2008年9月4日星期四

Toddler Bedtimes

An article from iParenting Media
By Keath Castelloe Low

Sometimes one of the hardest things about parenting a toddler is getting them to bed. Just ask Kristen Kirk, mom of two from Chesapeake, Va.

"The biggest problem for me is that my husband and I never worked together on a bedtime routine," Kirk says. "We would often come up with a plan and then he would cave, or I would cave."

Kirk admits that they had a hard time being consistent. "My kids are now 8 and 7 and I have to lie in bed with them for at least a half hour, sometimes an hour (each!) until they go to sleep," she says.

Sherry Antonetti, a mom from Gaithersburg, Md., has two toddlers. She sums up the frustrations many parents of little ones face with a simple tongue-in-cheek question: "Wait ... toddlers sleep?"

The Importance of Sleep

Dr. Daniel S. Lewin, a licensed clinical psychologist and director of the Pediatric Behavioral Sleep Medicine program at Children's National Medical Center in Washington, D.C., notes that sleep is critical for both maintenance of physical health and for our children's brain development. On average, toddlers need approximately 12 to 14 hours of sleep, including naps and nighttime sleep, within a 24-hour period.

Sleep actually serves many purposes. Adequate sleep contributes to the control of attention, mood and behavior. When children are well rested, they are less irritable, are better able to listen and follow directions, and are overall easier to manage and parent. "Sleep also allows downtime for toddlers and their parents," Dr. Lewin says. As any parent of a toddler knows, this downtime is vital for our well-being, too. Parents also benefit from adequate sleep!

Ever heard of the old wives' tale that when we are tired, we eat more? Turns out this isn't a tale at all. Dr. Lewin explains that decreased sleep time has recently been linked to weight gain and obesity in both children and adults.

Establishing Good Routines

Schedules and routines are "absolutely critical" to your toddler getting a good night's sleep. Still, many parents have difficulty with maintaining routines. Consistency is key. Dr. Lewin provides some simple tricks to establishing a bedtime routine and sticking with it:

  • Schedule a consistent time for bed that is appropriate for your child's age. The optimal time for toddlers, based on their internal sleep clock, is in the evening between 6:30 and 7:30.
  • Prior to bedtime, establish a simple routine – quiet reading time, quiet focused play, bath time, then bed. For some children bath time can be relaxing, yet for others the warmth of the bath may be activating. If this is the case for your toddler, move bath time before dinner. Routines right before bed should be soothing and relaxing in order to prepare for sleep.
  • Allow your child to fall asleep independently. If he is used to being with a parent as he falls asleep, you can gradually decrease the amount of contact you have with him and then check back in with him every five minutes for the first few nights, then every 10 minutes, letting him know that as long as he is quiet and stays in bed then you will continue to check in. This will help your child feel a sense of security around bedtime. Again, here consistency is key, so Mom and Dad should agree to be consistent and stick with the program for at least five days.
  • Turn off all electronic media (television, computer, movie, etc.) at least an hour before bed.
  • Avoid caffeine.
  • Make sure your toddler's sleep environment is comfortable and cool, but not cold or hot.
  • Keep the bedroom quiet and relatively dim. A night light is fine, but a dim room is best.
  • Keep environmental cues in the bedroom consistent. In other words, whatever is in your child's sleep environment when he falls asleep is what is needed for him to transition back to sleep when he has one of multiple awakenings at night. So if a child falls asleep to music, this music will be needed for him to fall back to sleep. If you are in the room when your child falls asleep, he will need you again when he wakes up at night.
  • Multiple awakenings are normal during the night. It is best to have your child rely on his own self-soothing skills or a transition object like a soft, plush, safe toy or blanket to help him transition back to sleep during the middle of the night.
  • Nap routines can be somewhat looser. By 24 months of age, most toddlers give up their morning naps but still need an afternoon nap. 

    Other Factors

    If your child continues to have difficulty with sleep at night, it is important to first rule out any physical or medical issues that may be interfering with sleep. Next, parents may want to explore the timing of their child's sleep. Is bedtime too early so your child just isn't sleepy? Is it too late and your child has become too irritable, too overtired, and as a result is having a hard time calming down?

    Dr. Lewin says that parents can also use time during the day to rehearse what will happen at bedtime.

    Kirk Otto, a father of two from San Antonio, Texas, developed a fun way to review the bedtime routine with his own children. Together they run through the schedule for the night, which begins with going potty. Otto will ask "What's after that?" and his children will call out "pick out a book!" After each response Otto again asks, "And what's after that?" until they run through the whole routine – "go potty, pick out book, get into bed, read story, hugs and kisses, love you, night-night!" This rehearsal is a great way to help a child understand expectations and make bedtime more predictable and fun.

    Nighttime fears can often create problems for toddlers at bedtime. These fears are natural and normal, but it is important to distinguish between nighttime fears and nighttime anxiety. Nighttime fears should be acknowledged by a parent, but not reinforced. Dr. Lewin provides an example:

    If a child is scared that there is a monster in the closet, rather than walking to the closet to check and assure their child that there is no monster, the parent can sit by the bedside and talk calmly with their child. Asking questions like "Are there really monsters?" and "Is our house safe?" helps address the fears by giving the child back control. When parents check the closet they risk reinforcing the child's fears that there may indeed be a monster and that the child needs their parent to check. Instead, a parent can help alleviate their child's fears by focusing on more of the calming and control.

    Anxiety, on the other hand, is a more serious issue. If your child is having problems with fears and anxiety during the day, as well as at night, it is important to talk to your pediatrician or to have him evaluated by a mental health professional. There are also sleep disorders, such as sleep apnea, that can interfere with your toddler getting a good night's rest. If your child is having difficulty falling asleep at night and snores, contact your pediatrician.

    Waking up Happy

    Does your child wake up independently in the morning, happy and refreshed? Dr. Lewin tells parents that this is one sure sign that your child is getting the sleep he needs. Children should be able to wake up on their own in the morning. If you have to wake up your child each morning, he probably is not getting adequate sleep at night. Review your child's bedtime routines and see where you need to make changes.

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