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Help! My Kid Doesn’t Sleep

There are few things more frustrating for a parent than a kid who can’t sleep. Exasperated parents come into my office everyday stating that they’ve tried everything and STILL they can’t get their child to sleep. The child is exhausted and ornery. The parent is exhausted and short-tempered. Everyone is in desperate need of a good night sleep.

While it’s true that some kids are naturally “better sleepers” than others (they seem to be able to fall asleep on command and sleep through anything), few people recognize sleep as a learned behavior. Just as with anything we do, we can learn good sleep habits or bad sleep habits.

If you’re really struggling with a “bad sleeper,” I’m going to give you a crash course in sleep training. It’s ALL about strict adherence to a sleep routine. You probably remember learning about the classical training experiment of “Pavlov’s dogs” in your high school science class. In essence, the scientist, Pavlov, trained dogs to salivate at the sound of bell instead of food, by associating the bell with the food. In sleep training, we’re using the same scientific principle of training the brain to sleep with a certain routine. Here are the quick steps with the details to implementing listed afterwards.

Steps to training:

  1. Make a detailed list of the things to do before going to bed, make the list 8-15 steps long (lasting anywhere from 15-30 mins).
  2. Write the list on a paper labeled “Bedtime Routine.” (Tip: If your child is too young to read, use small pictures for each step instead of writing).
  3. Post the list in the bedroom, near the bed.
  4. Look at and read the list after every step.
  5. Be rigid in following the list (in order and don’t get distracted).
  6. After completing the list, get into bed.
  7. If not asleep after 20 mins, get out of the bed and read in a chair until sleepy or 20 mins (whichever is sooner).
  8. Go back to bed and try to sleep again (repeat steps 7 and 8 as much as needed until sleep occurs).

What time should I put my child to sleep?

The time for bed will change as the sleep training progresses. The first night, you should aim to put your child to bed at the time that they typically fall asleep. So if you’ve been starting the bedtime circus at 9, but the child doesn’t fall asleep until midnight, then the first night, put your child to bed at midnight. This means the bedtime routine would start at 11:30-11:45 (depending on the length of the routine). Each subsequent night, put your child to bed 30 mins earlier until the desired bedtime is achieved. Depending on your child’s age, typical bedtimes are 7:30 pm (infants) to 10:00 pm (teens). Most school-aged kids should be in bed between 8-9 pm.

The scientific studies show that the body can only adjust the circadian rhythm by 30 mins every 24 hours (this is why it can take so long to fully recover from jet lag). If your child is accustom to falling asleep very late, it will take time to adjust that natural sleep time.

What is a typical bedtime routine?

When you create the bedtime routine for your child, be very detailed. My kindergartner’s bedtime routine list (as an example) is:

  1. Get undressed (clothes in hamper)
  2. Go to the bathroom
  3. Take a tub
  4. Hang up towel
  5. Lotion body
  6. Put on pajamas
  7. Brush teeth
  8. Aquaphor lips
  9. Brush out hair
  10. Family prayers
  11. Set out clothes to wear the next day
  12. Child reads to mom
  13.  Mom reads a chapter from the book we’re reading together
  14. Kiss goodnight
  15. Lights out

If done correctly, the brain starts to release sleep hormones that signal a child to feel sleepy as the child progresses through the list. While my child may be a monkey during the first 3 steps, by the end, she’s super tired and ready to sleep. Keep in mind that kids need a bedtime. Try to put kids the same time every night (regardless of it being a school night or weekend).

How to create the perfect sleep environment:

  1. Make the room dark (use a small nightlight if needed). My kids all have blackout drapes in their rooms. It solves the problem of it being too light outside in the middle of the summer at 8 pm. Dark also helps the body secrete the right amount of natural melatonin (which helps with sleep)
  2. Keep the temperature just right—slightly cool. Science shows that sleep quality is slightly better when the room is cool (68-70 degrees) vs warm (74-76 degrees).
  3. Quiet. Try to make the room quiet. Kids who have trouble sleeping don’t need more distractions. Also, try to avoid “white noise.” If there is a background music or white noise, the child will get conditioned to requiring that to sleep. As soon as the noise stops, the child wakes up. Don’t create unnecessary future problems for yourself.
  4. Loose, comfortable clothes to sleep in. You want the pajamas to be a non-issue rather than a distraction.

Absolute No-No’s for bad sleepers:

If your child is struggling with sleep issues, here are a few tips:

  1. No media for 1 hour prior to bed
  2. Don’t eat meals too late (it can be hard to digest a big meal right before bed, a small snack is ok).
  3. Don’t do vigorous exercise within an hour of bedtime. You should however exercise during the day.
  4. Don’t do anything on the bed, but sleep (no playing with toys, doing homework, etc.). The bed needs to be a conditioned sleep location only.
  5. No media in the bedroom, period.
  6. Avoid scary TV, movies, news, video games. Media with conflict, drama, anxiety, and violence can all carry over into creating sleep issues for kids.
  7. No naps (unless the child is 3 years-old or younger).

It can take weeks to properly sleep train a child, but the results are well worth it. Good luck, may we all get a good night’s rest.

