Your Baby and Toddler's Sleep When Sick

There are many guarantees in your child’s life and one of the biggest guarantees is that at some point, your child is going to get sick. The average child under age 2 will come down with an illness 6 times/year. And if your child attends daycare, that number could be doubled. Depending on the severity of the illness, a child’s sleep can really derail when they are feeling under the weather. Many parents struggle to know what to do when their child is sick - do all the rules go out the window? Do we still try to remain consistent? What should we be flexible with and where should we draw a hard line? Enter - this post! While it certainly is impossible to give a concrete game plan for your child when they are ill as it absolutely depends on the severity of the illness, this post is meant to give you a framework to work with so that hopefully you can rebound more easily when your child is back to full-strength. Happy reading!

Why do illnesses impact sleep?

As I always tell families, when dealing with a sick baby or toddler, we have to consider that their psychological needs need to be met as well. We want them to know that if they are unwell, we will be there to help them through it. Trouble arises when we need to introduce certain sleep associations to help them sleep when they aren’t feeling well [rocking, holding, nursing, bottle, etc.] as while these associations may not be inherently ‘bad’, especially when your child is needing support, the expectation of these associations continuing even once they are feeling better can be very high, especially with a toddler. As I’m sure you’ve experienced, it can be very difficult to sleep with a sore throat, cough, fever, ear ache, etc. and children need help managing these symptoms, but the key is that the day your child is better, we need to get back to our normal schedule/routine. Bigger issues arise when we allow the new habits to linger past the healthy point as more often than not, even if we’ve had to bring in all the big guns to help your child sleep, it should only take around 3-5 days to get back on track if we do so in a timely manner. If weeks have gone by since your child was sick and you are still supporting heavily to sleep, a bigger sleep training endeavor may be required.

Which rules should we try to follow?

Just because your child is sick, it does not automatically mean that all rules are out the window. Many children can maintain the same sleep habits when sick [and some even sleep harder/more easily/longer!] so it’s always important to give your child a chance first before we add extra support. Some rules to try and follow include:

• If your child is an independent sleeper, aim to still put them down awake for all sleep times and see if they are able to manage without extra support. Keep reading to find out what to do if this is not the case.

• If your child sleeps in a crib/their own bed, try to keep this consistent [vs. bringing them into your bed - this can be a very difficult association to remove, especially with toddlers!] If you would like to monitor your child more closely, consider making a bed on the floor of their room for yourself.

• If extra support is needed, try to intervene as minimally as possible at first, adding extra help as required. This means still waiting at night during any wakings, trying to comfort them in their crib first before moving to a pick-up if needed, and trying to save extra feeds as a last resort unless dehydration is suspected. Check out the information below for an actionable game plan for bedtime, naps, and the middle of the night!

Which rules are okay to break?

While not all rules go out the window when your kiddo is unwell, there are some rules that we certainly want to break in the spirit of giving your child the best chance possible to ward off their illness. These rules include:

• Waking them at a certain time in the morning [let your child sleep as long as they need!]

• Waking them at a certain time from their naps [let your child sleep as long as they need!]

• Following any sort of schedule [waketimes, by the clock, etc.] When your child looks tired, let them sleep/help them to sleep.

• Worrying about feeding too close to sleep or any sort of feeding schedule through the day - your child needs plenty of rest and plenty of fluids.

How else can we help our babies/toddlers when they are unwell?

• A nightly warm bath [especially helpful if you can run a hot shower first with the door closed to steam up the room for congesion]. If your child has a fever, a lukewarm bath [not cold!] would be ideal.

• Using a humidifier/vaporizer for congestion/cough. My favorite can be found here!

• A massage before bedtime can help with any body aches.

• A nasal aspirator [or ‘snot sucker’ as we like to call it] is worth its weight in gold. I literally do not know how any family can survive without one of these! Definitely one of my most highly recommended baby products.

• Offering medication as needed [especially 30 minutes before bedtime]. Wondering about which to use? Advil/Motrin [ibuprofen] are anti-inflammatories so will be especially helpful for illnesses with inflammation [croup, teething], and for higher fevers. It also lasts longer than its counterpart but should only be used in babies 6+ months of age. Tylenol [acetaminophen] would be the better option for stomach pain/upset and can be used for babies under 6 months. As always, make sure you are using the correct dosage and consulting your pediatrician with any questions or concerns. Parents should not hesitate to contact the pediatrician if a child continues to have a persistent fever.

Managing sleep during illness is never easy, even when a child isn't severely ill. All children have different tolerance levels for illness and some can seem to be impacted by even a minor cold. If all else fails, do what you need to do and don't worry about creating bad habits. And if you are in need of support to help get your healthy child back on track, do not hesitate to reach out!

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Pam Edwards is a Certified Infant & Child Sleep Consultant and founder of Wee Bee Dreaming Pediatric Sleep Consulting, based out of Kamloops, B.C. Healthy sleep is addicting and she has made it her life mission to help families all across the world get the sleep they deserve - a good night's sleep doesn't have to be a dream!

Teething and Sleep

As a Sleep Coach, there are many questions that I am asked quite frequently. How to approach sleep when baby is teething is definitely at the top of that list. If you’ve read my bio, you’ll know that as first-time parents we struggled majorly in the sleep department for the first few months. We climbed out of that sleep deprivation hole only for someone to casually say to me, ‘Wait until she starts teething’. WHAT!? NO! In my head, with every tooth that came in, we’d be back at square one with all-night wakings, zero naps, and a screaming, overtired baby. Luckily – this doesn’t need to be the case. Read on below to find out why teething can affect sleep and what to do to help ensure sleep doesn’t majorly regress during this inevitable time.

How can teething affect sleep?

Teething gets a really bad rep for creating a host of sleep issues and it can - especially for a child that already struggles to connect sleep cycles [sleep training for the win!]

Teething won't necessarily CAUSE your baby to wake through the night but for a baby that's already wakeful, it can make re-settling very difficult. It can also make the initiation of sleep more challenging as well if baby is experiencing discomfort.

