No Rest for the Wee One? Here Are Some Things to Think About

Lots has changed when it comes to kids, and not just in health care. What they watch and how they watch it, some of the games they play, even what they eat—all have evolved over the years. There’s one activity, however, that’s a constant and will remain so until the end of time: children have to lie down and go to sleep.

There’s another given: many infants and toddlers will resist all efforts at following through on bedtime. Others may get to bed OK, but will not only wake themselves, but everyone else within earshot. Given this age-old problem, you’d think we’d have an easy fix for this. Unfortunately, no one method results in somnolent bliss for every family. That said, there are a few tricks of the trade that make sense. Let’s explore those, with today’s emphasis being on bed inhabitants in the late infant-toddler range.

The (Sleep-Wake) Times They Are A-Changin’

Young infants generally sleep something on the order of 16-17 hours a day. However, their sleep pattern is very different from what it (ideally) will be several months down the road. It’s normal for our youngest individuals to wake after just a couple of hours. When you think of it, that’s as it should be, because they do need to be fed more often.

Sleep-wake intervals generally lengthen. By three to four months, most babies sleep for a few hours at a time. By six months, the majority are sleeping through the night; however, what we call “sleeping” still often does involve brief waking periods. (Even the good sleepers among those of you reading this can probably relate to short periods of wakefulness at night.)

However, also around six months, there are some things that go on in a developing child that may make lying down and going to sleep somewhat less of a happy proposition. Separation anxiety develops, making time away from Mom and Dad more of an ordeal for the little one. And in late infancy and toddlerhood, routines become much more important. Although you can’t really spoil a young infant (under a few months of age), it’s in late infancy that how you get your child to sleep and what you do when she wakes might come back to haunt you like the boogeyman.

Preventing and Treating Sleep Problems

 Knowing a little bit about an infant’s changing cycle and social development can help prepare parents to set the stage for good sleep habits. Between four and six months of age, it’s generally a good idea to begin to put infants to be put to bed before they’re fully asleep (they can be a little drowsy). This is really the first step to getting them to fall asleep on their own, with minimal help from Mom and Dad. Remember that young children thrive on routines, and if they’ve historically needed holding, rocking or a bottle to go to sleep, that’s what they’ll expect when they awake.

Despite the best of intentions, you may still end up with that older baby or toddler that will give you no peace without an intervention. When dealing with this situation, there are definitely do’s and don’ts. Let’s look at the “don’ts” first—many of them involve safety issues, and it’s always important to do no harm when trying to deal with children’s behavior:

  • Don’t ever put a bottle in bed with the baby. This can lead to significant problems with the teeth as they develop. Even if there are no obvious teeth yet, it’s still a no-no.
  • Don’t use an unapproved device for baby rest. Many have been associated with an increased risk of sudden unexplained infant death. It’s not worth the risk—practice safe sleep!
  • Don’t use sleep-inducing medications (including supplements) without checking with your baby’s provider. Most are questionable even in older children, and any concerns about their safety and side effect profile are multiplied in infants and toddlers. Some medicines marketed as sleep aids can have the reverse effect in young children, making them overly active.
  • Avoid taking your non-sleeper into your own bed. It just reinforces that this is what’s needed for sleep, and I’ve seen it go on for years. In addition, co-sleeping infants are subject to injury and suffocation risks.

Happily, there are some “dos.” Most of these are based on children’s preference for routines:

  • Do try and put your child to bed at around the same time every night.
  • Do establish a bedtime routine. Do you have a song you like to sing together? Or can you read a story? Not only is it a great ritual; it will help foster a child’s love of books and reading. Remember to wrap it up before the child is totally asleep.
  • Once you are certain there is no issue, such as illness, that’s causing your child’s crying out, do increase the length of time before you will response to any waking cries, so she won’t associate calling out with an immediate response.
  • Do keep any interventions to a minimum. If your older infant has been sleeping through the night for a couple of months until this week, he doesn’t suddenly have a nutritional need to be fed in the middle of the night. Picking up without feeding is better than feeding. Rubbing the tummy is better than picking up. Showing up at the door without touching is better than rubbing the tummy. (You get the idea….)


 I have always been about the “real world,” and nowhere does it seem to surface more than when we’re dealing with infant and toddler sleep problems. Here are two of the more common scenarios:

  1. We’re in an apartment and can’t wake the neighbors. Many might be a little more understanding than you think. Could you get them a white noise box? Can you switch around rooms temporarily, so that your little one still has his own room but is a little further from the neighbors?
  2. We all have to work tomorrow. Similarly, many people at your workplace have been through this at one time or another. Can you shut your eyes during a break? Can you work from home occasionally? Nap after work?

Finally, although no one sleep maneuver works for every family, some have had success by carving out about 48 hours—say, a weekend—to work on this one problem. (Maybe you can work around your neighbors’ schedule.) During this time, parents are extra vigilant about minimizing interventions, limiting them to making sure the child is safe and well. I’ve had parents who have characteristically “caved” try this—remember, it’s only 48 hours to be meticulous about keeping the child in the bed, and you can support each other (or enlist a trusted friend if you’re on your own)—and it’s worked often.

If it appears nothing works, it’s probably time for a consultation with your child’s provider. Physical and non-routine emotional problems can be ruled out, and all pediatricians have a few tricks they favor. In addition, there are many references on the subject written by specialists who can suggest some other safe approaches. (Always run these references by your child’s provider!)

We’ll likely have night wakers among our youngsters until the end of time. And we all will continue to have the need to get our own rest. But as caregivers, what we do have going for us is the fact that young kids will likely continue to develop the same way through the generations. Once you understand the basics of how a child’s development can affect how they sleep, you can anticipate the stage at which the sleep pattern changes. You can then be armed with your “bag of tricks” to give your little one his best shot at a good night’s sleep.

Stan Sack
Dr. Stan Sack has 29 years’ experience as a primary care pediatrician in Massachusetts and Florida. A medical writer since 2015, he enjoys blogging on topics that are on parents’ minds but are covered less often in books and on websites. He lives in the Florida Keys with his family and enjoys healthy cooking, fitness activities and singing in his spare time.

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