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Challenge: Sleep Solutions

A Pediatrician's Guide to Sleep

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I have never read a book about getting my child to sleep. I know there is a huge market out there of people ready to tell me how to ensure my kids sleep well, but I have to brag and say I have never had a problem with this. I wish I could say it was because I am such a great parent that I have mastered this universal challenge. I wish I could say it was because my pediatrics training taught me the secrets of sleep. It was just luck. If anything, I think my kids taught ME what they need for a good night’s sleep. And since my almost 3-year-old has been sleeping through the night since he was 3-months-old and my now 3-month-old has been sleeping through the night since 1-month-old, I will share our routines and rituals so that you can find some ideas, strategies, and hope from my good fortune. Remember, there is no science here. I am far from a sleep-expert. In fact, my kids made this so easy that I am awful at troubleshooting sleep problems, due to my own lack of experience in this area. Other parents: feel free to hate me, then read on.

1. Tire them out. While it wasn’t an intentional parenting strategy but rather my son’s innate need, we spend our days running around, playing at the park, and getting exercise. When awake, he is always busy. His afternoon naps and bedtime slumber are needed for him to recharge. By the time we are ready to put him to bed he is exhausted and his body is ready for rest.

2. Be consistent. Nap time and bedtime are the same each and every day. No exceptions. Due to my rigidity on this issue, we have missed events and parties, we have been captives in our home during most afternoons, and we are constantly planning our day around sleep schedules, but our children sleep well. When we moved into our new home when my son was 18-months-old, we coordinated the move so that his nursery could be disassembled and reassembled at the new house in time for his afternoon nap. And although he was in a new home with the noises of unpacking around him, he slept for two hours.

3. Have a routine. The events leading up to nap time and bedtime are also the same each day. Prior to bed, we take a bath, get him in his pajamas, read stories, brush teeth, turn out the lights, and say a bedtime prayer. N has come to expect these events to happen and if we attempt to skip one he lets us know of our error. While this may raise a rigid child if his entire day was so inflexible, I think that keeping his bedtime ritual consistent allows him to have a calm, predictable time where he can relax and wind down without surprises. This is how he transitions from his chaotic day into the predictability of falling asleep.

4. Let him fall asleep on his own. While there is a bedtime ritual, we do not draw out the time when he falls asleep. Once placed in his crib, he can do whatever he wants (sing, rock, read, play with stuffed animals) but must stay in his crib and entertain himself. We are not there rubbing his back, sitting next to him, or singing him songs after he gets in bed. As such, he has learned to self-soothe. He knows what he needs. He does not call for us to stall bedtime (i.e. another glass of water), but rather only calls for us if there is something wrong. So often the behaviors some parents engage in prior to bed serve themselves more than the child, making the parent feel needed when perhaps they are not.

5. Make it dark. One of the best purchases we ever made were blackout shades. This makes it easier for him to fall asleep in the afternoons when the sun would otherwise be shining in, and ensure that he isn’t waking with the sunrise in the morning. He does use a nightlight, but one that has a timer that turns it off after 20-minutes and doesn’t shine directly on him.

6. Make it calm. Bedtime is a time for quiet activities. The toys in the kids' rooms are blocks, books, stuffed animals– things that allow for quiet, imaginative play prior to bedtime and not noisy electronics or screens. Most of the high-energy play toys are elsewhere in the house. When we play before bed, the activities are typically ones that can be done while sitting and not running around, further sending the message that this is a time for rest.

7. Use sensory play. Our son has always craved movement and used it to help him fall asleep. As an infant, this meant taking walks in the stroller or carrier or sitting in a swing chair. Now as a toddler, he gets movement at bedtime through sitting in a rocking chair when we read stories or bouncing in our lap on a yoga ball. Not every kid needs sensory play to help calm them, but many kids still enjoy these sensory experiences. You can explore this in the bath (i.e. bubbles/foam), with music (i.e. dancing or singing bedtime songs), or with skin care (i.e. infant massage or applying lotions).


8. Celebrate sleep. Every morning one of the first things I say to my son is “how did you sleep” and “I missed you while you were sleeping, but I’m so glad you slept well.” He knows that I am happy that he gets a good night’s sleep and that I am thinking about him while he is sleeping. We give each other a big hug at this reunion point, reinforcing that I am always there while he is sleeping and always come back when he is awake. Recently he woke from a nap when I wasn’t around and when I came home later, although he had been up for hours he remembered to tell me, “Mommy, I slept well” and gave me a big hug.

9. Be translatable. When developing a bedtime routine, it was important to me that we not become dependent on things that wouldn’t translate to other environments. For example, our routine needed to work at Grandma’s house and hotels as well as it works at home. This is harder if you are dependent on particular products or environmental factors. While not every location will have blackout curtains, we can usually find a dark room (or make it dark enough). I have met parents though who say their child can only sleep if they have this one blanket or that exact stuffed animal and I have seen bedtime fall apart when said item is lost or fails to make it into the suitcase. We cycle through blankets and stuffed animals in our crib, that way there are a number of options and no one in particular needs to be present.

10. Be flexible. No matter how much I abide to these practices, there are days when the whole thing goes awry. An illness, unexpected travel, or life in general can make it impossible to adhere to these plans 100% of the time. As a parent, you need to be able to adapt to the circumstances and your flexibility will teach your child the same.

I was able to write all of this while my infant napped, making me even more confident that I might know a thing or two about sleep. There is a part of me though that fears the minute I publish this, I will jinx the whole thing. So I hope it is worth it to you and I wish you a good night’s sleep!

For more information about children and sleep, from people with more credentials and experience than me, check out:

[Disclaimer: The above information is not medical advice. Please talk to your health care provider about your and your child’s health. A version of this was previously posted on Mommy Call on 2/10/14.]

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