There are 2 different types of teething - chronic teething [which is basically happening all the time as the teeth are slowly moving their way up through the gums and is on and off for the first 2+ years of a child’s life] and acute teething. Teething is at its worst [acute teething] when you can see those little white bumps just before they pass through the sensitive nerve endings near the skin surface. Once the tooth is through, the discomfort is mostly gone. This should take no longer than 3 days to occur so if your sleep is out of whack for weeks - teething isn't likely to blame. 

It can be difficult to know with certainty whether wakings at night are teething related or not. One good way of determining this is whether your baby’s wakings are occurring in a pattern or not. So, for example, if your baby is waking up at the end of every single sleep cycle [60-90 minutes at the beginning of the night, every 2-3 hours as the night goes on] then teething isn’t likely to blame, and it’s more likely a habit/sleep association/schedule issue. If your baby starts waking up at random times [say, at 9:00pm when they usually sleep until at least 1:00am, or every hour in the second half of the night] then teething might be to blame.

If your baby’s gums look like this, be prepared!

What are some other tell-tale signs that your baby might be teething?

• Baby seems uncomfortable or extra fussy during the day

• Gums are red, swollen, or bulging

• You can see a little white nub right below the surface of the gums

What are not typically signs of teething?

• Drooling

• Hands in mouth

• Fever [a slightly elevated body temperature [think: 99-99.5°] can be normal but an actual fever is not an indication of teething and if your baby has a fever and is sleeping poorly, you may want to rule out an ear infection]

• Diarrhea

• Cough

• Congestion

• Vomiting

What can we do to help when baby is teething?

The best weapon against teething discomfort preventing a good night’s sleep is a dose of Tylenol/Motrin before bed. If your baby is 6+ months of age, then I would be giving Motrin vs. Tylenol as it is an anti-inflammatory as well as a fever and pain reliever. Give the Motrin 30 minutes before bed if you suspect teething pain/discomfort. If your baby has been waking in the middle of the night or early morning and struggling to fall back asleep/stay asleep, then go in at the 6 hour mark and re-dose baby to help them through the second half of the night [this is like a dreamfeed but with medicine, let’s call it a ‘dream dose’!. While your baby is still asleep gently put the syringe of pain reliever into the back corner of their mouth. Very gradually squeeze the medicine into their mouth. Most babies will just swallow the medicine without waking up. If the on-set of sleep or early part of the night is when baby is struggling, there’s no need to offer the dream dose unless they wake in the middle of the night and are having a tough time re-settling.  If your baby still wakes up for nightfeeds, you can preemptively re-dose them at one of their feeds just to help avoid any issues through the second half of the night.

**speak to your healthcare provider before offering any medication, this is not medical advice

If your baby wakes in the middle of the night and is needing comfort and that 2nd dose of medicine and you haven’t done the ‘dream dose’, consider holding them for 30 minutes until the medicine takes effect, and this should help you to be able to lay them down afterwards.

Keeping a consistent routine and schedule when your baby is teething is important as well! Continue to lay them down awake, continue to always give them time to re-settle on their own in the middle of the night if they do wake, continue to be consistent in how you respond to any protesting/middle of the night wakeups, and try to avoid bringing in any long-term habits for a short-term phase. It’s important to especially try to avoid bringing back the associations that you worked the hardest at undoing [i.e. if you were previously bedsharing and have now moved baby to his own bed, try to avoid bringing baby back into your bed and perhaps try to comfort by rocking instead. Or, if you have worked hard to eliminate a nursing association, try to avoid using nursing as a comfort tool if possible].  In saying this, if all else fails and your baby is really struggling, you can do what you need to do to help, but just remember the key is getting back on track the DAY baby is better.

So, put together, what might your teething plan of attack look like?

You notice baby is acting extra fussy today. You look inside baby’s mouth and there is a super swollen gum with a tiny white bump right under the surface with a small section poking through. In hopes of avoiding a tough night, you give baby a dose of Motrin before her bath, about 30 minutes before bed. Baby falls asleep well but then wakes up at 2:00am crying [this is an abnormal time for her to be waking up]. You wait 10 minutes to see if she can re-settle on her own without help, but then you go in and pick her up to comfort her. Seeing as it’s been 6+ hours since her last dose of Motrin, you re-dose her and hold her in the rocking chair for half an hour. After 30 minutes you lay her back down - but she starts to cry again. You leave the room to see if she can re-settle but after 10 minutes she’s still crying. Knowing she might be in discomfort, you go back in the room and hold her again, hoping to get her sleepy enough to lay her back down and have her stay asleep [I would repeat this in 10 minute intervals as needed]. The next transfer is successful, and she stays asleep the rest of the night.  The next night, you offer a dose of Motrin 30 minutes before bed but then also do a ‘dream dose’ at 1:00am [6 hours after 1st dose] to try and avoid the middle of the night waking – and it’s a success! To be careful you do this for one more night [3 nights total of possible teething discomfort].

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Pam Edwards is a Certified Infant & Child Sleep Consultant and founder of Wee Bee Dreaming Pediatric Sleep Consulting, now based out of Kamloops, B.C. Healthy sleep is addicting and she has made it her life mission to help families all across the world get the sleep they deserve - a good night's sleep doesn't have to be a dream!

The (Dreaded) 18 Month Sleep Regression

I hate to say it, but this regression is often the most difficult of the sleep regressions due to a discipline aspect that is involved which wasn’t present before. We really need to be diligent to ensure we don’t see a colossal setback with sleep during this time.

If you are struggling with this regression or are looking to prepare in advance, please check out the article below that I wrote for Baby Merlin’s Magic Sleepsuit’s blog for the 5 important steps to take to tackle it:

Click here to read the full article

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Pam Edwards is a Certified Infant & Child Sleep Consultant and founder of Wee Bee Dreaming Pediatric Sleep Consulting, now based out of Kamloops, B.C. Healthy sleep is addicting and she has made it her life mission to help families all across the world get the sleep they deserve - a good night's sleep doesn't have to be a dream!

