Solving Sleep Problems: Key Principles for Helping Your Child Become a Good Sleeper

Nine-month-old Lilah, previously a great sleeper, has started to protest when her mom puts her down to sleep.  She wakes up multiple times at night. She won’t fall back to sleep unless she gets a bottle that she scarfs down. 

Three-year-old Amir insists on an endless litany of demands at bedtime—2, then 3, then 4 more books, placing his cars in a specific order on his shelf, getting his blankets on “just right”. Even when his parents acquiesce, it’s never enough. He still flips out when they say they are leaving and it’s time for him to go to sleep. When they finally put a monkey lock on Amir’s door to keep him from leaving his room after lights-out, he gets them in the jugular by shouting things like: “It’s illegal to ignore your child!” 

Sleep challenges come in all shapes and sizes. And, like most childrearing challenges, a one-size-fits-all approach to help children become good sleepers does not exist. Every child and family is different. The underlying cause of the trouble can vary significantly from one scenario to another. One child struggles with separation anxiety; another tests limits; another doesn’t know how to fall asleep on his own. That’s why general prescriptions don’t work. In fact, they can lead to more frustration for parents when the suggested plan does not feel comfortable for them or doesn’t work for their child. Instead, what I have found most useful is to provide parents with a set of guiding principles to develop their own path to help their child (and themselves!) get a good night’s sleep. These are not solutions to specific sleep challenges, but rather overarching strategies and mindset shifts that empower you to come up with an approach that meets your child’s and family’s needs.  

Guiding Principles

Sleep is just another limit in a long list of limits you will have to set to help your child thrive. By now, most of you have probably read the myriad articles in popular media about the critical importance of sleep for all areas of healthy functioning. It is helpful to keep this in mind, because, if your child is like most I know, she will not go down without a fight. This is especially true if a pattern has been set in which your child has been dictating the plan when it comes to sleep (6 books, 10 kisses, mommy sleeping in the room, etc.). In order to set and enforce the clear limits kids need to learn to sleep independently, you will need to keep reminding yourself that limits are loving, even in the face of your child’s protests (I don’t feel safe! I’ll never go to sleep if you don’t lay with me!) and even some vomit. (More on that later.) For most parents, this requires changing the voice in your head that tells you that it is harmful for your child to be unhappy or distressed at times and that you must be doing something wrong and hurtful if they are upset. It is, in fact, a gift to help your child learn this important skill. One of the hardest and most confusing aspects of parenting is that what feels “right” and loving is sometimes not what your child actually needs to thrive.

Learning to sleep independently is a skill. And, like for most of us, learning any new skill entails some period of discomfort before we master it. None of us would have learned to ride a two-wheeler if our parents had never let go and allowed us to experience the wobbling (and occasional fall) that leads to learning to balance on our own. The same is true when it comes to sleep. Most children experience some stress when learning this skill. But the only way to master it is by working through it—experiencing that even though they feel they can’t survive without a parent next to them helping them go to sleep, they can actually soothe themselves and are okay on their own. This is what we consider “positive” stress—discomfort that is not detrimental but that leads to growth. 

