Infant and Toddler Sleep Problems

Infant and toddler sleep problems are common. More than a quarter of infants will wake at least one time every night.

In the first 6 months, your baby will wake and you will need to attend to him. But from an early age (3-6 weeks of age), you can teach your baby that night is different from day. So when feeding at night, keep the lights low and don't talk and play with your baby (so attend to his needs but don't play or excite your baby). This is good training for later.

From 6 months of age, you can manage infant and toddler sleep problems using the techniques outlined below.

Remember this page is only for those parents who want to change their baby or toddler's sleep behavior. Many children sleep with their parents and wake frequently and the parents are ok with this, so there is no need to change.

This page is for those of you who want to change your older infant or toddler sleep habits.

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My baby cries when he wakes and needs to be picked up before he settles again

It is important for babies to learn to fall asleep by themselves. If you always rock your baby in your arms until he's asleep and then put him in his bed (cot, crib), it will be frightening for him to wake in the night by himself. He won't know how to fall asleep by himself and will need to wake you for your help.

Every now and again it's lovely to let your infant or toddler sleep in your arms but don't make it the usual habit. Even if you have to wait until your baby is nearly falling asleep, put him in his own bed (cot, crib) before he actually nods off. He will learn that it is normal to be awake in his bed (cot, crib) and then to fall asleep and he will get used to the darkness.

So as a rule put your baby to bed awake just as he is getting drowsy so he learns to fall asleep in his crib (cot) and when he wakes at night he will be able to self-settle.

A night light is also a good idea to try as complete darkness when your toddler wakes can be frightening. Consider putting a piece of your clothing in your child's room so there is a familiar smell when he wakes and they feel you are near them. Some mothers kiss their child's hand leaving a lipstick mark so if they wake, they can feel connected.

If that fails, try the Controlled Crying Technique or the "Camping Out" method.

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My child cries in the middle of the night

At the beginning of this, you will want to check your child is alright.

Once, you recognize the crying as just wanting company, use the Controlled Crying Technique which is very successful for infant and toddler sleep problems. Alternatively, use the "Camping Out" method. Both are successful - choose which suits you best and which you are more comfortable with. A version of "camping out" is helpful for infants who cry as soon as you put them in the crib (cot).

Consider putting a piece of your clothing in your child's room so there is a familiar smell when he wakes so he can feel you are near him. Some mothers kiss their child's hand leaving a lipstick mark so if he wakes, he can feel connected.

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My baby cries when he is put in his crib (cot)

If your baby cries when you put him down to bed, you can use a modification of the "Camping Out" method. Put your baby in the crib (cot) and then just sit nearby so your baby knows you are there but can't see your face (maybe you will sit side on looking away). Don't make eye contact or have any interaction with him, other than to encourage him to sleep, such as "it's time for sleep now" (and only say that if he needs comforting). You should resist getting him out of his crib (cot) - just being in the room is usually enough for this infant and toddler sleep problem.

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What is the Controlled Crying Technique?

  • wait 5 minutes before going to your child (10 minutes if you feel strong. 2 minutes if you're a real softie)
  • go to your child and pick him up and comfort him - make him feel secure
  • as soon as he settles down (crying to a sob is enough), put him back in his bed (cot, crib) and leave the room
  • your child will probably start crying again immediately - wait and extra 2 minutes (so 7 minutes if you're average, 12 minutes if your a bit tougher and 4 minutes if you're a softie) before going to your child
  • comfort him
  • as soon as he settles down, leave the room
  • if he cries again, wait an extra 2 minutes before going back into his room
  • comfort him and as soon as he settles down, you leave

You don't have to pick your baby up to settle him every time and as time goes on you should resist picking your baby up. Just a gentle pat on the back and your gentle soothing voice will be enough if you persevere.

You need to be prepared to follow this technique through if it is to work to get your infant or toddler sleep disturbance resolved. If you give up half way, your child will just learn that if he persists long enough, you will come into the room.