The (Dreaded) 8-10 Month Sleep Regression

You came out of the 4 month sleep regression unscathed (sort of) and things are going pretty well in sleep-land when BAM! the 8-10 month sleep regression hits you like a ton of bricks. Babies seem to always be going through 'something' - whether it be a growth spurt, a mental leap, a regression, or some other super-fun phase that gets in the way of sleep. If we are prepared for these 'regressions' and understand why they are occurring, it can make it easier to get through and perhaps help to avoid a true 'regression' at all.  Read on to find out about the two main reasons for the 8-10 month sleep regression, the 4 month sleep regression's less popular friend.

What is a sleep regression?

The 4 month sleep regression is vastly different from the 8-10 month sleep regression because the 4 month sleep 'regression' isn't really a true 'regression'. A regression would mean that, with time, the baby's sleep would eventually resume as usual, but unfortunately, that's not what happens. The changes in a baby's sleep at 3-5 month's of age are here to stay. With the 8-10 month sleep regression, the changes are often temporary and are due to a baby's brain development. There is a lot that goes on cognitively at this age, and all of these changes can affect baby's sleep - whether that means they start waking more at night and/or start fighting/refusing naps.  Not coincidentally, these 'regressions' (which generally occur at 4 months, 8-10 months, and 18 months) all occur around the same time as nap transitions.  If we aren't prepared to handle these changes in baby's sleep, this can lead to the child becoming overtired, overtiredness leads to difficulty falling and staying asleep, and before we know it, a 'regression' has occurred.

8-10 month sleep regression cause #1 - Physical milestones

There is so much going on in baby's life at this age. They might be sitting up, scooting, crawling, pulling up, cruising, and some might even start walking. Baby is also learning the basics of communication and might start teething (if they haven't already). This is a lot in a little baby's life, and all these things take time, energy, and practice. Sometimes this 'practice' can occur at the wrong times, when baby should instead be sleeping. It can be hard for a baby to learn to shut down their brain, particularly a child that doesn't have self-soothing skills to begin with. Those babies that need more help to sleep may now start to really fight your soothing efforts, finding them too stimulating, and may try to take these opportunities of your company to show you their sweet new moves. If your 20 minutes of rocking has now become 60 minutes, that may be your baby's way of telling you that they are ready to be going down more awake on on their own, as your presence is inhibiting their ability to fall asleep, instead of helping.
If your baby is already an independent sleeper and has started to have some serious party time in their crib before sleep times, firstly you want to make sure that their environment is conducive to sleep. We want to be extra-vigilant that there is nothing stimulating in our child's crib and that their room is pitch black. A baby can be stimulated by anything - a wallpaper design, a toy across the room, a pattern on their crib sheets - so making sure that room is nice and dark will surely bore them into sleep (check out this company here that makes awesome custom window covers to get baby's room pitch black). As well, using a sleepsack for naps and nighttime helps to cut down on monkey business - it's not impossible to roll/sit up/crawl/stand with a sleepsack on, but it makes it more difficult. If baby is already sleepy, they might decide it's not worth the fight. Additionally, make sure your baby's sleep schedule is meeting his needs. Does he need a bit more awake time before naps so that he's tired enough to sleep easily? Here's a good way to determine if pushing a nap later might help:

• If your baby is taking a long time to fall asleep (much more than 15 minutes) with lots of protesting/playing but then still takes a good nap (over 1 hour) that he wakes up happy from - try pushing that nap 15 minutes later.

• If your baby falls asleep quickly at naptime, but then takes a short nap (under an hour) that they wake up happy from - try pushing that nap 15 minutes later.

• If your baby falls asleep quickly for a nap, but then takes a short nap (under an hour) that they wake up crying from - try pulling the nap back by 15 minutes.

• If your baby falls asleep within 1-15 minutes for a nap and then takes a long nap (over 1 hour) - you have nailed it, don't change a thing.
  
  

What not to do:

Don't give too much attention to the nap/bedtime battles. You don't want to make long-term habits for a short-term phase. This regression will pass in time, but if you make a habit of now rocking the child, letting them sleep in your bed, sitting with them until they fall asleep (unless you are already doing these things), or skipping naps entirely, this regression now turns into a new habit for the child, one that will be tough to break.

8-10 month sleep regression cause #2 - Nap transition

Eight months is the age where your 3rd catnap needs to be eliminated, if it hasn't already. Especially if you are finding the child refuses this nap at least 50% of the time, if the 3rd nap is occurring much past 4:00pm, or if with the 3rd nap, you are now clocking less than 11 hours of sleep at night - it's time to go. I generally recommend that even if you're not seeing these obvious signs of readiness by 8 months of age, you should still begin the transition towards a two nap schedule. Nap transitions are tricky and they can be messy if we're not handling them properly. If we  jump too quickly into a two nap schedule, this can cause baby to become overtired... and a regression is born. Nap transitions aren't a race - slow and steady really is best. Start by slowly adding awake time before each of your naps - maybe 5 minutes onto all of them or 15 minutes before one nap. The best order to add time in is middle first (2nd and 3rd nap) then 1st nap, then bedtime. It is normal during a nap transition to flip-flop back and forth between 2 nap and 3 nap days depending on baby's wake-up time and the quality of the naps. With time, you will find that you are unable to fit in a 3rd nap before 4:00pm so you'll want to use an early bedtime to compensate. I can't stress this enough, this is where nap transitions go wrong. Parents become too stuck on a 'set' bedtime, but now that we've lost an entire sleep period, that stretch between the 2nd nap and the 'set' bedtime is way too long, causing the child to become overtired (bedtime battles, nightwakings, sleep-cries, and potentially an early wake-up the next day are all symptoms of a too-late bedtime). There is no advantage to a later bedtime if the child is awake crying every 3-4 hours because the bedtime was too late. Do not be afraid of a temporary early bedtime during nap transitions - it is essential.

