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Quick reference medical handouts used by Pediatric offices


TODDLER WAKING UP AT NIGHT My 15-month old son has recently started waking up at midnight crying. We let him cry for a couple minutes but it distinctly sounds "scared" and when I go to him he clings to me. I can calm down his sobbing pretty easily but then he is wide awake and stays that way for 2-3 hours. This situation is very new. He is always put to bed awake and falls asleep on his own. Up until now, he has been able to get himself back to sleep on his own for the entire 10+ hours. Could this be a new manifestation of separation anxiety? Is this new behavior common in babies his age who have had good sleep habits previously?
    

Thanks for your question.

Waking up at night is fairly common in this age group. The major cause is not being put to sleep awake but being held by one of the parents until the child falls asleep. This does not seem to be the problem in your case. What ever the cause of his waking at night, it is important for everyone in the family that we find a way to get him back on an all-night sleep routine.

Here are some suggestions, courtesy of developmental pediatrician Dr. Barton Schmitt:

  • Continue to provide your son with a pleasant bedtime ritual. However, once he starts to look drowsy, place him in the crib. Your child's last waking memory needs to be of the crib and mattress, not of you. It is important that he can put himself to sleep, so that he can put himself to sleep when he normally wakes up at night.
  • When your child does wake up at night, do not stay in his room longer than one minute. Do not turn on the lights. Keep the visit supportive and reassuring. Act sleepy. Whisper, "Shhh, everyone's sleeping." Add something positive, such as "You're a wonderful boy," or "You're almost asleep." Never show your anger or punish him during these visits. If you hug him, he probably won't let go. Touch your son gently and help him find his security object, such as a doll, stuffed animal, or blanket. Often this goes better if Dad goes in.
  • Do not remove your son from the crib. Do not rock or play with your him or bring him into your bed. Brief contact will not reward your baby enough for him  to want to continue the behavior. Most young children will cry when you leave the room, but then will fall asleep.
  • Help your child attach to a security object. A security (transitional) object is something that helps a waking child go to sleep. It comforts your child and helps your child separate from you. A cuddly stuffed animal, doll, other soft toy, or blanket can be a good security object. Sometimes covering a stuffed animal with one of the mother's T-shirts helps a child accept it. Include the security object whenever you cuddle or rock your child during the day. Also include it in your ritual before bedtime by weaving it into your storytelling. Tuck it into the crib next to your child. Eventually, your child will hold and cuddle the stuffed animal or doll at bedtime in place of you.
  • Go to your son every 20 minutes while he is crying, but make your visits brief and boring. After your child learns to put himself to back sleep, awakening with crying usually stops in a few nights.
  • Don't change wet diapers during the night.  Change the diaper only if it is soiled or you are treating a bad diaper rash. If you must change your child's diaper, use as little light as possible (for example, a flashlight), do it quickly, and don't provide any entertainment. If your child is standing up in the crib at bedtime, you can leave him in that position. Try to get your child to settle down and lie down. If he refuses or pulls himself back up, leave him that way. He can lie down without your help. Encouraging your child to lie down can soon become a game.
  • Consider reducing the length of his afternoon nap.

Good luck.

 

As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.

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