. A habit may slowly develop in which your child learns to expect you to spend more time with her, putting her to sleep or returning her to sleep. Imagine what would occur if a baby-sitter gave your two-year-old candy every day instead of a real lunch. Once you discovered this, you would immediately stop the candy for meals. Your child might protest and cry, but would you give in and let her have the candy? No. If you are spending too much time at night with your child when she should be sleeping, consider what you are doing to be “social candy”—not needed and not healthy for the child. Be firm in your resolve to ignore the expected protest from your child when you change your behavior.
Healthy Sleep Habits, Happy Child Page 33