What not to do:

Don't let that third nap hang around too long if it's obviously causing issues with nightsleep. Naps are important but nightsleep is far superior.  If your 3rd nap is interfering with nightsleep and causing baby to clock less than 11 hours at night - it's time to go. 
Don't rush the transition - slow and steady is best.
Don't stall in the transition. You need to continue to slowly stretch baby's awake times to move them to a solid 2 nap schedule. Your day will likely start out like this:

7:00am - wake-up
9:30am-11:00am - nap 1
1:45pm-3:15pm - nap 2
6:15pm - bedtime

and should eventually look like this:

7:00am - wake-up
10:00am-11:30am - nap 1
3:00pm-4:00pm - nap 2
7:30pm - bedtime

Sleep regressions are an exhausting part of parenting but we all go through it at some point.  During these times, just remember to be flexible, be prepared, and be careful not to create a new sleep crutch (or bring back an old one).  As hard as it can be to remain consistent at times, it really is best for everyone and helps the regression pass in a more timely manner. If you’d like my information on the 3-2 transition, check out my Comprehensive Nap Transition Guide here!

Pam Edwards is a Certified Infant & Child Sleep Consultant and founder of Wee Bee Dreaming Pediatric Sleep Consulting in Grande Prairie, Alberta. Healthy sleep is addicting and she has made it her life mission to help families all across the world get the sleep they deserve - a good night's sleep doesn't have to be a dream!

Rollin' Rollin' Rollin'..... How to Cope with the Rolling Phase

fun fact: this video is almost 15 years old...WHAT?!?

Ahhh the dreaded rolling phase. I remember this so well with my second baby....it sucked. When my ovaries start twinging and I think I want a third baby - I remember this phase and it snaps me back to reality. As awful and frustrating and stressful as it is, it is very short-lived. In this post, I will give you some helpful instructions about how to cope with the rolling phase as best we can.

 

 

How to prevent the rolling phase

There are some ways we can seemingly prevent this phase (or at least, delay it as long as possible so that hopefully by the time the phase hits, baby is efficiently rolling both ways). A few tricks are:

1. Swaddling baby. Keep your baby swaddled for as long as possible. Until baby is able to roll in the swaddle, you can continue to keep her wrapped up. This often prevents baby from rolling in the crib (ensure that the swaddle is nice and snug as this makes rolling even more difficult).

2. Merlin's Magic Sleep Suit. I recommend these a lot as I really think they are pure magic. The Sleep Suit is perfect for babies who are unable to be swaddled (babies who are rolling in the swaddle or babies who are busting out of a swaddle even after using The Super Swaddle or a Double Swaddle (Super Swaddle + a velcro swaddle sack)). Also helpful for keeping babies positioned on their back (so not so helpful if your baby is a tummy sleeper who has just begun to flip onto his back). We are able to keep baby in one of these Suits until they are efficiently rolling both ways, and then the transition to a sleepsack is (generally) seamless.

The rolling phase has hit....now what?

You've done all you can to prevent this phase from coming (and it is a lot easier to prevent it if baby is a back sleeper, if baby is a tummy sleeper the rolling phase is a lot trickier) but it's now here. So what do you do when baby flips over, gets stuck, and cries? Well, there are a couple of things to try:

1. The child has just started rolling and it is only occasionally disrupting sleep. Put baby down in the usual position (so on back for a back sleeper, tummy for a tummy sleeper) and leave. If baby rolls over and is upset, always make sure to wait a minimum of 10-15 minutes before deciding if an intervention is required. If after the initial wait baby is very upset (more than just fussing), go to him, flip him, and walk out. This allows the child the opportunity to learn to sleep in the new position and/or roll back himself. You may choose to continue this for as long as it takes or move onto step 2 which is....

2. The child has been rolling for a while (may be able to roll back), sleep disruption is regular and frequent, and may be doing this for the attention or because it's fun. Put baby to bed in the new position (so on tummy for a back sleeper, on back for a tummy sleeper). If the child gets upset, use whatever method you are comfortable with (see sleep coaching methods here) for as long as it takes until the child has fallen asleep in the new position. Same goes for any nightwakings until midnight. After midnight, if baby is still struggling to sleep, use plan 1 above. This takes the novelty out of rolling and teaches the child to learn to sleep in the new position. After three days, it doesn't matter which way the child sleeps, she is used to both.

3. The 'One Free Flip' Rule. This is the most direct of the three approaches. For this technique, you put baby down in their usual position (back for a back sleeper, tummy for a tummy sleeper) and leave. If they roll over, you flip them back one time only. After that, it is up to them to either roll back or fall asleep in the new position. You would only use this method for a baby who you know can consistently roll both ways, they just seem to have magically forgotten as soon as they are in their crib.

aden + anais 7507F Cotton Muslin Issie Security Blankets, Duke Giraffes

aden + anais

In addition to following one of the plans above, it is also of pivotal importance to practice practice practice during the day. Practicing rolling front to back and back to front. It is especially important to practice right before sleep times, so incorporate a rolling session into your nap time/bedtime routine so it is fresh in his mind when he goes into his crib.
Making sure baby's bedroom is pitch black is especially important during this rolling phase, as we want to limit distractions. As well, you may want to consider introducing a small lovey (see my favorite product for young babies to the right) at this stage (if you are comfortable with it) as it gives the child something to do with their hands (especially those that were once swaddled and now have a new-found freedom of movement) while they are 'stuck' in their new position. 

Start this rolling plan at bedtime, as the drive to sleep is much higher at night and they are less able to fight us (as sleep will eventually overcome them). Once bedtime is not an issue, naps won't be an issue either. If you are consistent, the process should only take about three days.

Once babies are able to roll freely both ways in their cribs, they become much better sleepers. If we are constantly rolling them back to their preferred position all night long, we are not giving them the opportunity to learn to love different sleeping positions (this is especially important for back sleepers, as the vast majority of back sleepers turn into tummy sleepers, and once they learn to love their tummy, they sleep much better).

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Have you gone through the rolling phase? How did it pan out for you? Share your stories below and we can all commiserate together ;)

Pam Edwards is a Certified Infant & Child Sleep Consultant and founder of Wee Bee Dreaming Pediatric Sleep Consulting in Grande Prairie, Alberta. Healthy sleep is addicting and she has made it her life mission to help families all across the world get the sleep they deserve - a good night's sleep doesn't have to be a dream!

