Strategies to improve kids’ sleep

When a child’s sleep is off, the entire household feels it. Here, a CHOC pediatrician offers advice for parents on how to get a child back on track and improve their sleep – so the whole house can rest easy.

What is a normal amount of sleep for babies and children?

While every child of every age is different, Dr. Priya Mody, a pediatrician in the CHOC Primary Care Network, breaks down how much sleep is recommended for what age:

How can I create a sleep schedule for my child?

Here is a blueprint for a sleep routine for toddlers and older children:

• Newborns don’t have a set night or day schedule for the first few weeks of life. It’s best for a newborn not to sleep longer than five hours at a time in the first five to six weeks, as their small bodies need frequent feedings.
• Older babies and children should have a consistent nap time and bedtime schedule.
• Start with a quiet time, such as listening to soft music or reading a book, 20 to 30 minutes before bedtime. Put away any screens during quiet time. This means no TV, smartphones, tablets or computers.
• Set a time limit for quiet time and the routine so it doesn’t drag on and your child knows what to expect before bedtime.
• After quiet time, follow a bedtime routine, such as a diaper change, going to the bathroom and brushing teeth.
• Help get the child into bed while awake. This is important so they learn to fall asleep themselves.
• Say goodnight, turn off the light and leave the room.

Security objects, such as a special blanket or stuffed animal, can be part of the bedtime routine. Parents ought to avoid putting babies to bed with a bottle, as it can cause tooth decay and ear infections.

What can I do when my toddler resists sleep?

Children can easily fall into bedtime habits that are not always healthy. These suggestions from Dr. Mody can help when a toddler or smaller child doesn’t want to go to bed or is having trouble staying in bed:

• If the child cries, speak calmly and reassure them, “You are fine. It’s time to go to sleep.” Then leave the room.
• Don’t give a bottle or pick up your child.
• Stretch out the time between trips to the bedroom if the child continues. Don’t do anything but talk calmly and leave.
• The child will calm down and go to sleep if parents stick to this routine. It may take several nights for the child to get used to the new plan.
• If the child is used to getting a large amount of milk right at bedtime, start to cut down the amount of milk in the bottle by ½ to 1 ounce each night until the bottle is empty. Then take it away completely.
• Sometimes children get out of their routine of night sleeping because of an illness or travel. Quickly return to good sleep habits when things are back to normal.

How can I help an older child who is resisting sleep?

Sometimes older children go through a stage when they revert back to bad sleep habits or develop new problems in going to sleep. Here are some tips from Dr. Mody to help parents with older children who have problems going to bed:

• If the child gets out of bed, take them back to bed with a warning that the door will be shut (not locked) for one or two minutes if they get out of bed.
• If the child stays in bed, the door stays open. If your child gets out of bed, the door is closed for two minutes. The child can understand that they have control of keeping the door open by staying in bed.
• If the child gets out again, shut the door for three to five minutes (no more than five minutes).
• Be consistent. Put the child back in bed each time they get out of bed.
• When the child stays in bed, open the door and give them praise. For example, say, “You’re doing a great job staying in bed. Sweet dreams!”
• The child can be rewarded by earning a star on a calendar for staying in bed all night. Parents might consider giving them a special prize when a certain number of stars is earned.

How can I reset my child’s sleep schedule?

If the child’s current bedtime is too late, move it 15 minutes earlier each night until reaching the desired bedtime, Dr. Mody recommends.

Tuck sleep resisters back into their own beds, promptly and repeatedly, until they get the message that they are expected to get to sleep on their own.

What other measures can help improve sleep?

Here are a few other steps to take to help ensure sleep success:

• Unplug the bedroom. Turn off TVs, computers and cell phones. Better yet, keep such things out of the bedroom, which should be a stimulation-free zone.
• Set a wind-down routine. Start the transition to sleep with dimmed lights and a warm bath, and end with reading a book. Don’t watch TV just before bedtime.
• Go decaf. Drinking any caffeine during the day can affect sound sleep. Remember that caffeine is found not just in coffee and soda, but also in tea and chocolate.
• Reduce daytime stimulation. Overbooked kids who rush from band practice to dance class to dinner to homework may be too keyed up at bedtime to unwind..

If, despite these measures, the child still resists bedtime, has nighttime awakenings or snores, parents ought to consult with the pediatrician, Dr. Mody recommends.

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