Your sleep questions answered

Here is my full interview with Diane Tenenbaum, a pediatrician St. Peter’s Hospital, a portion of which ran in last week’s Unwind section.

The most common times that parents worry about sleep and their children is during the infant and toddler years, says Diane Tenenbaum, a pediatrician St. Peter’s Hospital, who agreed to answer some of our blog readers’ questions. Before she did, though, she reminded readers that they should talk to their own pediatricians about specific issues as well. After all, they have a relationship with you and your children that helps frame their advice.
She also points to the latest recommendations about infants and sleep in regard to safety: No infant should be sleeping on his belly or side until at least 6 months of age and bumper pads should not be used in a crib or bassinet due to risk of strangulation and suffocation.
That said, Tenenbaum has a lot of good tips when it comes to getting those darlings to shut their eyes — without the help of a moving swing, a snack, and most certainly, not a bottle in the crib.
Q: From Meg: Have been trying for the past 6 months to get my son to not wake up twice in the middle of the night for a snack! I really want him to just sleep all the way through the night and he is almost 12 months old. He usually wakes up around 11:30 p.m. and between 4:30 and 5:30 a.m.
As a rule, by the time babies are 6 to 9 months, they do not require any nutrition during the night at all. The other thing is understanding the definition of sleeping through the night. The official definition from experts for children under the age of 1 — you may even extend that up to 15 to 18 months — is midnight to 5, so actually 11:30 to 4:30 is really only a small variation of that. So what a parent might be looking for with respect to what’s the most convenient for that parent and sleep may not be exactly what that child’s body is doing at that point. The big thing for most children in this age if they’re not trained as nighttime feeders who are used to having bottles is the conditions under which they fall asleep may be somewhat different than the conditions under which they’re waking up in the middle of the night. This is really the Ferber theory. The theory is all of us, from the time we’re infants all the way through adulthood, really need to be able to completely replicate those conditions ourselves. (If) you are somebody who’s used to being rocked to go to sleep, you’re going to wake up in the night when you’re in a lighter phase of sleep and realize you’re no longer being held and rocked. So a big part of the battle for many children in terms of night waking, the real issue is how are you falling asleep at night? If you can completely recreate those conditions yourself, then you’re much more able to sleep through the night without anyone coming in to do anything.
Q: From Jamie: I have a wonderful daughter who’s turning 6 months on Saturday. She almost always sleeps through the night (10ish to 7ish), but won’t nap in her crib. She ends up taking a few 15- to 30-minute naps throughout the day, but if I try and put her in her crib, she instantly wakes up and wants out. On occasion, she will sleep for about an hour in her car seat after returning home from story hour. How can I get her to nap in her crib, or should I not be worrying about this? Thanks!
I have two schools of thought: One is most 6-month-olds still are taking one, if not two, naps a day. If she’s somebody who’s otherwise getting a solid at least 10, most babies that age are actually sleeping 12 to 14 hours in 24 hours. If she gets that, for the most part, I wouldn’t worry too, too much. That being said, if this is a baby who is really cranky by the time she gets put down or you as a parent feel she would be so much happier and is happier when she has a nap, then it’s something to work on. Many children are very sensitive to light and noise, and it may be a function of that. One recommendation would be for the family to get the room as dark as possible.
Q: From Person of Interest: What is the right amount of sleep for a child? I have a 5-year-old and a 7-year-old. The 5-year-old sleeps very well. He usually gets 10 1/2 to 11 hours a night and he will adjust pretty easily to a new bedtime/wake up time. My 7-year-old gets up at 5 a.m., whether it is light out or dark out and regardless of when she goes to sleep. We have moved her bedtime up to 7:30 p.m. so she will get 9 1/2 hours, which seems to be her minimum to be pleasant. Ideally, we would like her to get 10 or 11 hours starting at 8 p.m., but we can’t get her to sleep past 5 a.m. Even with daylight savings time ‘helping’ us out, she was back to 5 a.m. three days later. Any thoughts? Thanks.
To me, it’s about having the right amount of sleep for the child [to be] pleasant. That’s a parent who knows her child. And if she’s around 10 to 12 hours for both of these kids, she’s doing well. I think her approach to moving bedtime to a little earlier is fine. She’s actually doing really, really well. There are lots of adults where what she’s described is still true. If the child is otherwise getting the recommended amount of sleep and seems to be doing OK, then I think she’s just got somebody who likes to wake up early in the morning and will likely be a very productive adult.
Q: From Mom to 1: I have an 18-month-old who has always napped in his swing and is unable to put himself to sleep. Once he falls asleep in his swing, we transition him to the bed and he will sleep through the night; however, nap time is a major issue. I am afraid that we created a monster and we are (rapidly) reaching the weight limit on the swing. Any advice would be GREATLY appreciated!
You can go back to what I said on that initial question: You have to be able to recreate the conditions yourself under which you fall asleep. I’m sure they are exceeding the weight limit and that’s not the safest proposition. That being said, it’s time to wean from the swing. I know how hard that can be, though. That’s going to be true for both nap time and for bedtime.
Q: From JJBHmom: My 2-year-old sleeps through the night, and takes a daily nap (2 to 3 hours). But I seem to have the opposite of most parent’s concerns — he sleeps soooo much. I find myself getting him up so he won’t sleep the day away. During the day, he loves to play “night night” and snuggle on the couch, on my bed, the dog bed — anywhere he can get comfy and lay down! He is otherwise a healthy and a normal little guy. I was concerned about anemia, but he is fine. I expected this when he was 15, not 2. Should I be concerned?
That’s worth a visit to your pediatrician. There are many things that can cause increased fatigue and sleepiness in small children, so that’s worth a visit to your pediatrician.