5 Reasons Why your Child Isn't Sleeping through the Night

This blog post is meant to be PART THREE of my Toddler Sleep Series on Nightwakings (you can reads parts 1 & 2 here and here) but really, this information applies to babies and toddlers alike. Unless you have an all-star sleeper from birth (and damn you if you do. We are all jealous of you!) then we need to make sure that all of our ducks are in a row before your child will sleep through the night (whatever that may mean at their age, see here for the definition of 'sleeping through the night' by age). This list is meant to give you a helpful idea of the top 5 things that we as parents might be doing to sabotage our chances of our child sleeping peacefully the whole night through.

1. Baby is not falling asleep independently

What's that you say? You knew I was going to say that? Well sorry folks, but it's absolutely true. Unless your child magically fits into that very small category of babies who can be nursed/rocked/bounced/cuddled to sleep and stay asleep all night long (and I hate to say it but even if they are, there is a pretty good chance that their sleep might regress and you can start to see nightwakings in your future) then we need to ensure that our child is falling asleep 100% independently with NO props (that bottle that baby takes to bed? That's a prop too! That paci they use to fall asleep? Prop!) In order to help your child fall asleep independently, some sleep coaching will likely be necessary, and there are a range of methods from the 'let cry' to the 'no cry' that can help them do just that. Why is it so important that they fall asleep on their own? We often use this analogy and it's the best way to help parents realize why it's so crucial.
Imagine if every night you fell asleep in your comfy cozy bed, but when you woke up in the middle of the night, you were in your kitchen. You would sit up and wonder how the heck you got here and of course, being so confused, you would not simply be able to roll over and fall back asleep. You would have to get up, walk back to your bedroom, and fall back asleep in your bed. Now imagine this happened to you night after night after night. Soon, you would start fighting sleep in hopes of catching the person that keeps moving you! Now think of it how a child sees it. Every night the child falls asleep snuggled up to Mom, maybe with a boob or a warm bottle in her mouth. When she wakes up everything has suddenly changed. Now she's in a dark bedroom, all by herself, the boob and bottle are nowhere to be found. Unlike an adult who just gets up and walks back to their bed, baby is unable to simply get up and re-create these conditions she used to fall asleep. So what does she do? She cries. And if this same sneaky change of scenery keeps happening night after night, she might start to fight sleep in order to prevent it from happening. Our goal with babies and children alike is for their to be no surprises in the middle of the night. We want everything to be exactly the same when baby falls asleep as it will be when they wake in the middle of the night (as all children do!) These same rules apply to toddlers, and laying in bed with your toddler until they fall asleep is going to cause the same issues as nursing a baby to sleep.

2. Baby is being put down 'drowsy but awake'

I am sure all of us at some point have had someone tell us that we need to be putting our babies down 'drowsy but awake', and while this is great advice for someone with a newborn baby (0-4 months), after this age, we really want to be putting baby down wide awake, and helping to teach them to go from that wide awake state to a fast asleep state completely on their own. Why doesn't drowsy but awake work? While it seems like helping baby to that drowsy state will facilitate the falling asleep process, it actually works the exact opposite. When a baby is in the 'drowsy' state (eyes open but heavy, looking around but slowly) they've already entered the first two stages of sleep. Now, when they are put down in this drowsy state, they are either going to a) fight sleep or b) succumb to sleep, but they are still associating the 'falling asleep' part with wherever they became drowsy. So what happens when they wake at night? They need those same conditions re-created (as we talked about in #1). So instead of bouncing/rocking/nursing baby until drowsy, make your bedtime routine short and sweet, include a song/short rocking right before put down time to relax baby, but not to help them become drowsy.

3. Baby is being fed too close to sleep times

This goes hand-in-hand with #2. A feeding too close to sleep time will work against us in the same way that helping baby to the drowsy state works against us. First off, even if baby is not falling asleep while being fed, it is pretty likely that this feeding is helping them to that drowsy state, and as we talked about in #2, we want baby falling asleep 100% on their own. Second, feeding baby too close to sleep times can still cause a feeding-to-sleep association even if it's not necessarily to sleep. When a feeding is the last thing that we are doing at the end of the night, guess what's the first thing on the child's brain when they wake at night?  Ding! Ding! Ding! Food!!!! As well, while it's pretty popular advice to 'tank baby up' before putting them down for the night in the hopes that they will sleep longer, past 4 months of age we really don't want to be trying to 'clusterfeed' baby anymore. Think about how you feel right after you eat a huge meal. Your digestive system goes into overdrive and it would be difficult to sleep (and if you did sleep, it would be a very restless and non-restorative sleep). Same goes for baby. In reality, if you are seeing multiple nightwakings all night long past 4 months (or any nightwakings at all past 8/9 months if baby is growing on time), they aren't hunger-related, so no amount of food is going to make them stop. Therefore, try moving the last feeding of the night to the beginning of your bedtime routine (for a baby 8/9 months or younger that still wakes multiple times a night) and for a baby 8/9 months who is still waking during the night, move the feeding even further, to immediately before/after dinner (or a cup/bottle with dinner if you've introduced one). This same advice goes for toddlers. Food = calories and calories = energy, and if we are giving our toddler a late-night or middle-of-the-night snack, that food turns into a burst of energy and your child is going to have a hard time falling asleep and staying asleep. Make sure that you are separating any snacks from bedtime by at least 30 minutes and that you are feeding your child enough healthy food during the day to ward off any late-night hunger.

4. Baby's daytime schedule is not age-appropriate

'Sleep is not logical, it's biological'. This is what I tell my families when they call me crazy for all the sleep-related advice that seems so backwards; tanking baby up won't help them sleep longer, early bedtimes = later wake-ups, and more daysleep leads to more nightsleep. That last one there couldn't be more true. The more baby sleeps during the day (as long as it's not in excess), the more baby will sleep at night. A well-rested child accepts sleep more readily, sleeps better, and sleeps longer than an overtired child. This means that in order to see A+ nightsleep, we need to see A+ daysleep - naps aren't optional, your child needs them. Making sure that your baby isn't kept awake too long in between naps (see here for how long is too long), making sure that baby has an appropriate number of naps and an age-appropriate bedtime (read here to find out if your baby's bedtime is too late). Keeping baby up in hopes that they will sleep longer at night may work for one night, but sleep debt is accumulative. Following that night up with another day of crappy naps and another too-late bedtime will almost certainly backfire. Making sure you respect your child's need for sleep will pay off in a big way.

