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|Quick reference medical handouts used
by Pediatric offices
Night Awakenings from Holding Until Asleep
The Trained Night Crier
Night Awakenings From Holding Until Asleep
(Trained Night Crier)
Your child is over 4 months old and wakes up and cries one or more
times a night.
The crying occurs most nights.
Your child is held, rocked, or walked until asleep.
Your child doesn't need to be fed in the middle of the night. (Until
the age of 2 or 3 months, most babies need to be fed during the night.)
Your child has awakened and cried at night since birth.
The child's parents are tired, but the child is not.
Holding or rocking your baby until asleep.
All children normally wake up four or five times each night after
dreams. Because they usually do not wake up fully at these times, most children
can get back to sleep by themselves. However, children who have not learned
how to comfort and quiet themselves cry for a parent. If your custom at naps
and bedtime is to hold, rock, or lie down with your baby until asleep, your
child will not learn how to go back to sleep without your help. Babies who
are not usually placed in their cribs while they are still awake expect their
mothers to help them go back to sleep when they wake up at night. Because
they usually fall asleep away from their cribs, they don't learn to associate
the crib and mattress with sleep. This is called poor sleep-onset
Providing entertainment during the night.
Children may awaken and cry more frequently if they realize they
gain from it; for example, if they are walked, rocked, or played with, or
enjoy other lengthy contact with their parents. Being brought to the parents'
bed makes the problem far worse. Trained night crying can also begin after
situations that required the parents to give more nighttime attention to
their baby for a while. Examples of such problems are colds, discomfort during
hot summer nights, or traveling. Many babies quickly settle back into their
previous sleep patterns after such situations. However, some enjoy the nighttime
contact so much that they begin to demand it.
Believing any crying is harmful.
All young children cry when confronted with a change in their schedule
or environment (called normal protest crying). Crying is their only way to
communicate before they are able to talk. Crying for brief periods is not
physically or psychologically harmful. The thousands of hours of attention
and affection you have given your child will easily offset any unhappiness
that may result from changing a bad sleep pattern.
If you try the following recommendations, your child's behavior will
probably improve in 2 weeks. The older your child is, the harder it will
be to change your child's habits. Children over 1 year old will fight sleep
even when they are tired. They will vigorously protest any change and may
cry for hours. However, if you don't take these steps, your child won't start
sleeping through the night until 3 or 4 years of age, when busy daytime schedules
finally exhaust your child.
HELPING A TRAINED NIGHT CRIER
Place your child in the crib drowsy but awake for naps and
It's good to hold babies and to provide pleasant bedtime rituals.
However, when your baby starts to look drowsy, place her in the crib. Your
child's last waking memory needs to be of the crib and mattress, not of you.
If your baby is very fussy, rock her until she settles down or is almost
asleep, but stop before she's fully asleep. She needs to learn to put herself
back to sleep. Your baby needs to develop this skill so she can put himself
back to sleep when he normally wakes up at night.
If your baby is crying at bedtime or naptime, visit your baby briefly
every 5 to 15 minutes.
Visit your baby before she becomes too upset. You may need to check
younger or more sensitive babies every 5 minutes. You be the judge. Gradually
lengthen the time between your visits. Babies cannot learn how to comfort
themselves without some crying. This crying is not harmful.
Make the visits brief and boring but supportive.
Don't stay in your child's room longer than 1 minute. Don't 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
baby," or "You're almost asleep." Never show your anger or punish your baby
during these visits. If you hug him, he probably won't let go. Touch your
baby gently and help him find his security object, such as a doll, stuffed
animal, or blanket.
Do not remove your child from the crib.
Do not rock or play with your toddller or bring her to your bed.
Brief contact will not reward your baby enough for her to want to continue
the behavior. Most young babies cry 30 to 90 minutes and then fall
For crying during the middle of the night, temporarily hold your baby
until she is asleep.
Until your child learns how to put herself to sleep at naps and bedtime,
make the middle-of-the-night awakenings as easy as possible for everyone.
If she doesn't fuss for more than 5 or 10 minutes, respond as you do at bedtime.
Otherwise, take your crying child out of the crib and hold her until she
is asleep. Don't turn on the lights or take her out of the room. Try not
to talk to him very much. Often this goes better if Dad goes in.
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.
Later, phase out the nighttime holding.
Phase out nighttime holding only after your child has learned to
quiet herself and put herself to sleep for naps and at bedtime. Then you
can expect her to put herself back to sleep during normal middle-of-the-night
awakenings. Go to her every 15 minutes while she is crying, but make your
visits brief and boring. After your child learns to put herself to sleep
at bedtime, awakening with crying usually stops in a few nights.
Other helpful hints for sleep problems.
Move the crib to another room.
If the crib is in your bedroom, move it to a separate room. If this
is impossible, cover one of the side rails with a blanket so your baby can't
see you when he wakes up.
Avoid long naps during the day.
If your baby has napped for more than 2 hours, wake her up. If she
has the habit of taking three naps during the day, try to change her habit
to two naps each day.
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.
Keep a sleep diary.
Keep a record of when your baby is awake and asleep. Bring it with
you to your office follow-up visit.
CALL YOUR CHILD'S PHYSICIAN DURING REGULAR HOURS IF:
You think the crying has a physical cause.
Your child acts fearful.
Someone in your family cannot tolerate the crying.
The steps outlined here do not improve your child's sleeping habits
within 2 weeks.
You have other questions or concerns.
Written by B.D. Schmitt, M.D., author of
"Your Child's Health," Bantam Books. Copyright 1999 Clinical Reference
As a reminder, this information should not be relied on as
medical advice and is not intended to replace the advice of your childs pediatrician.
Please read our full disclaimer.