I think one of the most common questions I get at ALL well child visits is about sleep. How much does my child need? How do I get him to sleep better? How do I make changes?
Sleep needs vary by ages, but many children are not getting anywhere what they need. Common culprits include bedtimes that are too late and giving up naps too early. Most children should be going to bed between 6-8 p.m. and waking between 6-8 a.m. This is an average… so your family may be slightly different, but overall these are good guidelines. In addition, most kids up to 9 months have 2-3 naps per day. The morning nap tends to disappear naturally around 15-18 months… but unfortunately it often gets taken away much earlier, likely due to older siblings and activities, daycare, or a very stimulated child (a.k.a. “nap-fighter”). Children tend to give up naps altogether around 3-5 years of age, although I do still recommend a quiet time every day to help recharge their little brains and bodies.
This is a chart that shows typical sleep needs in a 24-hour period. Keep in mind these are averages and your child’s needs may vary slightly.
Let’s review a few key points that will work with children of most any age.
1. Sleep begets sleep.
The more well-rested your child is, the better he/she will sleep overall. Overtired children tend to put up more of a fight for naps/bedtime and their quality of sleep is less.
2. Earlier bedtimes often produce later waking times.
It seems counter-intuitive, but it’s true. Often times the answer to early waking is to put children to bed earlier by 30 minutes (or more!).
3. Stimulated children/bedrooms do not foster quality sleep.
This seems obvious, but television, video games, and bedrooms that are lit up do not help ready the body/brain for sleep. Screen time should be cut off at least 1 hour prior to bedtime. That hour should involve quiet activities such as reading, puzzles, coloring, etc. as well as the bedtime routine of bath, pajamas, snuggling, and whatever else you and your children enjoy.
Every parent wants her child to get a good night’s sleep. Ideally, we’d love for them to sleep through the night and for us to be well rested also. Some children do this on their own. Some don’t.
1. Sleep training does not simply mean “crying it out.”
There are many different methods to help teach your child to sleep better – some including hardly any crying at all. The most important things are that parents are ready and on the same page and that the child is healthy.
As a parent and pediatrician, I personally prefer the “cry it out” method. I think it’s faster (typically takes 3-4 days, or at the longest, 1 week), but it is also the hardest method (i.e. most emotionally difficult for a parent). Some parents do not want to do this and I completely understand why. There is also the “gradual extinction” method where parents check on their child every 5, 10, or 15 minutes and gradually lengthen the time between checks. This may be perfect for some families who are okay with some crying but have children who would respond better to a slower, more gradual process. For families who would prefer even less crying, there are several other options which can be found in my favorite book about sleep, Healthy Sleep Habits, Happy Child by Marc Weissbluth.
We are entrusted to teach our children to communicate, eat healthy, and play nicely…. Why should teaching them to sleep well be any different?
2. Co-sleeping can be a hard habit to break.
The American Academy of Pediatrics recommends that babies have their own space to sleep from day one. Sleeping in the same room is recommended. Sleeping in the same bed is not. Research has shown that the incidence of SIDS is increased for children who share a bed, but decreased for sharing a room.
I understand that there will be families who disagree with this advice—and in the end, you have to do what is best for your family. YOU are the parent.
Am I saying I never had my babies in my bed with me? No. I’ve been there, too… in that old familiar place of complete exhaustion… but is it the safest place for my son to sleep? No, it’s not.
Recently I had some parents in my office with their 1 ½-year-old who were wondering how to go about getting him into his crib at night after bed-sharing for his entire life. He screams when they attempt to put him there now.
My best advice for transitioning from co-sleeping to crib sleeping is what I like to call the “Super Nanny Method.”
You can go as fast or as slow at this as you want, and you can choose to be more or less affectionate depending on how you feel your child will respond.
3. Children over 6-9 months do not physically need to eat during the night.
They may want to, for the emotional and social connection they get with their parents, but at this age it’s only creating a poor sleep habit for later down the road. Remember, sleep begets sleep.
4. Please make sleep a priority.
If you can, try to make naps and nighttime sleep be in a similar place. I realize this is difficult with older children, but a bed produces higher quality sleep than a stroller. Good quality sleep is as important to a child’s growth and development as a healthy diet.
Lastly, know that breaking a few of the “rules” sometimes is okay. Your children are only little for so long. Enjoy them.
Meet Guest Blogger Dr. Tricia Cooperrider
Hello! My name is Tricia Cooperrider, and I’m a local pediatrician in Waukee with UnityPoint Clinic.
I grew up in southern Minnesota on a farm. I went to college in Minneapolis at the University of Minnesota. After graduation, I worked for one year doing Applied Behavioral Analysis therapy with children with autism. I then moved to Des Moines for medical school and pediatric residency at Blank Children’s Hospital. Following completion of my residency in 2011, I was able to find my dream job with the UnityPoint Clinic Pediatric location in Waukee. It’s been wonderful to grow my practice and develop relationships with my patients over these last few years. I look forward to watching these children grow up into amazing people.
I am not only a full-time pediatrician, but also a full-time mom and wife. I am constantly working to find the balance between work and home. I’m married to my husband of five years, Jeff, and we live in Waukee. I have a very energetic 3-year-old, Liam, and I gave birth to our second son, Noah, this past August.
I love my job taking care of children but struggle to be everything to everyone – home, work, family – it’s overwhelming! Despite the craziness, I’m in love with my life and my work. I hope to be able to offer you a little perspective from the world of pediatrics while keeping it real… because, let’s face it—textbook advice does not always line up with reality!