5. Rushing in too quickly in the middle of the night

Guilty! When I was a first-time mom, I rushed in at first peep. I rushed in before there even was a peep. I didn't let my daughter learn to soothe herself because I was so afraid of my baby feeling any sort of pain, sadness, or loneliness. But as the months went on and the sleep got worse, I came to realize that I myself was sabotaging it. By rushing in too quickly, I wasn't giving K the chance to soothe herself in the middle of the night, and what I was the most shocked to discover were the phenomenon of 'sleep-cries'. All babies will have the occasional sleep-cry (and overtired children can have many sleep-cries over the course of the night, and the combination of chronic overtiredness and an inability to self-soothe means these sleep-cries may often turn into full-blown nightwakings). A sleep-cry is exactly as it sounds - a cry that baby makes while in their sleep. The cry is often a very piercing cry, it almost sounds like they are in pain, and it can last up to 10 minutes in duration. Rushing in during a sleep-cry will only awaken the child when they would have simply returned to sleep on their own (if you have a video monitor as I do, you can see that in fact, babies eyes are still closed while crying). If you are experiencing many sleep-cries within the first 3-4 hours of baby falling asleep, this is a good sign that your child is overtired and you may want to take a look at their daytime schedule and bedtime to see if it's meeting their needs. Sleep-cries are the reason that I always recommend to all my families to wait 10 minutes (up to 6 months) 15 minutes (up to 11 months) and 15-20 minutes (for toddlers) before deciding if you should intervene in the middle of the night. Your baby may surprise you one day and return to sleep unassisted, and they would never have done it if you hadn't given them the opportunity.

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Pam Edwards is a Certified Infant & Child Sleep Consultant and founder of Wee Bee Dreaming Pediatric Sleep Consulting in Grande Prairie, Alberta. Healthy sleep is addicting and she has made it her life mission to help families all across the world get the sleep they deserve - a good night's sleep doesn't have to be a dream!

The Dreaded 4 Month Sleep Regression

The '4 month sleep regression' has celebrity status in my sleep world.  I hear this phrase almost every single day; from an exhausted mom of a 5 month old, wondering why her baby's sleep has gone downhill in the last month, to parents of a toddler who say that "their baby has never slept well since 4 months of age", or even from a mom of a 3 month old, worried about the upcoming "regression".  I am here to help you realize what goes on around 4 months, and how we can prevent a true 'regression' from occurring.

What is a sleep regression?

A sleep regression is thought to occur when a baby who is normally sleeping well begins to wake frequently at night and/or fights/refuses naps.  These regressions seem to come out of nowhere and can last indefinitely.  There is thought to be a regression around 3/4 months, 9 months, and 18 months.  Not at all coincidentally, we can see that all of these 'regressions' occur around the same time as nap transitions (the 4-3 nap transition around 4 months, the 3-2 nap transition around 9 months, and the 2-1 nap transition around 18 months).  In my opinion, these regressions are really just our babies' sleep needs changing and parents are not prepared to handle these changes properly, thus leading to baby becoming overtired.  You know by now that an overtired baby will wake frequently at night and/or fight/refuse naps so - voila!- a 'sleep regression' is born.

So what causes the '4 month sleep regression'?

Four months is a very busy time for babies.  There is a lot that happens with our children's sleep at this age.  Four months is the time where a baby's sleep becomes more like an adult's.  I won't bore you with the details about how this happens, but it's important to know a little bit about why some of the things that you were previously doing (i.e. rocking/nursing to sleep) seem to quit working at four months of age.
Previous to 4 months, when a baby would fall asleep, they would immediately enter into a deeper non-REM sleep.  This is why you would have been able to rock/nurse your baby to sleep and then put them down without them waking up.  As well, they were likely able to sleep just about anywhere; in the car seat while grocery shopping, in the stroller while you took a walk, or in the carrier while you did your household errands.  Around 4 months, as sleep becomes more 'adult-like', your baby will not enter immediately into that non-REM deep sleep stage as soon as they fall asleep.  Instead, they will first enter into a lighter sleep stage of non-REM.  If we are nursing/rocking baby to sleep, and then try to put her down....POP!  She is up, wide awake, and ready to go.  Then the process of helping her to fall asleep is repeated again and again, only causing baby to become overtired.

Four months is also the age where some babies begin to roll.  This means that the swaddle is no longer safe to use.  The downside to this is that most babies at this age still have some, if not all, of their startle reflex (which is what we are trying to prevent with the swaddle).  Simply unswaddling our babies and moving straight to a sleepsack will often cause baby to begin waking themselves up at night or start to have difficulty falling asleep/staying asleep for naps.  This is why I am such a fan of the Baby Merlin's Magic Sleepsuit.  It is a fantastic tool for babies who aren't able to be swaddled but just aren't ready for a sleepsack quite yet.

At four months, we begin to see sleep patterns mature and nightsleep consolidate.  This means that your baby who was previously sleeping in until 7:00 or 8:00am may begin to shift his natural wake-up time earlier, to around 6:00-7:00am.  This then means that we need to begin shifting the bedtime earlier as well to account for this.  It is a very common misconception that putting your baby to bed later will help them to sleep in - it is the exact opposite that is true.  Putting your baby to bed later in hopes that they will start to sleep in will only backfire and lead to an overtired baby who will in turn wake up even earlier.  This early to bed, early to rise pattern is here to stay and trying to fight it is going against baby's natural sleep rhythms.  Check out my blog post here to find out if your baby's bedtime is too late for his/her age.

