Avoid Bedtime Battles: Sleep Tips for Babies and Toddlers

Mar 7, 2019

“Does my baby have their nights and days mixed up?”

It’s a question Katrina Willie-Musoma, M.D., a pediatrician at USMD Mansfield Clinic, hears often from sleep-deprived parents.

While newborns sleep on-and-off about 20 to 22 hours a day—waking briefly for feeding, burping and diaper changes—that doesn’t last long.

“The body produces a hormone, melatonin, that naturally starts to rise in an infant’s body at three to four months of age,” Dr. Willie-Musoma explains. “When that happens, babies start to consolidate their sleep, and the biggest stretch will usually be in the evening.”

Still, it’s pretty rare for babies to sleep all night long.

“You may have friends or other people tell you their baby slept 10 hours straight at that age, but that isn’t common,” she says. “It’s important for parents to remember that the definition of sleeping through the night for a four-month-old baby is around six hours. That six-hour stretch may be from 8:00 p.m. to 2:00 a.m., which can be difficult for parents. At the four-month checkup, if parents tell me their baby is sleeping between five to seven hours at one stretch, that’s great—the baby is doing exactly what they are supposed to be doing.”

How can sleep-deprived moms and dads cope?
“First, accept that it’s going to be tough for the first six months,” says Dr. Willie-Musoma. “Make a plan before your baby arrives. Facilitate a schedule that works for your family.”

Take turns. Plan who will take which shifts.

If you can, ask family members to help out for the first few months.

Sleep when the baby sleeps.

What should parents know about sleep safety?
The American Academy of Pediatrics recommends that babies “room share” for a minimum of six months and for the first year, if possible. That means babies should sleep in the same room as their parents, but not in the same bed.

“Babies should not be in bed with their parents because it increases the risk of Sudden Infant Death Syndrome (SIDS),” Dr. Willie-Musoma says. “Instead, babies should be placed on their backs in a bassinet or crib without a pillow, blanket or bumpers—anything that could pose a suffocation risk. I also recommend babies sleep with a pacifier. There have been studies that show pacifiers in the first months of life offer protection against SIDS.”

When should a bedtime routine be established?
“At some point, letting your baby fall asleep in your arms without waking will not work. Six months of age is a good time for parents to begin a bedtime routine,” says Dr. Willie-Musoma.

Offer a calm environment around bedtime—bath time, reading a book, soft music are all good ways to set the mood. Allow your baby to get sleepy and drowsy, but don’t allow them to fall asleep in your arms, if possible.

“Before they fall asleep, they actually need to be placed in their crib or bassinet so they can learn to self-soothe and figure out how to settle down and fall asleep on their own,” Dr. Willie-Musoma adds.

“Self-soothing should not include a bed-time bottle. Babies shouldn’t be given a bottle at bed, but they can have a pacifier.”

By the age of one, babies should also be sleeping in a different room than their parents. A video or audio monitor should be used so parents can easily keep tabs on their sleeping baby.

The big question: Is “crying it out” okay?
This is one of those gut-wrenching issues parents often struggle with. “A lot of parents ask me is it okay for their baby to cry themselves to sleep,” says Dr. Willie-Musoma. “There is so much information out there about sleep-training methods—including “crying it out” or the CIO method—but there isn’t one method that works for every child. You just have to try them to see what works best for your child and your family.”

If you do decide to try the CIO method, there are a few of things parents should keep in mind:

Crying it out should never be used on a child younger than six-months old.

Only begin sleep training when your child is well. Make sure your baby isn’t teething or not feeling well due to another reason.

Before you begin sleep training, make sure everyone is on the same page. If someone rescues a child who is upset and crying, the CIO method is not going to work.

“Even if you’re doing sleep training, it’s okay to respond to your baby if they’re crying for reasons other than not wanting to go to bed,” Dr. Willie-Musoma adds. “They may cry or get upset if their diaper is wet or if they have a fever or a cold and really need you. But if your child is only crying about falling asleep, give them time to see if they can figure out how to fall asleep on their own before running to them.

Be ready for toddlers to test your boundaries.
Perseverance and patience will serve parents well during the toddler years. “This is the time when children begin to assert their independence and challenge limits,” Dr. Willie-Musoma adds.

As children transition to a toddler bed somewhere between 18 months and two-and-a-half years of age, they often get up after they’ve been put to bed or come into their parent’s room in the middle of the night. “Again, it’s important that parents are on the same page about taking them back to bed,” advises Dr. Willie-Musoma. “I recommend not making much eye contact when taking your child back to their bed. Say goodnight and then leave. Sometimes you’ll feel like a winner as a parent, sometimes you won’t, but helping your child understand how to fall asleep on their own and stay in their own bed is worth it—and needs to happen.”

Have more parenting questions about your child? Dr. Willie-Musoma is here to help. To schedule an appointment with her, call 817.557.5437.