It was, of course, painful for Amir’s parents to hear his screams and protests when they erected the boundary to help him stay in his room at bedtime. But three days later, when they woke up and saw that everyone in the house had gotten a good night’s sleep, and that Amir was as happy as could be (and not holding the grudge they feared), they realized that it wasn’t just Amir who needed to live through a challenge to see he could master it.
It’s all about associations. In order to make sense of this big, complex world, children are constantly trying to put two and two together. It starts in the earliest months of life when babies stop crying when they hear their parent’s voice coming closer. They have learned that this sound means care is coming and they calm down. By nine months, they reach their arms up in the air because they have learned that this results in a trusted caregiver picking them up. When it comes to sleep, if children associate falling asleep with being fed, held in someone’s arms, rocked, or with someone laying right beside them, they come to depend on these experiences to doze off. So, in the middle of the night, when they wake up due to natural sleep cycle fluctuations, they need the parental support they are used to in order to fall back to sleep. Changing these associations means going through a period of discomfort until the child experiences that he can survive not being rocked or fed, and that he can fall asleep on his own. That is why the key to an effective strategy is often having the parent to whom the child has a less strong association around sleep carry out the plan. If mom is nursing, it is less stressful to have dad be the last one the baby sees before being put in the crib and the person who appears in the middle of the night. The baby doesn’t associate dad with being soothed at the breast—she doesn’t smell the milk on him—and thus, tends to protest less. It is also a good idea to provide some space between feeding and putting your baby down in order to disconnect going to sleep from being fed. This is exactly the plan we put in place for baby Lilah that had her sleeping through the night again within four days.
Less is more. When devising a sleep strategy, keep in mind that the more you emotionally and physically engage with your child after lights-out, the harder it will be for her to settle herself. Interaction = stimulation, which makes it harder for children to get back to a calm place. (Think about what it’s like for you. If, in the middle of the night, you roll over to adjust the blankets and your partner starts talking to you, you are now more fully awake and it’s harder to fall back to sleep.) Further, engagement in the middle of the night is confusing to children. Kids do best when expectations are clear: daytime is for interaction, play, cuddling, etc. Nighttime is for sleep—the time when bodies and minds need to be quieted and calm in order to grow big and strong. So, it is preferable to peek into a room to whisper a loving mantra to a child from the doorway (“Goodnight, sleep tight, everything is alright, I love you”) and then leave, instead of making physical contact by holding or rocking a child. It will feel awful when he starts crying out for you to come back—how could it not? That’s when you have to keep reminding yourself that while he wants connection with you, engagement at this time is not helping him adapt to the fact that nighttime is for sleep, not interaction. This is another example of how what feels right and loving is actually counter to what your child needs.

Be sure that the plan you come up with is one you can actually implement. Some parents decide that going cold turkey is the best approach. They say goodnight. They put up a gate, if necessary, to provide a boundary so the child is unable to keep coming out of the room. And they don’t come back until morning no matter how hard their child protests. Others know there is no way they would be comfortable with this plan and instead decide to take a more incremental approach; for example, sitting by the child’s bed and then each night moving the chair further back until the parent is out of the room. (Be mindful that while this latter approach might feel more loving, it can actually be more stressful for both the child and parent. Having mom or dad in the room presents a major stimulus for a child at a time when he is supposed to be calming himself to sleep. In this situation, most children will keep bidding for their parent’s attention which is very hard for most moms and dads to resist. So, you can see how this plan could backfire.) 

There is not a right or wrong plan. What’s most important is that you can enforce the limits you are setting. For example, telling a child to stay in his room is useless because you can’t actually make him do that. If he can leave the room at will, he is in control. That is where a gate or monkey lock can be very useful. While it may feel uncomfortable to erect this boundary, it is much more loving than engaging in the ugly tug of war that tends to take place when children repeatedly come out of their rooms after bedtime.
It’s all in the way you execute it. There’s a big difference between taking a harsh and threatening approach than a loving and empathic one. Threatening, “If you don’t stay in your room, we will put up a gate to make you stay in there!” engages the child’s negativity and defiance. This is the perfect set-up for a protracted power struggle. But if you explain calmly and matter-of-factly: “The rule at bedtime is you stay in your room so you can calm your mind and body to sleep. If you choose to come out, we will escort you back and put up our friend ‘Mr. Gate’ who helps you stay in your room.” It is important and helpful to acknowledge your child’s experience of this change; that you fully understand that she may not like the new rule, and that’s okay, you don’t expect her to. But you will still be setting this limit because it’s your job as a parent to keep her healthy and safe. The key is to avoid trying to talk your child into accepting the limit as that puts her in the driver’s seat. She knows you are dreading the tantrum and will do anything to head it off. When you let your child know that it’s okay if she doesn’t like the rule and that you are not afraid of her melting down, it diffuses the power of the protest. (For more on setting clear and enforceable limit, check out this blog.)
Let your child know exactly what the plan will be. Children thrive when they know what to expect. Devise a plan that you feel is loving and appropriate, and that you can follow through on no matter how much push-back you get. Then, clearly lay it out for your child. If/when he protests any part of the plan, you reiterate that you fully understand his perspective—that he doesn’t like a three-book limit or that daddy isn’t going to fall asleep next to him. And that’s okay. He doesn’t need to like it but you will still be following through on it. Expect that it will get worse before it gets better. Many kids up the ante to see if their parents are really going to stick to the limits. But once they see that you are not changing your mind, the adaptation and coping begins. 

