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Sleep tight -- and right!

By Dr. Wade F. Horn

Q: My wife and I spend several hours each night trying to get our 23-month-old daughter and 5-month-old son to sleep. I say we should just put them in their room and let them cry for 10 minutes or so until they fall asleep. My wife wants to make sure that they never cry and will spend upwards of two hours a night messing around with them.

When I tell her that this is ridiculous, I am a big meanie! She went out of town a couple of weeks ago and my system (putting them to bed and letting them cry themselves to sleep) worked like a charm. When I tell her that she is just reinforcing the crying behavior by going in and trying to convince our daughter to go to sleep (as if a child that age responds to anything approaching logic!), all I get is an icy glare and the big guilt trip about how insensitive I am.

This is starting to affect our marriage. We rarely get to spend any "down" time together. I also resent being told I am so mean. Do you have any suggestions?

A: Next to money matters, the thing couples fight over most is parenting. One of the first big battles is often over the best way to help infants and toddlers fall asleep on their own.

How best to do this will depend upon the child's age. How one helps a 5-month-old go to sleep on their own is different from how one encourages a 23-month-old to do so.

Let's start with the 5-month old.

If you're very, very lucky, infants will begin to fall asleep on their own without any help from mom and dad. But most infants require a little help.

Generally, parents can begin teaching babies to sleep through the night at about five or six months of age. Keep in mind that you will need to proceed gradually. The essential point is to help your baby differentiate between daytime and nighttime.

This will take some time. So don't expect that it will happen "overnight" (Get it? Overnight? Hey, you gotta keep a sense a humor about these things!).

A good first step is to keep the lights dim and the atmosphere calm during evening feedings. This helps the baby understand that evening equates with darkness and reduced activity level. Then begin to slowly cut afternoon naps short as you establish an evening bedtime routine. By doing the same things every night, in roughly the same order, the bedtime routine will begin to signal to your baby that it is now time to go to sleep.

After -- and only after -- you have done all of the above, you can start to allow your baby to cry a bit at night before going in to comfort him.

One method for doing this is described in Richard Ferber's book " Solve Your Child's Sleeping Problems. It involves putting babies in their crib while they are still awake, comforting them for a few minutes, and then leaving the room. If your baby cries, you should wait for approximately five minutes and then go in to make sure your baby is not ill, hurt, or in need of a diaper change. If not, spend two or three minutes soothing your baby, but do not to pick your baby up.

After this relatively quick comforting session, leave the room before the baby goes to sleep (you want to teach your baby to fall asleep by himself, without you around). If your baby continues to cry, wait a little longer this time (maybe 10 minutes) before going back in.

Again, check quickly to make sure everything is alright, and spend a few minutes soothing and reassuring your baby -- but do not pick him up.

The next time wait 15 minutes before going back into your baby's bedroom.

Continue checking every 15 minutes until your baby falls asleep. Using this procedure for four or five nights in a row usually does the trick. The key to success in consistency. Using this technique intermittently (sometimes picking up your baby, sometimes not; or using it on Monday night, but not on Tuesday) is likely to make this process more difficult.

It is important to emphasize that the "Ferber method" is not the same thing as letting kids cry themselves to sleep. It is important that you intermittently go into your baby's room to reassure both you and your baby that everything is alright. Also, this method is not meant for every baby. Some babies are simply too fearful, particularly those who are experiencing an especially intense period of separation anxiety, for this method to be successful.

Now, as for your toddler, believe it or not, you can reason with a 23-month-old. Well, reasoning may be a little too strong a word. What you can do is explain what you are about to do. Here's what I suggest.

Tell your daughter that she is now a "big girl," and one thing that big girls do is have a bedtime and fall asleep on their own. As with infants, it is important to then establish a bedtime routine.

Start by letting your daughter know that the bedtime routine is approaching by giving her a 10 minute warning. When the 10 minutes are up, go on to give her a warm bath, followed by a bedtime story. Then give your daughter a goodnight kiss and leave the room.

It is important that you leave the room before your child falls asleep. If you lie in bed with her until she falls asleep, she will still be relying on you to help her fall asleep.

She needs to learn to do this on her own.

If all goes well (and it won't, at least not for the first week or so), she'll fall asleep.

More likely, she'll test your resolve in enforcing a bedtime by getting up and asking for a glass of water, saying she's scared, or crying out to you from her bedroom.

When these things happen, be gentle but firm about the bedtime rules. If your daughter gets out of bed, identify with her feelings ("I know it's hard going to sleep on your own, but I'm sure you can do it."), and then gently but firmly guide her back to her bed. If your child starts to cry out to you from her bedroom, simply say something reassuringly from another room, such as "Daddy's right here, reading a book."

To help with nighttime fears, both a nightlight and a transitional object, such as a favorite stuffed animal or cuddly blanket, can help. Then, when your child wakes up in the middle of the night, she can draw comfort from the blanket or stuffed teddy bear. This helps children learn that they are capable of comforting themselves, rather than having to rely on you. This is an important part of growing up.

Learning to fall asleep on one's own is an important skill for infants and toddlers to master. But teaching them to do so can be stressful. To help accomplish this task, parents need to work as a team. So come up with a plan together, and stick to it. Simply arguing and fighting about who's right will do no one -- not your kids, not yourselves and certainly not your marriage --- any good.


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