Sleep Problems

Sleep Problems 2017-03-22T02:18:08+00:00

“Why doesn’t my baby sleep through the night?” is a question that we are asked many times in our practice. Most parents do not realize that it is their (the parents) behavior in the vast majority of cases that is responsible for their infant or child’s nighttime awakening.

Attention to three areas of parental behavior can cure the vast majority of nighttime awakening.  Most children, especially during the first year of life, awaken up to four to five times each night even though the parents may not be aware of this night time awakening. However, most of these children can put themselves back to sleep without parental help. Children who have not learned to master this will cry for their parent. If you provide too much attention, your child will become dependent upon you for returning to sleep. Children with this behavior are known as trained night criers. Usually, the child will be rocked to sleep by his parent and placed in bed asleep. Then, the parents will tiptoe out of the room to make sure not to wake the baby. Whenever the child awakens, the parent will immediately come back into the room and re-rock the child to sleep again. This pattern is repeated over and over, making for exhausted parents and children alike.

Parents of trained night criers will often place signs on their front porch stating something like this, “please don’t ring the doorbell, child is sleeping”. You see, parents of trained night criers need all the rest that the baby will give them and anyone who would wake their sleeping baby is quickly chastised. In essence, the baby rules the house.

Infants who are fed at night if they wake up are called trained night feeders. It is only during the first two to four months of life that a child may need to be fed at night.  From birth to two months of age most babies normally awaken two times per night for feedings. Between two and three months of age, most babies will need one middle of the night feeding. By four months of age, over 90% of infants can sleep more than eight hours consecutively without feeding. Only premature and small newborn infants need to be awakened for nighttime feedings. You should let your child sleep through the night if he will, especially after four months of age.

Fearful night criers are children who are fearful or who panic when the parent leaves the room. Many times, these children will becomes extremely manipulative, crying until they vomit, or crying nonstop for hours. These children do not tolerate separation from their parents very well. Most parents feel guilty about letting them cry and will give in to their bedtime demands. The child, thus, “rules the roost” and parents have a great deal of difficulty in disciplining them. Many times fearful night criers turn into young children who throw tremendous temper tantrums. This is probably due to a lack of discipline. Events surrounding bedtime are extremely important in your child’s discipline.

Some children have aspects of trained night feeders, trained night criers, and fearful night criers in the cause of their sleeplessness. We recommend that you take the following steps to promote healthy sleep habits for your child.

  1. Put your child to bed while he is awake. It is disorienting to a child to go to sleep in his mother’s arms in a rocking chair during a feeding and then awaken in his crib without his mother being present. The last memory of your baby before he goes to bed should be of his crib, not of you, your breast or the bottle.
  2. Don’t feed your baby at night. If your baby is four months of age or older, he does not require nighttime feedings. If he awakens at night and demands something to eat, give him water only, and after a few days discontinue this. It is OK to feed your baby prior to going to sleep, but do not let your baby keep his bottle in the bed and use it as a pacifier. Offer him a pacifier instead. You should increase the daytime feeding intervals to at least every three hours. A child that feeds every two hours in the daytime cannot be expected to make it eight to ten hours at night without feeding.
  3. Have your child sleep in his own bed in his own room. Letting the child sleep with you in your bed or having the crib next to your bed is not a good idea. This will further foster your baby’s reliance on you for normal sleep.
  4. Eliminate long daytime naps. If your baby has slept for more than two to three hours, you should awaken him. If he is taking several naps per day, you should try to decrease that number.
  5. Don’t change your baby’s diaper during the night. Babies can survive until morning with a wet diaper. Of course, if the diaper is soiled or if you are treating a diaper rash, you can change it.
  6. Keep the room dark. Most of the time if a baby cannot see anything he will go back to sleep.

To convert your baby from a trained night feeder, a trained night crier, or a fearful night crier to a child who sleeps all night will require patience and diligence on your part. We realize that if you institute the measures outlined above, this will more than likely initiate crying at bedtime for your child. We recommend not giving in to your child’s wants but forcing him to conform to the above pattern. This will enable your child to develop healthy sleep habits that will last a lifetime. We do not recommend letting your child scream for hours on end without comforting and consoling him. Usually, we would recommend that you check on your child periodically while he is crying to make sure that he is OK. You should comfort your child, but do not turn a light on, nor entertain him. Once the crying has subsided, you should leave the room again. You should not pick up your child while you are trying to retrain his sleep habits. Usually, within a very few days of the above treatment, your child will be sleeping all night long.

Solve Your Child’s Sleep Problems by Richard Ferber MD is an excellent book on this subject.  The recommendations on this page are borrowed from him.

 Reviewed by Dr. Byrum on 3/22/17