Child Sleep Solutions

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The No-Cry Sleep Solution for Toddlers and Preschoolers

WebMD Live Events Transcript

Does your toddler or preschooler have sleep issues -- does he refuse to go to bed, fuss about naps, crawl out of his bed and into yours, go to sleep too late or wake up too early? On June 8, 2005 Elizabeth Pantley joined us with advice for getting your child to go to bed, stay in bed, and sleep through the night.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

MODERATOR:
Welcome to WebMD Live, Elizabeth. Thank you for joining us.

PANTLEY:
Hello everyone! I am happy to have this chance to chat with all of you. Today we get to talk about my favorite parenting topic: children and sleep!

Sleep is such a huge issue because when children are not sleeping, parents are suffering their own lack of sleep, and sleep deprivation affects every minute of every day for every person in the family. As a mom of four I have plenty of personal experience in my history!

The good news is that every child can have better sleep when parents know how to identify the issues, and when they learn what solutions to apply in their own case. I am ready to talk with you about your questions.

MODERATOR:
Why do so many children have sleep problems? And how is this affecting their parents?

PANTLEY:
Would you believe that new research shows that over 70% of children under 5 years old have sleep issues? Of course, when children aren't sleeping, neither are their parents -- and that's the biggest problem for us.

MODERATOR:
What is the "gentle" solution you propose for getting children to sleep?

PANTLEY:
I'm a mom of four and a "gentle" mother. I have never believed in letting children cry to sleep. Yet I need MY sleep. So I researched and discovered hundreds of tips to help children sleep better without the tears. Every child is different, and every family's sleep issues are different. But there are lots of solutions that will suit every family.

MEMBER QUESTION:
When you use gentle, no-cry sleep methods does it take longer than cry-it-out sleep training?

PANTLEY:
It is a disturbing myth that a gentle sleep plan is slow and a cry-it-out plan is quick. The TRUTH is that either method can bring quick results. But in most cases, either way, cry or no cry, it will take weeks or months before a child is going to sleep easily and sleeping all night every night. Just like teaching a child to walk, talk, or use the potty, there is no one-day solution. And there is no simple one-size-fits-all solution.

"You can invite the "morning fairy" into your house -- she is the tooth fairy's sister. She leaves small prizes outside the hall of young children who sleep in their beds all night and don't wake Mommy and Daddy."

MEMBER QUESTION:
How do I help my 16-month-old sleep though the night? We run a regular schedule but she still doesn't sleep. She still wakes up for a bottle.

PANTLEY:
What a great (and common!) question! First of all -- it is actually impossible for ANY child to sleep through the night. All human beings wake up five or more times every night, mainly when shifting from one stage of sleep to another.

When your child goes to sleep with a specific sleep aid -- like a bottle, pacifier or breastfeeding, or rocking -- she will look for that same situation whenever she wakes between sleep cycles. So what we want to do is gradually help her to fall asleep without the bottle in her mouth! First, start giving her less liquid in the bottle (You can buy cute bottles that hold less fluid.) Then, start diluting the liquid (milk/juice) with water; it won't be so interesting then. (You can give her a CUP of milk.) Eventually the bottle will lose its appeal. Those are some great first steps to take.

MEMBER QUESTION:
I have a 2-year-old, my last child, and he has slept in the bed with us for his whole life. I breastfed him at night for the first 14 months and got lazy because I have two other children to tend to at 6:00 in the morning. I want to get him in his own bed for the night and have him stay there.

PANTLEY:
The brand new Sleep in America polls showed us that up to 40% of children end up in their parents' bed at some point during the night.

For lots of families, like yours, it's OK for a time. But at some point parents may decide it's time to move their little one to independent sleep. There are so many ways to do this that are gentle and easy! I'll quickly cover a few of them. Again, since all families are different you won't use all of these ideas. Just pick the ones that make sense for YOUR family. And before I even do that, I need to say that make sure this is what your family wants to do, not what the neighbor, your doctor or Aunt Matilda tells you that you should be doing. It's OK to make the change, but only do it if it's the right thing for you.