I have used this techniques very successfully with parents who were getting no more than 2 hours sleep a night with a 14 month old toddler - the key, though, is commitment to the technique from both parents.

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What is "Camping Out"?

"Camping Out" is a technique you can use for toddler sleep problems such as waking at night. Bascially, you sleep in your toddler's room on a camp-bed so that you can immediately comfort him if he wakes at night. You can comfort by touching or patting your child or just by a soothing voice.

Initially, the camp bed will be close to your baby's crib (cot) so you can reach out and gently pat him, but then you should slowly get further and further away every few nights. You shouldn't have to get out of your bed, just soothe your baby with your voice - saying "it's ok, go back to sleep".

If your baby cries when you put him down to bed, you can use a similar technique by just sitting in the room so he knows you are there. Don't make eye contact or have any interaction with him, other than to encourage him to sleep, such as "it's time for sleep now" (and only say that if he needs comforting). You should resist getting him out of his crib (cot) - just being in the room is enough. As this starts to work, spend shorter times in the room.

Another way is to spend a short time in the room and then tell your toddler "I'll be back shortly" and then leave and return after a couple of minutes. After a short time, say the same and leave but wait a bit longer before you come back. This is another way of teaching your toddler that you will always come back even if you leave.

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My toddler never stays in bed

You need to make sure you have a routine that your toddler understands. For example, a toddler sleep routine could be:

  • tea time
  • some time to play
  • bath time
  • quiet time
  • bed time (I like a bed time story) and then it's lights out

If your toddler doesn't have a bedtime routine, it will be hard to keep him in bed, so first make sure you have a routine.

Once you have a routine, if your toddler gets out of bed, put him back being firm. Tell him it's bedtime and make it clear that there is no alternative but bed. If he gets up again, it's straight back to bed again being firm. Don't make it a game - children love to play and so any game is great for them. Children can think it's a game even if you don't so you need to stay calm, focused and firm with a "no nonsense" energy about you. Once your toddler knows that there's no point getting out of bed because he'll be put straight back, he'll stop getting out of bed.

A gate across the bedroom door is a good way for keeping your toddler in his room. Rather than seeming to "lock" him in by opening and closing the gate, step over it yourself when you take him in and out of his room. Toddler sleep is not a punishment so you don't want to be "locking your toddler in".

Some families find success with a child alarm clock designed to teach them to sleep - so the clock has a night face and a day face, (some are animals and their eyes are closed at night and open in the morning). Your child learns that if the night face is showing, they need to stay in bed. When the day face comes on, it's ok to get up. Parents often turn off the audible alarm so it is just a visual cue for the child.

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My child wakes and wants to play

If your child wakes and is awake, then playing is alright as long as it doesn't interfere with the rest of the house. Toddler sleep doesn't always coincide with parent's sleep. Putting some toys in your toddler's bed (cot, crib) gives him something to keep him occupied. Do this only after 1 year of age as younger than that, soft toys may cause suffocation.

AAP (American Academy of Pediatrics) guidelines for pacifiers are that they should not be attached to clothing or be put around your child's neck. This is because of the risk of stranguation. However, some babies wake because they want their pacifier (or dummy as it is called in many parts of the world), and if this is the case with your baby, you might want to attach it to his clothing so he can find it in the night. However, if you do attach it, use only a short tape (from the collar to the mouth) - you don't want any long strings or tapes that could potentially strangle your child. Do not put the pacifier on a string that you put around your babies neck, either.

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Useful Resources for Toddler Sleep

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References

  • Green C. Toddler Taming. Doubleday. 2001. ISBN: 1 86471 053 5
  • TASK FORCE ON SUDDEN INFANT DEATH SYNDROME,SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment, Pediatrics, 2011 Nov

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Last reviewed 11 February 2013

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Dr Maud MD

Dr Maud MD (MBChB, FRACP, FRCPCH), a specialist pediatrician, provides health information and medical advice for parents of babies and toddlers. Read more about Dr Maud.



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