Categories: expert advice
Tracy Ormsbee

4 Responses

  1. CJ says:

    I mean no disrespect, but this pediatrician is really saying nothing. Saying “work on weaning from the swing” or that daytime naps are “something to work on” tells me nothing of value. What are some tips for doing these things?

    I have the same questions as some of these readers, but this offers me no solutions. How would you attempt to get a baby to nap in her crib? Other than to “work on” it, can you give me some strategies? Other than darkening the room, what are some ways to encourage napping?

    Also, if you do have a baby who has become a trained night feeder, what are good ways to wean that habit? I’ve practiced the Ferber method, and it does work for getting baby to sleep in her crib, but what are some suggestions for breaking the once or twice a night feedings? I would like to do a gradual wean, rather than cold turkey. If you have some concrete tips, I would love to hear them.

    Thank you!

  2. maggie says:

    CJ – we started feeding solid foods before bedtime (starting with multi grain cerial, then moving to real food, but not fruits). That helped our daughter sleep through the night. We have a very old-schol pediatrician, who basically said that as long as we were not feeding her clay from the river bank, we should model her eating on what worked best for all of us. So I tried the foods that filled me up and kept me full, and it worked for us.

    For naps, we plopped her in her crib, and now her toddler bed, with books and stuffed animals and told her she didn’t have to sleep, but she had to stay in bed. We also have a crib toy that plays music that has gone on for every nap and bedtime at home, and knocks her out like majic. For older children, when I was babysitting, I always told them to get in bed in the dark and try to stay awake. Nothing made then fall asleep faster. I think the biggest assistance is that our daughter knows that we expect her to sleep, and there is no hope for repeal of the sentence.

  3. Magpies says:

    Babies fed grains before bed definitely sleep better. We also played the radio set on country music stations as it’s very repetitive and gets the job done. As adults, though, your kids will sleep through music.

  4. Meg says:

    Yeah this didn’t really help me. He is put down in his crib sleepy but awake and he usually drops off by himself. I don’t rock him to sleep or interact with him as he falls asleep. He usually plays with his cuttlefish toy or his pillow until he drops off. But one good thing to know is that he technically is sleeping through the night by this Dr’s opinion. I have started having a bottle of water near his crib in case he is just thirsty, but sometimes milk or formula is the only thing that will do it. I will still work on the weaning portion of the nighttime feedings.