As a physician I get lots of patients coming into my medical practice with concerns about poor quality sleep, insomnia, and difficulty falling asleep. A lot of these patients are new moms with little ones under the age of 1 at home.
When my daughter Madi was only 11 months old, I was on call at a busy hospital centre, my husband was finishing his last year of Otolaryngology residency as a Chief Resident, and the two of us plus our daughter Madi were beyond exhausted. Before we started sleep training, I did implement a healthy bedtime routine and a structured approach to bed time to help Madi fall asleep. Even with this though, Madi was still waking up every 2-3 hours throughout the night. We decided that for our family, sleep training was a good option to get a good night’s rest all around! I wrote about the misinformation behind sleep training on my medical blog www.lifeofdrmom.com. Sleep training is a personal decision and our family decided to sleep train, but it is totally alright if parents choose not want to sleep train!
If you do want to sleep train, make sure you get the go ahead from you primary care provider and then check out the steps below!
Step 1: Create a Bedtime routine
Creating a bedtime routine for your baby or toddler is very important, regardless if they can fall asleep with or without the use of sleep training techniques. A bedtime routine consists of relaxing and self-care activities that allow the brain to “slow down” making it easier to fall into sleep.
Step 2: Have a consistent Bed Time
Establish a consistent bedtime is very important and helps your bodies natural rhythms (circadian rhythms) sync. When my daughter Madi was 0-18 months, we put her to bed around 7pm. It’s important to stick to the same time every single night. Otherwise, you might disrupt the body’s natural sleep rhythms, which makes it more difficult to get your baby to sleep.
Step 3: Figure out how much time your baby needs to sleep in a day, and schedule your nap times consistently.
When we started our new bed time routine, we considered how much time Madi needed for napping. At 6 months, some infants may require 2 naps while others may require 3 naps. Madi only required 2 naps. The amount of time your baby needs for night time sleep and napping depends on their age. Please see my post on how much sleep your baby needs to help determine this.
Before your child goes to bed, implement your relaxing bedtime routine for 20-30 minutes beforehand. Before your child naps, also try and take 15-20 minutes to do some relaxation strategies to help your child get drowsy and fall asleep.
Step 4: Use positive reinforcement to encourage your child’s healthy sleep practices!
Positive reinforcement is a style of parenting and discipline that has been shown through medical evidence to be very effective and appropriate at all ages. Positive reinforcement can also be used with sleep, but typically with older children. For example, if the child sleeps in their own bed all night they get a sticker in the morning that they can put on their special sticker board. For older children, the reward can be modified to the child’s interest. Make sure your toddler knows that she is behaving positively when she is able to soothe herself to sleep at night.
Step 5: if your child is still having difficulty sleeping, try some of the common sleep training methods.
The most popular sleep training methods including Graduated Extinction, Unmodified Excitation, and Bedtime Fading. Personally, I had success with “Unmodified Extinction” or the “cry it out” method.
To learn more about these techniques check out my blog on sleep training techniques here.
Written by Dr. Stephanie Liu, M.D. M.Sc, wife, Mom, and Blogger at Life of Dr. Mom. Life of Dr. Mom is a health and medical blog designed for the modern mom to provide credible information for moms to help with parenting, and to support families and the healthy development of their children. Doctor Mom works to educate the modern mom with the most relevant up-to-date medical evidence, using her expertise working in women’s health, mental health psychiatry, postnatal care, and pediatrics.