WHEN A 2-YEAR OLD WON’T STAY IN BED

NEW YORK TIMES COLUMN:  FAMILIES TODAY:
WHEN A 2-YEAR OLD WON’T STAY IN BED
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. How can we keep our 2-and-a-half-year-old daughter in bed? Two weeks ago she climbed out of her crib and never looked back. However, I don’t feel that she is developmentally ready to stay in bed.

We are patting her back until she falls asleep, but this goes against all the parenting I’ve done with my other kids. I would like her to rest and sleep in her own bed, by herself.

A. We’d love to know what else happened two weeks ago. Has an important change or event affected the family – a move, illness or death, a pregnancy, a parent’s job loss? When children this age experience a new stress, the first sign may be a change in sleep patterns.

Parents sometimes assume that a child is “too young” to realize that something’s up, which is appealing when a change is hard to face and parents wish they could protect a child from knowing. At such moments, though, young children need parents’ help to understand what is happening, and how the family will manage. What young children can’t put into words they may translate into actions, like refusing to stay in bed.

Another potential cause may be allergies, asthma or even a cold. Check with your pediatrician.

If your child had been sleeping through the night, she’s mastered how to settle herself down at bedtime. But going to bed means she must temporarily separate from parents and surrender to being alone – unless she is sharing a room.

Separation can be tougher when a child’s world seems less predictable. She needs to believe you will still be there, and respond as always, in the morning.

Another sleep-disrupting event can occur within the child – a developmental threshold we call a touchpoint. At age 3 or 4, children become newly aware of their emotions and of the moral judgments that go with them. They realize they can feel angry or vengeful or jealous. Such emotions may frighten them or make them feel guilty. Often this awareness surfaces as fear about monsters and witches, and in nightmares of angry, vengeful, hurtful creatures.

Parents can help to ease this stress by talking gently about the full range of emotions (their own and their children’s) and by reading children’s books that deal with them – for example, “Where the Wild Things Are” by Maurice Sendak, or “There’s a Nightmare in My Closet” by Mercer Mayer.

When children know their parents can help them handle emotions so they won’t act in scary ways, the fears and nightmares will subside.
(See our book, “Touchpoints: 3 to 6: Your Child’s Emotional and Behavioral Development.” Da Capo, 2006)

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Before Dr. Brazelton’s passing in 2018, he was the founder and director of the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is now the director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

HOW MUCH SHOULD TODDLERS SLEEP – AND NAP?

NEW YORK TIMES COLUMN:  FAMILIES TODAY:
HOW MUCH SHOULD TODDLERS SLEEP — AND NAP?
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. How much sleep does an 18-month-old really need? My son sleeps 10 hours at night (waking several times) and takes a 1 hour nap during the day – well below what the books (and common sense!) say he needs. However, he seems rested and energetic and is developing normally. What do you think?

A. What the books say about the amount of sleep children need at different ages is usually limited to averages. Individual children, though, may fall at one end of the range or the other. (The average at this age would be about 12 hours at night plus 1 to 3 hours of napping.) We think that your observations that he is rested, energetic and developing normally are reassuring.

However, you also mention that he wakes up several times at night. Does he just briefly rouse, never becoming fully awake, and quickly settle down to sleep? Or does he become fully awake, and if so for how long, and what does it take for him to get back to sleep?

Has this only begun to occur recently? If so, and if it rapidly resolves itself, it may mean that he is responding to some minor stress, or even to the stress of development – the temporary backslide in one area of development just as a new developmental skill is coming together – a touchpoint.

But if this has been going on for some time, or persists, then we would suggest that you bring this to the attention of your child’s pediatrician. There are a wide range of readily treatable causes of sleep disturbances that you wouldn’t want to miss. If the waking at night is a regular bother for you or for him, then it is a sleep problem worth addressing. (See our book “Sleep: The Brazelton Way,” DaCapo Press, 2003, for more information.)

Q. I have a 3-year-old son who is becoming terribly resistant to taking naps until late in the afternoon, which of course impacts on his behavior (and we have a 5-month-old baby boy in the family now as well, which is a part of this as well).

If he does eventually put himself down for a nap in the late afternoon, bedtime is a nightmare as well. How hard should we try to get him to take a nap? I really do not think he is ready to completely drop his nap, based on his mood on days he doesn’t get one. I just don’t know how much of an issue I should make it. Any advice would be much appreciated.

A. It does sound as if he may be beginning the transition away from the afternoon nap – not a struggle you want to fight, nor one you’re going to win. We’d bet that he wants to be up and around as much as possible so as not to miss out on all the fun his baby brother is having.

Why not put him down for a “rest” early enough to prevent the bedtime “nightmares?” If he sleeps, fine; but if he doesn’t, don’t bother with a nap too late to help. Instead, when he doesn’t nap in the afternoon, try moving up his bedtime a little earlier. Some children who aren’t getting enough sleep actually start sleeping less and less, or sleep less restfully. If he really isn’t ready to give up his afternoon nap, he may show you this by sleeping more at night – if given the opportunity. (Three-year-olds average about 11 hours of sleep each night and an hour’s nap each day, but the range varies from one child to another).

If you can break away from the 5-month-old briefly in the early afternoon, this could be your special time to cuddle and relax together with your older child. Maybe this will help with his moods. As you say, sharing you with his new brother is bound to affect his moods and his sleep.

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Before Dr. Brazelton’s passing in 2018, he was the founder and director of the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is now the director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.