Feature Archive

Tackling Toddler Sleep Problems

You asked, we answered: WebMD takes on your tot's sleep issues.

By Denise Mann
WebMD Feature

Reviewed by Louise Chang, MD

Your 1-year-old cries so hard when you put him to bed that he actually throws up. Your 2-year-old still doesn't sleep through the night. Your 2-and-a-half-year-old shares your bed, or perhaps your 3-year-old wakes in the middle of the night screaming bloody murder.

Sound familiar? If these toddler sleep issues don't ring true yet, they probably will someday. Such toddler sleep problems are the bane of many a parent's existence.

While most toddler sleep issues are related to ages and stages, sometimes underlying health or psychological problems may be at play. Regardless of the nocturnal nuisance, sound sleep solutions abound, experts tell WebMD. Here are some common troubling toddler sleep scenarios and our experts' opinions on how to effectively troubleshoot them.

Nocturnal nuisance: Your toddler wakes up several times during the night.

Sound sleep solution: Getting your child to sleep through the night is a common and challenging toddler sleep problem. Troubleshooting this one depends on your child's age and whether or not the child has stopped sleeping through the night out of the blue, explains Susan Zafarlotfi, PhD, the clinical director of the Institute for Sleep and Wake Disorders at the Hackensack University Medical Center in New Jersey.

For example, she says, "Young toddlers may wake up from teething or they may be sick." In general, "parents need to step back and see what has happened in recent weeks in their toddlers' lives. Is there a new bed? A new sibling? A change in caregivers? Is the child taking a longer nap?"

If waking up is just a habit and unrelated to teething or any other health issues or changes, "intervene by delaying bedtime 15 to 20 minutes to attempt to make them more tired," she says.

If your tot calls out to you during these middle-of-the-night caterwauls, "you can go into their room and comfort them with a lullaby, soft music, or any other soothing routine that you use at nighttime," she says. "Assure them that they are OK and leave their room."

If this scenario happens night after night after night, delay going into their room to soothe them by five minutes each night, she suggests.

Nocturnal nuisance: Your child cries so hard at bedtime that he makes himself vomit.

Sound sleep solution: Should you really just let your toddler cry it out? Often called Ferberizing, this method may seem cruel to some parents, especially if the child cries himself or herself sick. Other parents swear by it.

"It's very hard to do, but we know of no negative effects of using the Ferber method," says Mary Michaeleen Cradock, PhD, a clinical psychologist with St. Louis Children's Hospital in Missouri. Often times, one parent can handle the wailing and the other one simply cannot, she says. "If you are letting your child cry it out, one of you may want to go to the gym or put on their iPod while the other deals with the crying."

Ferberizing is really all about changing your toddlers' sleep associations, which, in turn, should solve this toddler sleep issue. "If a mom rocks her toddler to sleep, this is that child's sleep association, but if the goal is to get the toddler to go sleep by themselves, you need to shift the association to one that she can do herself -- the Ferber method is one way to do that," Cradock says.

If letting them cry until they vomit seems too barbaric, go into their room after they cry for a set amount of time, rub their back, and say, 'Mommy is going to sleep, too' and then walk away, Zafarlotfi adds. You may have to do this a few times a night before your toddler is comfortable. If this cry-it-out method is not something that you or your partner (or toddler) can stomach, discuss alternative methods with your pediatrician.

Nocturnal nuisance: Bedtime goes on for hours and pits you and your partner against each other.

Sound sleep solution: "The goal is to make bedtime a positive experience," says Rafael Pelayo, MD, an associate professor of sleep medicine at Stanford University School of Medicine and a sleep specialist at Lucile Packard Children's Hospital, both in Palo Alto, Calif.


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