Introduction
It is an all too common scenario: Mrs. Lewis brings in her daughter, Samantha, for her two-year-old checkup. Mrs. Lewis looks terrible; her eyes are red and she seems to be dragging around with little energy. Samantha, on the other hand, is as happy and active as she could be—a delightful little girl. I begin by discussing the usual things that I discuss at checkups: safety, diet, behavior....When I get to that last one, I hear the question that comes my way more than any other question about the behavior of young children: “Doctor, when will my child sleep through the night?”
It seems that Mrs. Lewis has not had an uninterrupted night's sleep for the past two years and it definitely shows.
One of the most frequent problems that concern and aggravate parents is the battle of the bedtime. Many of us find ourselves unable to get the kids to bed at a reasonable time without an unending struggle. Persistent crying and frequent nighttime awakenings further frustrate us. Let's take a look at how the problems start and some possible solutions.
Rock-a-Bye Baby
The problem often begins in early infancy. Most parents of very young infants will feed them at night while rocking them to sleep. They will then quietly tip-toe to the baby's crib and gently lay the child down, praying to all the powers that be that the baby will not wake up. This bedtime ritual is common and perfectly appropriate for the very young infant. I repeat, for the very young infant. Unfortunately, a great many parents mistakenly continue this same technique as their child grows older. It is not unusual for me to see a two-, three- or even a four-year-old put to bed in this fashion. The problem arises when there is a brief awakening in the middle of the night. We all wake up like this several times a night. However, when this child awakens briefly, she has not only no idea where she is or how she got there, she also has no idea how to fall asleep again without the same rigmarole needed to get her down into bed in the first place. The end result is the crying, inconsolable child who must be repeatedly rocked to sleep all night long. Children need to learn to associate being in the crib alone with going to sleep, as opposed to being fed or rocked to sleep. Somewhere between the ages of four and nine months, you must begin to teach your child how to fall asleep on her own.