Quick GuideSleep Disorders: Insomnia, Sleep Apnea, and More

Sleep Disorders: Insomnia, Sleep Apnea, and More

First idea: A little at a time. Put a small mattress in your room next to your bed and have your child fall asleep there. You can do the bedtime reading in "the little bed". Even stay until your child is asleep. But don't YOU fall asleep! You need to go up into "the big bed". During the night, if your child calls to you, go to him in the little bed and then return to your big bed. Over time, move the little bed farther away from your big bed, and eventually, down the hall to his own room.

Here's another idea. I said that there are lots. Redecorate his bedroom to make it inviting for sleep. Get new bedding, glow stars on the ceiling, and a bedside pet (like a fish or turtle) to keep him company. Then encourage him to sleep in his new room.

It's important that you have a joyful, quiet bedtime routine the hour before bed so that it ends peacefully in his room. You can invite the "morning fairy" into your house -- she is the tooth fairy's sister. She leaves small prizes outside the hall of young children who sleep in their beds all night and don't wake Mommy and Daddy. She does this for a few weeks, until new habits are in place, then she goes off to visit other children who need her help. You might even line the hallway outside his bedroom with little wrapped prizes as a midnight reminder. This is a fun idea that you can use for lots of issues.

MEMBER QUESTION:
How can I get my 2-year-old excited to go to sleep in his own bed? His 3- and 4-year-old brothers are also in the same room.

PANTLEY:
What a nice family! There are several different issues here. One is siblings in the same room. I think it is WONDERFUL and helps them be lifelong friends, but it can also make bedtime too much like playtime, so a good bedtime routine is critical. Children thrive on routine and if you can have an enjoyable bedtime routine that they all are involved in then they will all look forward to bedtime, and so will you.

Also, I love sibling co-sleeping. Kids love to cuddle, and sometimes they will sleep better in a bunch. So, put the mattresses on the floor, side-by-side and make a sleeping place.

MEMBER QUESTION:
I have an 8-, 6- and 4-year-old. The 8- and 4-year-olds share a room and the 6-year-old sleeps in his own room. My 4-year-old creates problems at bedtime and makes a lot of noise so the others can't go to sleep. My husband and I usually give in and let her stay up. Even when we go to bed, she'll cry and say she's not tired and will keep talking to us -- shouting from room to room. If we don't answer, she cries and screams. How do we control the situation and get her to bed on time?

PANTLEY:
A few ideas for you and your chatty little one:

Use music (lullabies) or white noise like the hum of a fan, or a white noise machine that plays ocean waves or other sounds. These sounds can mask noises from one child that keep the other ones awake.

Also, look at the 4-year-old's nap schedule. A nap that is too long or too late in the day will prevent a child from being tired at bedtime. Or maybe it's an opposite problem -- no nap, or a short nap, means your 4-year-old may be overtired and wired and can't sleep. So try having a quiet time after lunch. Put your child in a dark room with soft music, white noise or an audio book and perhaps she'll fall asleep.

MEMBER QUESTION:
I have a 5-year-old that does not want to sleep in his bed. He winds up on the loveseat or couch and sometimes in our bedroom. I nursed him until he was 14 months and now I have a 5-month-old that I am nursing. One more little one in our bed with arms, elbows and kicks is just too much. What can we do to help him go to bed in his room? Giving in is not helping. I really don't think he will sleep with us forever, but I want a way to help him get a good night's sleep, not to mention us. Jealousy over the new baby has been addressed and this is not the issue, he is a very well rounded and happy, he just doesn't want to sleep alone.

PANTLEY:
You have your hand's full! And here we are again to that one concept: routine.

Lots of us have routines; they are just unplanned and not so fun! The key is to purposely create an hour-long, specific and gentle bedtime routine that invites sleep. You may need to purposely make things very different so that new routines can take their place.

If your child normally falls asleep on the couch, then do a nice session of bedside reading, or play an audio book in bed so that he's very sleepy in his own bed.

Be gentle though. Having a new sibling takes some getting used to, but all will be well for you, I'm sure.

"When I surveyed children about sleep, a surprising 97% of kids gave the same answer to the question, "How do you know its bedtime?" The answer was "Mommy tells me." Or "Daddy tells me." This gives parents more power than they realized."

MEMBER QUESTION:
I have a 2-and-a-half-year-old girl. She has always had issues going to sleep at night. She doesn't want to go and then she wakes up crying for me in the middle of the night. Her older sister never did this, I never had a problem. Now that we've tried to move the little one out of the crib, she is always coming into my bed in the night. What do I do?

