Toddler sleep can be a challenge. Getting your little one to sleep through the night is the holy grail for most mums, and having to get up in the night is exhausting for everyone. When you feel like you’ve tried everything, what can you do?
Hi Dr Justin,
I’m writing out of sheer desperation. My 18- month-old has never slept through the night. Ever.
We have a calm bedtime routine, and he will happily nurse to sleep at 7:15pm, and we will not hear a peep until 10:30pm, when like clock work, he wakes for the first time. After that, I am lucky if he sleeps in two-hour blocks for the rest of the night, or until 6am, when I give up, and get up for the day.
BUT, when he wakes, he is screaming, inconsolable, and absolutely beside himself. Usually I breastfeed him back to sleep, but lately, that is not working.
Last night he screamed for almost two hours! He was not hungry or thirsty, he was not hot or cold. I changed his nappy, I offered the breast, we offered cuddles with Dad, and we even gave him some Panadol, because we feared he was in pain and couldn’t tell us. NOTHING WORKED.
So I’m writing for help. We need help. My husband and I are anxious, tense and exhausted. Our three-year-old is waking at night and acting out towards his brother. We are not prepared to do ‘crying it out’ or ‘control-crying’, and I really don’t want to give up breastfeeding, because some days it is the most reliable source of nutrients – he is a particularly picky eater.
Please help. I am at my wits end.
Georgia
Dr Justin responds:
By 18 months old, you usually expect (or hope!) your child will be sleeping through the night. Here's a list of suggestions to help improve your toddlers sleep.
There are few things more challenging than dealing with the sleep-deprivation that being a parent brings. The tiredness we feel is sometimes so intense that it physically hurts. And we’re still expected to function as a rational, kind, understanding human being through it all!
It sounds like you are doing most things right with your little boy. You have identified a clear routine, a consistent bed-time, and a desire to maintain a strong and healthy attachment relationship with your son. As such, I’m going to reiterate some basics that you are probably already doing (for the benefit of others who are having similar difficulties), and then pinpoint a handful of minor suggestions that are generally helpful for this situation.
Routine
When it comes to babies and toddlers, routine is key for sleep. This means going through the same process each night at the same time in the same way to calm and relax the baby. It might be dinner at 6.15, bath at 6.45, stories at 6.55, songs at 7.05, and cuddles or prayers or grateful things at 7.10 so that lights are out at 7.15. Obviously we can be flexible, but the pattern and timing should be generally the same each night.
Sleep hygiene
The room should be the right temperature to allow for comfortable sleep. We don’t want too much light (and ideally there will be no light at all), but sometimes small children prefer a soft night light so they feel safe. The room should be quiet, although once again some children respond better to some soft white noise or gentle music.
A full tummy
Children will often wake during the night because they are hungry. Breastfeeding is fabulous for bub, but it is important to be sure that even your picky eater has had enough to eat before going onto the breast. At his age, breast milk is a supplement or a top-up.
Readiness
As children grow and develop, their sleep patterns change. Their daytime naps shift from two per day to the one per day that most 18-month-olds prefer. The duration changes too. This means that as daytime naps shorten, evening bedtime may need to change. We want to put our children to bed at approximately the same time each night, usually about 10-20 minutes before they need to go to sleep (depending on their age), but if we go too early or too late, it does not work.
Medical
I always recommend that parents take their little tyke to the GP for a check-up. Sometimes the doctor will ask about something that no one else has thought of, and that can change everything for the better. It’s always best to rule out any health-related issues.
Based on your email I think you’re probably getting these things (above) pretty close to right.
Here are a few tips that might be useful to improve toddler sleep
Anxiety
When our baby will not sleep, we become anxious. And some researchers have found support for the idea that our anxiety creates anxiety in our children. They ‘catch’ it, and feed off it. Of course, trying not to be anxious when you are anxious often makes you even more anxious! It’s like trying not to think of white bears when someone tells you not to. Your mind goes straight there. But by working to stay mindful and in the moment, and by remaining calm, our children will often respond the same way.
Wrapping
Some experts argue that children older than six months do not need to be wrapped. This may or may not be the case but I am yet to read high-quality research about the best age to stop wrapping children. Your son is still only 18 months, and may respond well to the secure, snug feeling of being wrapped.
Routine
Yes, I mentioned this above, but I am reiterating it. Stick with the routine. Avoid introducing new things. It may take a day, a week, or a month. But being consistent, kind, and clear will eventually get you there. Sometimes it is simply something that you need to push through with consistency and your baby will ‘get it’.
Of course, all of this might simply be a horrible, uncomfortable stage that your son is going through for a few weeks and that he will quickly grow out of. Yes, it is exhausting. Yes, we all wish there was something that could be done. Most of the time, we can improve the situation with tweaks around the ideas I’ve suggested. Jo Ryan (www.babybliss.com.au) and Pinky McKay (pinkymckay.com.au) both offer terrific – and slightly different – ideas beyond what I have suggested, and are worth checking out.
But try these ideas, be consistent, go to bed early so you get some rest, and hopefully soon enough you’ll be sleeping well again.
Does your toddler still need lots of support to get to sleep?