Sleep Disorders with Kids (cont.)

MINDELL:
Time to stop the bedtime bottle, as she has figured out that the moment she falls asleep it goes away, which wakes her back up. Decrease her bottle at bedtime by an ounce per night to make a slow change, rather than taking it away abruptly.

MEMBER QUESTION:
Is there a recommended age for transitioning from two naps a day to one?

MINDELL:
Most babies switch from two naps to one by 18 months, although there are some who continue until 20 or 22 months.

Some signs your baby is ready to make the switch:

  • She takes a long time to fall asleep at one of the naps
  • She doesn't nap at all, either in the morning or the afternoon
  • When she misses a nap she doesn't fall apart later in the day

All these are signs she's probably ready to make the switch. It can take a few weeks of some bumpy days when you switch her from two naps to one, as it usually doesn't happen overnight.

MEMBER QUESTION:
My 4-and-1/2-month-old baby wakes at around midnight and demands a bottle. Then he sleeps until sometime between 5 and 6 a.m., when he's hungry again. Is he demanding the midnight bottle out of habit or because he really needs it?

MINDELL:
One thing you may want to try is getting him up and feeding him before you head to bed, around 10 or 11 p.m. This way, if he wakes up at midnight you'll know that he really isn't hungry.

Adding a focal feeding will probably make it so that he can either sleep through or just get up for his 5 a.m. bottle.

"To help her make the transition, you may want the Sleep Fairy to visit and leave a present if she sleeps in her bed all night."

MEMBER QUESTION:
I can't get my 4-and-1/2-year-old daughter to stay in her bed at night. She gets up every night, early morning and gets in bed with me. This has gone on since we moved into a new house almost a year ago.

MINDELL:
At this point it's probably pure habit that she's waking up every night and coming to your bed. To make a change, be sure to bring her back to her bed every single time she heads your way.

To help her make the transition, you may want the Sleep Fairy to visit and leave a present if she sleeps in her bed all night. Sleep Fairies often leave a sticker or a penny or a note to let your little girl know that she's done a good job.

Start with having the Sleep Fairy reward her if she sleeps in her own bed all night, even if you have to return her during the night. Once that is going well, you can then have the Sleep Fairy come only if she stays in her bed all night without coming to you.

So start with a step where you know she can be successful, and you'll likely find that things will change quickly.

MEMBER QUESTION:
A friend of mine has a sick 19-month-old child who has had a cough for a couple of months; he can't get through the night without waking up once or twice. He then cries until his mom comforts him back to sleep. When is it OK to let him cry and when is it OK to comfort him?

MINDELL:
At this point with such a persistent cough, his parents should really check out what's going on. Some things like asthma can lead to nighttime coughing. While they're figuring this out, please have them comfort him during the night. It sounds like he's having a hard time.

MEMBER QUESTION:
My 5-year-old refuses to go to sleep. She insists on keeping the light on all night. When we try to leave her room at night she either becomes hysterical or keeps finding excuses to get out of bed. She usually falls asleep around 11:00.

MINDELL:
Start by moving her bedtime routine close to the time that she typically falls asleep, so start at 10:30 expecting her to fall asleep at 11:00. Don't worry. Later on you can start moving her bedtime earlier by 15 minutes every day or two.

Second, try to calm things down by staying with her at bedtime until she falls asleep. In a few days, you can start moving yourself out of the bedroom at bedtime, moving several feet away every few nights.

The key to the whole thing is being consistent and being clear about bedtime rules, and at the same time, being as boring as possible so you don't get into long discussions about what she is and is not allowed to do. Slow and steady changes and being completely consistent is going to help you make a change.

MEMBER QUESTION:
My son is almost 7 years old and cannot fall asleep at night. He is up until 11, 12, 1 or 2 a.m. and then cannot get up for school. He does not know why he can't sleep but it is really bothering all of us. He was crying the other night for us to give him a sleeping pill. I don't know what to do. Our pediatrician says there is nothing he can do.

MINDELL:
Given how long it's been going on, it's well worth consulting with a pediatric specialist. Either your doctor can give you a referral or try contacting a children's hospital in your area. I understand there aren't that many pediatric sleep specialists out there, but hopefully there is one close by you.

"The same National Sleep Foundation poll that found that televisions and caffeine caused sleep problems, also found that including reading at bedtime, whether you are reading to your child or your child is reading to you, was related to more sleep and fewer sleep problems."