PANTLEY:
Oh my, that's about 10 questions in one! Let's address several things here for you:

She doesn't want to go to bed. Examine her nap and bedtime schedule and see how it looks. She should be having a nap of about 1 1/2 to 2 hours. Plus 11 to 12 hours of nighttime sleep. If she is getting too little or too much sleep it will affect her biological clock and she won't be tired at the right time.

And back to the bedtime routine. The key is a PEACEFUL, HAPPY routine that you both enjoy that ENDS with her in bed. Try telling her a story after the lights are out. A story about her is the best! See, since reading a book involves lights and eyes open it can prevent sleep with a child like your daughter. But listening to a story in the dark can invite tiredness.

You said she always visits your bed in the night -- that's really common! About 40% of young children end up in their parents' bed at some point during the night. If this disturbs your sleep and you want to change it I suggest the "rubber band bounce," which means anytime your child gets out of his bed you gently, quietly and without emotion lead her right back to her own room. It helps to make her room inviting with stuffed animals, soft music or a bedside pet like a goldfish. But you have to be consistent at first for this plan to stick.

Keep in mind that all children are very different. I have four and they all have very different sleep patterns. You can't truly compare one of your children to another.

MEMBER QUESTION:
How can I get my 2-and-a-half-year-old to go to bed at 9 p.m. instead of 11 p.m.?

PANTLEY:
Excellent question! And not an uncommon one!

The best bedtime for most toddlers and preschoolers is between 6:30 and 7:30 PM; it's a biological thing. If we don't listen to the biological call we miss bedtime and then a child gets a second wind and is up until 11 p.m.

First, make sure your child isn't taking a long, late nap. For example, some people let their child take a dinnertime nap, which with a little nudge can become an early bedtime.

Quick GuideSleep Disorders: Insomnia, Sleep Apnea, and More

Sleep Disorders: Insomnia, Sleep Apnea, and More

And an interesting thing I learned: When I surveyed children about sleep, a surprising 97% of kids gave the same answer to the question, "How do you know its bedtime?" The answer was "Mommy tells me." Or "Daddy tells me." This gives parents more power than they realized. They may have never realized that setting a bedtime is as simple as setting a bedtime!

So create that peaceful bedtime routine I've been talking about and set an earlier bedtime. It really, really helps if that routine takes place for an hour and is quiet, peaceful and dimly lit. Bright lights and noise prevent tiredness.

Also, learn to read your child's tired signs, since tired children don't always yawn and look tired. A sleep-deprived child might be whiny, fussy, hyperactive or stubborn. He might be grumpy and have temper tantrums and frequently fall asleep in the car. A child who is fussy from dinnertime to bedtime is telling you that he needs more sleep.

MEMBER QUESTION:
I don't know if you can help but my son just turned 4 and he still doesn't sleep very well at night. I have an easy time getting him to sleep but he's got asthma which interrupts his sleep sometimes with coughing. Also, in the last month, he's been waking up crying in pain that his legs and sometimes his arms hurt. I've been rubbing them and I give him Tylenol to help, but I'm not sure what to do. Also how much sleep is usually needed for a 4-year-old? He still takes an hour nap in the afternoon.

PANTLEY:
The funny thing about sleep is that even if children sleep well as babies they can come up with a whole new crop of issues when they get older. Very good question! And I do have chapters in my book about asthma, allergies, special needs, medical issues, newly adopted children, twins, etc. Sleep issues cover all kinds of situations!

First, for a 4-year-old, maybe a nap of about an hour, although some children that age have given up naps completely. From age 2 1/2 to 5, children need about 11 hours of nighttime sleep to be well-rested and healthy.

With children who have medical issues like asthma or allergies, it's important to talk to a medical professional since these can certainly get in the way of good sleep. Some things that may help are raising the head part of the bed (try taping the legs to tuna cans) and using an air purifier. A humidifier may help also.

MEMBER QUESTION:
My 3-year-old takes a nap at daycare with no problems. He is the first to go to sleep and the last to wake up. On the weekends we have a battle. He does not want to take a nap. What can I do?

PANTLEY:
Not an uncommon question!