This was the basis of the plan we put in place for Amir. His parents laid out what the bedtime routine would be. They baked in a set amount of time for him to arrange his room the way he likes it. They let him know what would happen if he came out of his room and role-played it with him—a great strategy whenever putting in place a new limit. It helps kids experience what the new plan will feel like; and, it’s fun, which takes some of the tension out of what are usually stressful encounters. The role-playing also had benefits for Amir's parents who felt better-equipped to actually implement the plan in the heat of the moment.

Whatever plan you come up with, what’s most important is that you are loving, clear and consistent. When your child is losing it he needs you to be his rock and stay loving and present even in the face of his protests and vitriol. When the rules keep changing it causes confusion: children don’t know what to expect, or where the boundaries are. They keep testing to see where the porous, “gray” area is that they can exploit. Remember, children are strategic, not manipulative–they’re trying to get you back in their room, not to drive you crazy. So, take the time you need to develop a plan that you feel you can implement. Play out all the possible scenarios in your head and be sure you feel ready to maintain the limit no matter how hard your child protests. Otherwise, you are more likely to cave and the cycle continues.

Common Challenges
The following are typical scenarios parents face around sleep and ways to address them:

  • Your baby is able to sleep through the night but then starts waking up and is only soothed by a bottle. He gulps the whole thing down, making it seem like he needs it. Just because a child drinks many ounces in the middle of the night doesn’t mean he physically needs it. Food is comforting. I would strongly suggest refraining from feeding after bedtime if your child can go through the night as this can quickly turn into a physical craving if his system gets used to ingesting calories during the night. It becomes a habit that is hard to break. The general rule for when babies are physically able to take in enough nourishment during the day to go eight hours at night without eating is when they are four months and 14 pounds. Consult your child’s health care provider for guidance on what to expect for your baby.

  • Your child throws up from crying. I know this is going to sound heartless, but I find the best way to eliminate this behavior is to give it as little attention as possible. Quietly and gently change your child and put her back in bed with minimal engagement. This prevents her from associating vomiting with interaction. If you make a big deal about it and then bring her into your bed or lay down with her, she puts two and two together and, voila, the vomiting is reinforced as a successful strategy for engaging you. This goes in the category of things that feel mean but are actually loving.

  • Your child throws his lovey out of the crib. Again, as heartless as this may feel, if your child knows this tactic will result in your returning to her after lights-out, it confirms this as a successful strategy and is thus, reinforced. Let your child know that she has two great choices: if she keeps her lovey in bed with her, she gets to have lovey all night with her. If she chooses to throw lovey out, she will have lovey in the morning. Remember, children learn to make good choices by experiencing the logical consequences of their actions. 

  • Your child has an endless list of tasks he has to do before he can go to sleep.  Your child wants to arrange the toys on the shelf just-so, closing the closet door exactly the right amount, etc. Just when you think he is satisfied, he conjures up one more task. In this case, I suggest baking into the bedtime routine a few minutes during which he can organize things the way he likes them. When time is up, it’s lights-out and you leave. If he is really desperate to make more changes, he is free to do that on his own. You really can’t stop him unless he’s still in a crib. The key is that it no longer serves as a delay tactic. Miraculously, the desperation to do more organizing evaporates when it no longer results in parental attention.

  • Waking up in the middle of the night. I suggest going through the same steps you used at bedtime. Repetition enhances learning and builds new associations. When your child awakens and calls for you in the middle of the night, pop your head in one time, say the mantra, and leave. If you do this consistently, your child comes to associate the mantra with your love and serves as a reminder that all is well. I discourage going back in repeatedly because we find children get very focused on waiting for their parents' return instead of calming themselves back to sleep.

When it comes to these kinds of tricky scenarios, I find it helpful to take a step back and unpack what’s going on in these encounters and what your child actually needs from you versus what he wants from you.

What about nightmares? Check out this blog for dealing with that dynamic.

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