As I touched on briefly, 3-5 months is the average age that the 4-3 nap transition occurs.  The longer wakeful periods begin to push baby's naps later therefore making bedtime too late as well.  Remember, around this age we do not want any nap occurring later than 4:30-5:00pm.  If you are finding that the 4th nap is happening much past this time - it is time to drop that nap and move bedtime earlier.  That is the key!  Bedtime needs to move earlier to account for that entire sleep period that's been eliminated.  

For more information on newborn sleep, check out my Comprehensive Newborn Sleep Guide here!

As I mentioned above, at four months of age it becomes increasingly difficult for baby to fall asleep on-the-go.  Where a newborn could sleep through just about anything, babies at four months are becoming increasingly aware of their surroundings.  Many parents find it inconvenient to be home every 1.5 hours to get their baby the rest that she needs but if we keep trying to push babies to fit into our schedules, they are going to re-pay us by waking frequently at night.  In addition to this increasing awareness making it difficult for babies to nap on-the-go, it also means that your previous methods of soothing baby to sleep (i.e. nursing/rocking/bouncing/etc.) in fact become the opposite of soothing - they become too stimulating for baby.  If you are finding that you are spending hours using all of your tricks to get baby to sleep, she might be telling you that she needs to be falling asleep more on her own.

So what can we do to avoid this 'regression'?

It is all about recognizing our baby's changing needs and having a flexible schedule that is in sync with our child's natural sleep rhythm.  We as parents may think that because we started one way (by always nursing to sleep, by rocking to sleep, by holding baby for all sleep) that this is the way that baby will always need to sleep.  This is definitely not the case!  When these things stop working we need to switch it up and find something new to help our babies get the sleep they need.  Sometimes, a little bit of sleep coaching is necessary to break the cycle of overtiredness and to reinforce healthy sleep habits but at such a young age we are able to use super gentle methods and they unlearn these 'bad' habits very quickly.  But just remember, no amount of sleep coaching will work on a baby who is overtired and whose schedule is not meeting their needs, so do not be quick to 'sleep train' your child unless you are prepared to make sure baby is napping enough during the day and at the right times, and is in bed at night with an age-appropriate bedtime.  Otherwise, this sleep training will only lead to even more overtiredness and unnecessary crying.
We also always need to be sure that we have an age-appropriate schedule for baby that meets his needs.  Check out my blog post here for what a 'typical day' in the life of a 4 month old should look like.  While it is very true that a baby rarely fits into our schedule, the time that is spent in 'babyhood' is so very short, and besides food, there is nothing else that is more important to a little baby than sleep.

While it would be nice if this '4 month sleep regression' was only a phase that will disappear in time, unfortunately, it is not.  It is more often a product of poor sleep habits and an inappropriate schedule.  As long as we are aware of all the developmental points above and are prepared to adapt to meet our baby's new needs, we will be able to dodge this dreaded regression and continue to enjoy the benefits of a good night's sleep.

Is Your Baby's Bedtime Too Late?

A vast number of the sleep issues I encounter are products of a bedtime that is too late.  The awake time between the last nap of the day and bedtime is the most sensitive.  What I mean by this is that if we are putting baby down too late, stretching baby out too long, it is a recipe for nightwakings, a restless sleep, and an early morning wake-up.  Therefore, it is vital that we are really 'nailing' bedtime and that we aren't keeping baby up too late.  What time would you put an 8 year old to bed?  Likely not at 10:00pm, right?  Then why should a little baby, only months old, have a bedtime that late?  It should be the exact opposite - babies should be going to bed much earlier than older children as their sleep needs are exponentially more than a school-aged child.  Below, I hope to help you figure out what your baby's ideal bedtime is and whether a too-late bedtime is the cause of your sleep problems.

Why is an early bedtime important?

Sleep coaching helps teach baby how to fall asleep independently.  Just because a child knows how to sleep, doesn't mean they will sleep through the night.  In order to help our babies to consistently sleep through the night (and I mean an age-appropriate length of time, see my blog here for what sleeping through the night means at different ages) our children's needs must be in sync with their natural sleep rhythms.

Parents may think that because their baby is still clocking 11-12 hours of nightsleep with a 9pm-9am schedule that this is working well for them.  While it's true that a small percentage of babies, about 10%, do well with a later bedtime, if your child has multiple nightwakings and rarely does longer than a 3 hour stretch at night, then this late bedtime is in fact not working for your child.
Many parents may think that their baby just naturally rises later in the morning, but if baby is up several times a night, the 'sleeping in' is baby trying to catch up on lost sleep.  A true natural wake-up time is only evident once the child is well-rested and sleeping through the night.

Should I use a 'set' bedtime for my child?

While there are many studies out there that prove that a consistent, or 'set', bedtime is important for children, these studies are for children much older - those who no longer nap during the day.  It is very important that once our children drop their last nap that they have a consistent bedtime every single night.  This consistent bedtime has been shown to help children regulate themselves, develop positive behaviors, and function successfully at home and in the community.  Inconsistent (and especially too late) bedtimes have been shown to have long-term effects on behavior - and none of them good.  So while it is important to have consistency with older children, babies need more flexibility with bedtime.  Bedtime should vary depending on the day's naps, activity level of the day, and the previous nightsleep.  Therefore, bedtime can vary by as much as two hours, especially during nap transitions.

So how do I know when I should put my baby to bed for the night?

As I mentioned in the first paragraph, it is of utmost importance that the stretch from the last nap to bedtime is not too long as this will cause fragmented nightsleep.  Below, I will outline how long that last stretch should be, and as well, how many naps on average that babies need at each age.  Keep in mind as well, that if the last nap was very short, you may need to shorten the awake time even more.  

0-2 months: babies this age sleep around the clock and have 4 or more naps every day.  Bedtime in newborns is naturally late, usually around 9:00pm or later, but it is important to start moving the bedtime earlier around 6/8 weeks.  By 2 months, baby's last nap should be ending by 6:30pm. Bedtime should be around 6:30-8:30pm and should occur about 1-2 hours after the last nap ends.

3 months: babies this age should be on a solid 4 nap schedule with the last nap of the day ending by 5:30pm.  Bedtime should be no later than 1.5-1.75 hours after the last nap ends.  Remember, this is asleep by time so we want to put baby down 15 minutes prior to this to allow him time to fall asleep.  So, this means that bedtime should not be much later than 7:15pm.