First, I'd find out from daycare exactly what the daily routine is. When does your child eat, play, and lie down for a nap? Ask about the napping room. Is it light, dark, noisy, quiet?

Try to keep the same nap/eat/play schedule (as much as possible) seven days a week. Also, he may be more interested in playing with you, so create a pleasant prenap routine and enjoy the time.

MODERATOR:
How can you tell if your child still needs a nap?

PANTLEY:
If your child wakes up in a good mood, but gets whiny and cranky as the day progresses, or if he becomes hyperactive in the evening and if he has temper tantrums during the bedtime routine it's likely that a nap would help.

And one more important sign that your child still needs a daily nap: you desperately need the break to recharge your own battery and be a better parent.

"The key to ending bedtime battles is to create a consistent, predictable bedtime routine that is appealing to your child.""

MEMBER QUESTION:
I do get concerned about day naps. My son does not take naps and I really think sleep is important for his learning in school. If his night sleeping is so difficult, should I encourage a daytime nap? Thank you for the wonderful ideas.

PANTLEY:
Yes, Yes, Yes! Actually a good nap means better night sleep. Weird, but true!

And you are right, during sleep the brain sorts what has been learned during the day and creates permanent files. Without adequate sleep, memory fails, and new information can be lost. A good night's sleep is critical for clear thinking and all that a young child has to learn.

MEMBER:
My child actually takes a nap by himself he gets so tired from preschool. Lucky me, huh?

PANTLEY:
Indeed, lucky you! I had one of four like that. She'd head upstairs on her own and say, "Me nap!"

MEMBER QUESTION:
My 2-year-old's biggest issue is going to sleep. He throws a tantrum every time I put him down for a nap or for bed at night, to the point where he makes himself sick. Where do I start?

PANTLEY:
Tantrums at bedtime are a sure sign of a sleep-deprived child, believe it or not.

We are back to a daily naptime and bedtime routine. But the key is -- A PLEASANT, JOYFUL ROUTINE THAT YOUR CHILD LOOKS FORWARD TO! OK, yes, I was yelling, but it's that important!

You child should be looking forward to your routine. Include lots of bedtime reading or storytelling since it helps relax a child. Also, you don't have to announce that it's naptime or bedtime -- just gradually go about the peaceful process.

MODERATOR:
What are the other elements of a good bedtime routine?

PANTLEY:
The key to ending bedtime battles is to create a consistent, predictable bedtime routine that is appealing to your child. This pleasant routine should take about an hour from start to finish and happen at exactly the same time every night. It should be quiet, peaceful and dimly lit. And NO TV or wrestling!

MODERATOR:
Let's talk about those monsters that live under the bed. How do you deal with them and other things that go bump in the night?

PANTLEY:
Lots of kids take flying leaps onto the mattress to avoid being grabbed by what waits beneath. The best solution is to simply eliminate the "beneath" by putting the mattress directly on the floor and pack away the bed frame for a year or two. After all, there can't be anything under the bed if there is no under the bed!

Fear of the dark is one of the most common childhood fears, and for most of us it lingers even as adults. Think of the fact that all scary movie scenes occur in the dark. You can help make the dark less mysterious with occasional fun activities like building a campfire or having a candlelight dinner or reading by flashlight.

You can give your child stuffed animals to sleep with, a small bedroom pet like a turtle or fish, and a bedside flashlight to help her feel safer.

Since the creatures that scare your child are imaginary, you may be able to banish them with a spray bottle of "monster remover" or a magic wand.

MEMBER QUESTION:
My son has had some night terrors. We can't calm him down when he has one. We don't touch him, but quietly talk to him. He will run out of his room; it's pretty scary. What is the best thing to do?

Quick GuideSleep Disorders: Insomnia, Sleep Apnea, and More

Sleep Disorders: Insomnia, Sleep Apnea, and More

PANTLEY:
Night terrors are very different from fears or bad dreams. Night terrors are terrors for the parents to watch -- a child looks so frightened and can't be calmed down.

The good news is that he's NOT frightened, NOT dreaming and NOT awake! He's kind of stuck between two sleep stages and not aware of what is going on and won't remember it.

The best thing to do is keep him safe, try to guide him back to bed, shush him a bit (Shhhh Shhh) and wait it out. Most kids outgrow these over time.