3 Easy New Year’s Resolutions To A Healthier Family

I am a goal driven person. It should come as no surprise that I like setting New Year’s resolutions. However, I haven’t always been good at it. I used to set goals like “lose weight” or “eliminate all refined sugar in my diet.” Those goals never stuck. The problem was that these goals either didn’t have a specific plan to accomplish them or weren’t sustainable. As I’ve changed my approach, I’ve had more success. As you decide on the best goals/resolutions for you and your family, here are 3 easy, doable, long-term healthy suggestions to incorporate in your family.

Eat dinner together.

There is a mountain of scientific research out there touting all the benefits of eating dinner together as a family. The benefits are particularly noted when the meal is prepared at home and done without the involvement of media. In case you aren’t convinced, a huge study (involving 182,000 children) published in Pediatrics (a renowned scientific pediatric journal) showed families that eat dinner together at least 3 times a week had these benefits:

  1. Decreased risk of being overweight (12% less risk)
  2. Better eating habits (20% decrease in unhealthy food choices)
  3. Reduced risk of eating disorders (35% reduction in rate of anorexia and bulimia)
  4. Better social-emotional health (better relationships, more emotionally resilient, more empathetic, decreased risk of depression).

Multiple other studies have shown benefits like decreasing risk of suicide, anxiety, and drug use. Kids who eat dinner with their families also have better academics and relationships with parents. So in case you were trying to figure out if it’s worth your effort, one single daily habit change has far reaching effects.

TIPS:

  1. Turn off the TV while you eat
  2. Talk together

At the Wonnacott household, we have dinner at our table 5 nights a week. We’ve had to adjust meal times and activities to accommodate it (it’s hard with extracurricular activities, work, etc.), but I believe it is well worth the sacrifice. The table is considered a “media free zone” (including no cell phones). We also play a game called “Hi-Lo” at the table. We go around the table and everyone tells their “high” for the day and the “low” for the day. It’s amazing the kind of conversation and support that comes from celebrating each other’s victories and supporting the low moments.  Feel free to use our ideas if it works for your family.

Create media free zones/curfews.

Media Free Zones

Media of all sorts is pervasive in our world today. Can you imagine going anywhere without your cell phone? We’d feel naked. Designate a few “media free zones” in your home. A simple “no media at the table” rule (including phones, iPads, TV, etc.) can make a significant improvement in the quality of the mealtime experience. It’s amazing what kids will share with you when they aren’t distracted by media. As a family, you may determine other media free zones. We also recently made our children’s bedrooms “media free.”

Media Curfews

The media curfew component has more to do with preventing disordered sleep patterns. I am seeing tons of teenagers who are chronically tired and have sleep problems related to nighttime media use. Kids stay up late on their media. Their friends text in the middle of the night and wake them up.

Decide what time “media off” is going to be and stick to it (some of that will depend on your children’s ages. It may be anywhere from 7 pm to midnight; you’ll know what works best for your family).

Leave the cell phone/media device in a designated location (not in the child’s bedroom) after curfew.

Establish bedtime routines.

My favorite time of the whole day is when I have a few minutes with each individual child at night (for my youngest, that involves a snuggle and a few minutes in the rocker, while for the others it is reading with them). If you have teenagers, it may be as simple as going into their rooms each night for a minute to say goodnight. I’ve arranged my children’s bedtime routines to stagger “mom time” (wouldn’t being in multiple places at once be great?). That time is often when I hear little “nuggets” about friend dramas or happenings in my child’s day (when kids are quiet and have your one and one attention is when they are more apt to talk). Those little talks create teaching moments for me with my children (e.g., I may coach them with what to say or how to handle another child being rude or mean). In addition to all those benefits, there is the obvious benefit of bedtime routines helping improve overall quality of sleep. And who couldn’t use more quality sleep?

Good luck choosing what goals/resolutions to make happen this year. May it be a happy, healthy 2017!

How To Stop Your Baby From Climbing Out Of The Crib

Three separate parents in clinic yesterday brought up the problems of their young child crawling out of the crib. In all of the cases, the parents ended up moving the child to a toddler bed before the child was developmentally ready because they were appropriately worried the child would get hurt. Crawling out of the crib creates a two-fold problem. First, the child can fall and get hurt. Second, the child is up and out of the crib at all hours of the night.

As many of you know, I have a nearly 2 year old. She’s cute, but a complete monkey. The first time she climbed out of the crib, I came up with this solution. This is a picture of her crib. All I did was take the metal frame out of the crib and put the mattress directly on the floor. I left the wood frame completely assembled. As you can see, it works because the wood side slats come down farther than the top of the mattress (there is no gap where she could crawl out). It’s a simple solution to the scaling toddler.

Most kids need to stay in a crib until they are potty training age (generally 2-3 years old). And some kids do better in the crib until they are over 3 years old; it depends a bit on the child. Most young children roll around when they sleep. If they are contained to a crib, most will wake briefly and go back to sleep. If they are in a toddler bed, many will get out of the bed (seeking mom and/or dad) and be up at night. And let’s be honest, all parents could use more uninterrupted sleep. May you have more restful nights. Feel free to share the tip!