You Can Develop Healthy Sleep Behaviors in Infants and Toddlers

Joshua slept like, well, like the baby he was until about 10 months of age. Then, he began waking up around three o’clock in the morning and wailing until he was picked up.

Samantha was, according to her parents, a wonderful sleeper. She settled into a sleep routine the first week after she was born and continued her sleep pattern until she was 15 months of age. Then, she began resisting going to bed at night and crying for long periods.

Nicholas was a restless sleeper from the day he was born. Throughout infancy he would awaken several times during the night and could not go back to sleep on his own. His sleep problems kept his parents up at night and left them frustrated and concerned. Would Nicholas ever be able to sleep through the night? Would he always have sleep problems? Would his parents ever feel fully rested again?

Research reported in Pediatrics, the journal of the American Academy of Pediatrics, indicates that about 10 percent of infants and toddlers have sleep problems of one sort or another. In addition, the recent study that followed more than 350 mothers and their children for more than three years found that young children with sleep difficulties were more likely to continue to have sleep problems as they got older.

Most children during the first three years of life are likely to experience sleep disturbances of one kind or another. This can include night-time awakenings, difficulty going to bed at the usual time, night terrors, nightmares, and resistance about sleeping in their own crib or bed. The most common kind of sleep problem in toddlers is waking up during the night. Up to 30 percent, according to previous research, experienced waking up at night as often as two or three times a week. Whether or not these situations rise to the level of serious sleep disorders is questionable.

However, the latest research reported in Pediatrics suggests that as many as 20 percent or more of children with sleep problems in early childhood still had sleep problems at age three. The research recommends that parents, rather than accepting these sleep problems as normal, should report them to the pediatrician with the hope that the problems can be remedied early.

Studies over the last several years have indicated that behavior management is very effective in dealing with some of the common sleep disturbances. This is especially true for frequent night awakenings.

Parents often believe that picking an infant or toddler up, moving them to another room, rocking them, or getting them a drink will help them go back to sleep. While this may be true to some degree, the principles of behavior management suggest something quite different. That is, behavior management is effective with sleep problems because children are trained to be better sleepers. Behavior management depends on reinforcement and a major tenet of behavior management is that the behaviors that are reinforced and encouraged are more likely to be repeated.

Therefore, doing anything other than reinforcing appropriate sleep patterns is making the problem worse rather than better. The most common example has to do with children awakening in the middle of the night. If you reinforce night-time awakenings by picking her up or rocking her, then it is likely your child will be trained to wake up at the same night every night with the expectation of being held or rocked.

The best approach in dealing with any kind of sleep problem is to make sure you are not reinforcing the maladaptive sleep behavior. If you want your child to learn to go back to sleep when she wakes up in the night, than you cannot reward her for waking up or crying out at night.

It is very important that babies learn to fall asleep on their own and be allowed to learn to go back to sleep without a parent’s help. It’s difficult for many parents to understand this as they believe it is cruel to allow babies to be fussy or to cry during the night. While infants and toddlers may need some soothing from parents, it is perhaps more cruel to reinforce poor sleep habits so that those poor habits continue to develop over years.