MEMBER QUESTION:
I know this chat is for toddlers or preschoolers, but I have a 6-and-a-half- month baby and he sleeps 12 to 13 hours at night. He wakes up for a bottle and goes right back to sleep for two to four hours. Is that too much sleep?

PANTLEY:
Too much sleep is a very rare question!

If your child is healthy, growing well, happy and hitting normal childhood milestones, I wouldn't worry at all. But prepare yourself. This can (and likely will) change at some point. So stock up on your own sleep now!

"Keep in mind, that most of us wouldn't leave our babies alone for 10 minutes during the day, yet we want them to be alone for 11 hours at night."

MEMBER QUESTION:
Do you have any tips for getting 9-month-old twins to sleep? My boys are bottle-fed, no pacifiers, great nappers, but don't sleep more than three hours at night; then they won't go back to sleep without a bottle, and always want to be swaddled loosely. Help!

PANTLEY:
You lucky mommy!

You need to reread everything I've said about routines, as that's even more important for moms of twins, mainly because there is only one of you!

You can work towards better night sleep by weaning them from that sleep-time bottle. (We spoke about that earlier -- less fluid/adding more water over time.)

Swaddling is a good thing if they enjoy it. But as they get older and too old to swaddle try warm sleeper pajamas which give a similar feel of enclosure.

White noise and lullabies playing softly all night might help too.

MEMBER QUESTION:
I'd like some advice on helping a 7-month-old learn to sleep through the night.

PANTLEY:
New babies are so much fun! But getting that all night sleep is always a goal we tired parents want to reach. This question could be answered in lots of different ways, since all babies have different issues.

First, make sure you are creating good sleep cues. These are NOT rocking, bottle, pacifier or breastfeeding every time your child falls asleep as he will come to rely on that every time he wakes in the night. (Remember that all human beings wake up five or more times every night when going through sleep cycles.) The sleep cues that you want are white noise, cozy bed, and darkness. And a good naptime schedule helps a lot.

When your baby wakes in the night you should be minimally helpful, keep the room dark, don't talk or sing or play. Be boring. Your little one will learn that dark, night is for sleeping.

Keep in mind, that most of us wouldn't leave our babies alone for 10 minutes during the day, yet we want them to be alone for 11 hours at night. This is something they will grow into. (And so will we.)

MEMBER QUESTION:
I see the point of routine and that make me feel better. I do wonder if my son (5 years old) is the only one who can be eating and fall asleep. He just drifts off during dinner. It's not often, but it happens. Is it a myth that sleeping just after dinner creates future health problems?

PANTLEY:
Actually, this is more common that you'd think. If you look on my web site under "Eating Out with Kids" you'll see a photo of a toddler who fell asleep with a mouth FULL of corn! However, this tells me your little one needs a bit more sleep. Perhaps an earlier bedtime?

And no, eating before bed is not a bad thing -- if it's a healthy snack. Actually, professional bodybuilders and other athletes often have a snack right before bed for healthy fuel.

MODERATOR:
We are almost out of time. Before we wrap things up for today, Elizabeth, do you have any final words for us?

"Always remember this very important point when it comes to taking care of your child: Do what works for your family. There are no "rules" about children."

PANTLEY:
Thank you all, this was wonderful. If you want updates and newsletters from me in the future, please sign up at my web site at www.pantley.com.

Always remember this very important point when it comes to taking care of your child: Do what works for your family. There are no "rules" about children. No matter what any expert says (even me!) it is most important that you follow your own heart and do what works best for you and your family.

I'm sending big hugs to all of you and to your sweet children too.

MEMBER:
Thanks very much for covering all that you did, Elizabeth. I'm going to look for your book!

MEMBER:
Thank you for all your advice today. I am going to give it a try and hopefully get more sleep at night.

MEMBER:
Great information, thanks!

MODERATOR:
Our thanks to Elizabeth Pantley, for joining us today. For more information, please read The No-Cry Sleep Solution for Toddlers and Preschoolers: Gentle Ways to Stop Bedtime Battles and Improve Your Child's Sleep and The No-Cry Sleep Solution: Gentle Ways to Help Your Baby Sleep .



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Reviewed on 6/27/2005 3:03:44 PM

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