Q. My 22-month-old daughter has started to become unsettled at night. She has never been a good sleeper but we thought we were getting out of the woods until a few months ago when she developed a chest infection. As expected, she would wake a lot during those nights and the only thing that would comfort her was to give her a bottle and take her into our bed. Now she is fully recovered but she continues to wake several times a night and demands a bottle. Because she is in a little bed, she can get out and come into our room. If we try to divert her or don’t give her a bottle, she starts screaming so it is easier just to give in as I can’t have her waking the other children. Her bedtime routine is okay and she still has a nap during the day though on both occasions she asks for a bottle to get her to sleep. What can I do to break this habit? I work full-time and am completely worn out. Her child minder has noticed that she is taking longer naps during the day so this is another sign of her being unsettled.
A. I think your question will resonate with many parents who have found their sleep disrupted this winter. Illness, teething, developmental changes can all re-disrupt an established sleeping routine for toddlers and young children. This is especially the case for children who might have had a history of poor sleeping at night and just as you think you are making progress you can experience a setback in the form of a cold, chest infection or a cough. A sick child needs their parents to comfort them and this invariably leads to a series of disrupted nights during the height of the illness.
Unfortunately, as you have discovered, the extra comfort you provided during the illness can create a new habit and your child can continue to seek you in the night even after they have recovered from the illness. In a normal night’s sleep cycle, even when children are not ill, they still tend to wake up briefly or go through periods of light sleep. If you are lucky they can self-soothe and get themselves back to sleep. However, it seems that your daughter now uses the bottle to soothe herself and get herself back to sleep and given that this depends on you getting up to get it, your own sleep is disrupted as well.
Re-starting sleep training
Re-establishing a better night routine usually involves going back to basics and restarting sleep training with your daughter. How did you get her into a good sleep routine previously? What worked before and how can you start again? The key is to reintroduce sleep associations and self-soothing strategies such as cuddling a soft toy, using a soother or rolling into a comfortable position, that your daughter can learn to do herself and can replace the use of the bottle and coming into your bed. You may allow her to have a drink of water from a “non-spill” beaker that she can access herself at the top of the bed.
Change the habit during the day, not at night
It is difficult to break a bottle-feeding habit during the night when you and your daughter are tired and when a tantrum is liable to wake the household. Generally, the better place to start is when you put her to bed at night and during her daytime nap routine. During these times, remove drinking a bottle as an option for her and instead start a new relaxing sleep routine that exposes her to different sleep associations. If she gets upset or distressed without the bottle, gently soothe her, encourage her back into her bed and redirect her to other comforts, repeating the same key phrases in a gentle tone such as “sleepy time now . . . into your comfy bed”. It can take a bit of patience to help her get back into her old routine, but gentle persistence usually pays off.
Ensure she is well fed during the day
When some young children are sick they go off their food and they rely more on the bottle at night for nutrition as well as comfort. If this is the case, make sure she is well fed at other times during the day. Offer her the bottle when she is up in the morning or at other times during the day. Some parents give their children a last bottle on the sofa while reading a story so its association with the bedroom and falling asleep is removed.
During daytime naps, try to replicate the same routine as much as possible when she is put down to sleep – ideally using the same language and the same associations. In busy households this may not be possible, but at least agree with the child minder that your daughter will not get a bottle at sleep time and that you will aim for early time-limited naps in the morning rather than in the afternoon in order to reduce the disruption to night time.
She may continue to wake at night for a period and it is important to think through a plan as to how you will respond to this. You could opt to bring her back to her room when she wakes up and go through similar bedtime routine steps as you tuck her back in (rolling her into a comfortable position, giving her a teddy or allowing her a short drink of water), using the same gentle tone and language.
Alternatively, you could opt to make a temporary exception in the middle of the night allowing her to come into your room (if this is the least disruptive to everyone) while continuing to work on establishing a relaxed bedtime routine. Once the bedtime and daytime nap routines are established, night time waking generally fades of its own accord.
Dr. John Sharry, Irish Times Newspaper. John writes in the Irish Times Newspaper every Tuesday.