Thursday, May 28, 2015

Bedtime Routine

Before the child reaches his second birthday, and he begins to resist bedtime, the Prudent Parent begins to develop a bedtime routine to ease the transition from waking to sleeping.

Infants

Babies need to be taught to sleep more of the time at night than during the day, so you must help them to differentiate between nighttime sleep and daytime sleep. You can do this with the bedtime routine.

The goal is to signal to the baby that it is time to wind down from the day’s activities and go to sleep. Certain things may be helpful in this regard. Turning the lights down low and playing soft music can begin to signal the bedtime period. In addition, giving the child a warm bath may be helpful, as a bath is relaxing for most babies. Next, a clean diaper and night clothes. After that, nursing or a bottle. Then story time.

Your child will begin to derive benefit from including the reading of stories in his bedtime routine by about 3 months of age. By that time, he will be able to sit propped up in your lap, and you can read to him more-or-less comfortably. This is also about the time that most babies are able to sleep through the night (but this is not assured, as some babies don’t sleep through the night until 6 months of age or later).

Once story time is over, you can kiss your baby, lay him in his crib (on his back), say a breezy “good night, sleep tight” and leave the room. It is important to put him to bed while he is drowsy but still awake. This will enable him to learn to comfort himself and to fall asleep independently. This becomes important if he wakes in the night. Rather than cry for you, he will learn to self-soothe and fall back to sleep. This takes time and patience, however. In the meantime, the Prudent Parent acts as if she intends for him to sleep through the night even if she thinks that he won’t.

As you teach your baby to soothe himself to sleep, he is likely to cry a bit before falling asleep. Don’t give in to the feeling that it would be better to let him drift off to sleep in your arms. This is a habit that is very hard to break and doesn’t teach him to soothe himself, leaving him no resources on which to rely when he awakens in the night.

The first time he cries, go back into the room, leaving the lights off, and talk quietly to him while touching his head or his feet. Do not pick him up, however. After a few minutes, say “good night, sleep tight” again, and leave the room. Extend the time before you go back into the room to tend to him if he continues to cry. You may want to use a timer and set it for one minute longer each time, since holding yourself back may be painful. The first couple of nights will be difficult for both the baby and you, but after a few nights, you’ll both get the hang of it and you'll both be able to tolerate a little crying.

One thing that I will advise here is that you don’t fall into the trap of “co-sleeping” with your child. It sets a precedent that will disrupt everyone’s sleep for years to come. Consider making it a family rule that "everyone sleeps in his own bed," and start enforcing that rule when the child is very young (“I know that you want to sleep with mommy and daddy, but everyone in this family sleeps in his own bed.”). While there’s nothing wrong with bringing a nursing infant into your bed while you feed him, make sure he goes back in his crib after he’s finished eating.

Toddlers

Toddlers may resist going to sleep at night. This can occur for several reasons. The child’s need to be independent may make him reluctant to do what you want him to do because it’s not necessarily his idea. In addition, at this age, he may still suffer from a certain amount of separation anxiety. Furthermore, he may be distracted by normal household noises, light, and movement by others, although this is less likely to be a problem if the house was not kept unusually quiet when he was an infant (which is a good idea). Other problems may include fear of the dark or an inability to “sleep on demand.” The toddler may need a night light and some quiet time in bed before he can wind down enough to sleep. Parents may add to the sleep problem by insistence that the toddler remain in his crib long after he is ready for a bed. Most of these issues may be addressed by the proper use of the bedtime routine.

If your toddler wakes in the night, wait a few minutes before going into his room. When you do go in, comfort him with gentle words (“Everything is fine. It’s time to go to sleep now. I’ll see you in the morning.”), but don’t get him out of his crib. Remind him that it is time for sleeping now, and then say “good night” and leave the room. Your minimal response to his wakefulness demonstrates to him that you have confidence in his ability to go to sleep on his own. If he climbs out of his crib, he is signaling that it is time to move him into a “big-boy” bed or to put the crib mattress on the floor. In order to keep him in his room at night, you may need to install a baby gate in the doorway.

Preschoolers

Recognize that the bedtime routine may take up to 30 minutes for preschoolers and start the routine early enough to avoid rushing the child. Also recognize that sleep problems in preschoolers can often be traced to the response of parents to the child’s crying in infancy. Allowing the infant to cry a bit before going to him enables him to use his own resources to settle down to sleep. This heads off many future sleep problems.

Preschoolers may have nightmares or night terrors, and it might help them to have a night light and/or quiet music that shuts off after playing for 30 minutes or so. In addition, if the child wakes up in the night and needs to be comforted, it is best if you go to him rather than letting him come to you. Having a rule that “once in bed you stay in bed” helps preserve the parents’ privacy and encourages the child’s independence.

When dealing with bad dreams or night terrors, reassure the child that while his fear is real, the dream is not. In order to reduce the incidence of nightmares, eliminate anything that might trigger bad dreams such as violent or frightening television programs or scary stories.

What should you do if your child gets out of bed at night? First, lead the child calmly back to bed (without talking to him) and let him tuck himself in (you only do that once when you put him to bed initially). Once he’s back in bed, you remind him that it is time for sleeping, he needs his sleep, and if he can’t sleep, he should rest quietly in bed. You may have to repeat this procedure many times in the first few nights, but the child will eventually stay in bed.

Bedtime routines may be needed for a long time to help your child relax after the day’s activities. Parents can help by limiting highly-stimulating activities (including screen time) during the hour preceding bedtime. Some children will need to have quiet time in bed before they will be able to go to sleep, and parents should allow for this, not forcing the child to sleep before he is ready.

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