4 months: This is the age where babies will transition from 4 naps to 3 naps.  This might mean that your baby will flip-flop back and forth between 4 naps and 3 naps depending on what time she woke up in the morning, and the quality of the day's naps.  If it is a 3 nap day, it is likely you will be needing an early bedtime.  Do not be afraid of an early bedtime during nap transitions - it will be your saving grace!  At 4 months, all naps should be ending by 5:00pm with bedtime happening about 2-2.25 hours after the last nap ends.  So again, this means that bedtime should not be much later than 7:15pm.

5 months: Babies at this age should be solidly on a 3 nap schedule.  All naps should be ending by 5:00pm and bedtime should occur no later than 2-2.5 hours after the last nap ends.  This means that bedtime will be around 7:00-7:30pm which is a very age-appropriate bedtime considering you just lost one entire sleep period when you transitioned from 4 naps to 3, and babies this age still need 11-12 hours of nightsleep with up to 2 nightfeedings.

6/7 months: Babies still need 3 naps at this age and most stay on a 3 nap schedule until 8/9 months of age.  Naps should be ending by 5:00pm with bedtime happening 2.25-2.75 hours after the last nap ends.  So a bedtime of no later than 7:45pm is age-appropriate.

8/9 months: This is the age where most babies will drop their 3rd nap and move to a 2 nap schedule.  This nap transition also means that we want to use a super early bedtime on the days where we can't fit in a 3rd nap or baby refuses it entirely.  Do not be afraid of putting your child down to bed as early as 4:45pm.  This does not mean that baby will be up at 4:00 in the morning!  Remember, less daysleep = more nightsleep.  You have just lost an entire sleep period so baby will need to make up for this loss of sleep during the night.  Our goal with babies younger than 9 months of age is to protect nightsleep at all costs.  There is no advantage to a late catnap and thus a later bedtime if baby is up every 3-4 hours at night crying.  All naps should be ending by 4:00pm with bedtime occurring 3-3.75 hours after the last nap ends.  This means a bedtime no later than 7:30/7:45pm.

10-18 months: This section is for babies within this age range but still on 2 naps.  Most babies keep 2 naps until 13-18 months, with the average being 15 months.  Do not be too quick to drop that second nap as the longer we can hold off this transition, the smoother it will be.  Again, all naps should be ending by 4:00pm with bedtime happening between 3-4 hours after the last nap ends.  Note: we would want to use the lower end of that range for younger babies closer to 10-12 months.  As well, as we approach the 2-1 nap transition the afternoon nap may shrink and become less restful.  This means that you will want to shorten the time between this nap and bedtime as well to keep baby well-rested.  Bedtime should be no later than 7:00-8:00pm.  If you are finding that baby starts to wake frequently at night or earlier in the morning than usual, try scaling back bedtime even more, possibly to even 2.5-3 hours after the last nap ends.  This is a normal pattern as we get closer to dropping the second nap.

13-18 months: This section is for babies who have transitioned to 1 nap.  At the beginning of the transition, the stretch between nap and bedtime will be longer as we push the morning nap later and later.  Once the one nap is solidly occurring around 12:30pm, we would want bedtime to be occurring about 4.5-5 hours after the nap ends.  The 1 nap should be ending by 3:00-3:30pm.

19 months-3/4 years: Baby's one nap will be well-established and consistent at this point and should be occurring around 12:30-1:30pm every single day.  Most children keep one nap until 3 years of age or beyond.  At this point we still do not want to be using a set bedtime, and instead bedtime should occur 4.5-5 hours after the nap ends.  The nap should always be ending by 3:00-3:30pm or even earlier if you are finding that the nap is pushing bedtime too late.  You may have to start waking the child up at 3:00 to maintain a bedtime of around 8:00pm.  It is normal for bedtime to become later the longer the child keeps their nap.  

3 years and beyond: This is the average age when kids drop their last nap.  Even though your child is not napping anymore, it is very important that you still institute a mid-afternoon quiet time to help your child regroup and recharge for the day.  If you notice that your child has a fussy time around 2-4pm, that is when they should be in their bedroom for 45 minutes of quiet time.  Now that your child is no longer napping, we will want to establish a consistent bedtime.  In order to find the ideal bedtime at this age, we must keep in mind the total sleep requirements of children.  At 3-5 years of age, children still need 10-12 hours of sleep every single day.  So, if your child wakes up at 7:00am, they need to be asleep for the night between 6:00-9:00pm.  Experiment with the bedtime and if you notice it is very difficult to get your child to sleep at 8:00pm, move the bedtime earlier as it is likely you are missing their optimal sleep window and they are overtired by that point.  As well, what is their mood like during the day?  That is the most important indication of whether a preschool/school-aged child is getting enough sleep.  Do they have a short attention span, or are irritable, moody, cranky, or extra defiant?  Try moving that bedtime earlier to see if it helps.

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It can seem daunting to move your child's bedtime earlier when previously they were going to sleep much later but it is very important in order to ensure good quality, healthy, and restorative  nightsleep.  Make sure that if you are working to move the bedtime earlier, that you have a consistent and soothing bedtime routine in place to signal to the child that this is in fact bedtime and not another nap.  At the beginning, you may want to do a bath every single night as this is often a surefire cue to babies that bedtime is impending.  A lot of parents may complain that their spouse will never see the baby if bedtime is so early but if baby was previously sleeping in because of the late bedtime, then the other parent may get an opportunity to see baby in the morning once baby's wake-up time moves earlier and to a more 'natural' time.  Unfortunately, babies very rarely fit into our schedules as their sleep needs are just so high, but there is not much for a baby that is more important than healthy sleep (well, food maybe!) 

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Pam Edwards is a Certified Infant & Child Sleep Consultant and founder of Wee Bee Dreaming Pediatric Sleep Consulting, now based out of Kamloops, B.C. Healthy sleep is addicting and she has made it her life mission to help families all across the world get the sleep they deserve - a good night's sleep doesn't have to be a dream!