{     Offering the Best Childhood Preparation for Social and Academic Success.     }

Posts Tagged ‘Sleep’

Turn off the tech early so kids get a great night’s sleep

download (13).png

CHILDREN’S tech obsession can be hard enough for parents to deal with during the day – but new evidence suggests they should be concerned about the effect it’s having on kids at night too.

Research shows that the 40% of children aged between six and 11 years who use mobile phones, laptops or tablets in the hours before bedtime are getting around 20 minutes less sleep a night than kids who don’t use tech in the run-up to bedtime. So children who use tech before bed every night could end up with a sleep debt of around 121 hours a year.

The research, led by cognitive developmental psychologist Dr Anna Weighall from the University of Sheffield, in conjunction with the University of Leeds and Silentnight, questioned 1,000 parents, and also found that on average, children slept 60 minutes less if technology devices were in the room, compared to those who slept in a tech-free zone.

“Technology can benefit our lives in so many ways,” says Dr Weighall, “but parents need to be aware of the negative impact it can have on children when it comes to sleep.

“The presence of tablets and phones in a child’s bedroom, even if they’re switched off, can leave them feeling unsettled.

“A 20-minute sleep debt may not seem a lot, but if you look at it over a year, or even throughout their childhood years, you begin to see the significant impact of a tech-filled bedtime routine. Having clear rules about the use of technology close to bedtime is a small change that has the potential to make a really big difference to our children’s daily lives.”

When light levels drop in the evening, our circadian timer switches on and stimulates the production of the sleep hormone melatonin, but the use of tech before bed disrupts this natural process, explains Dr Nerina Ramlakhan, Silentnight’s sleep expert.

Dr Ramlakhan says screens on phones and tablets emit blue light which suppresses the production of melatonin and stimulates production of the chemical dopamine, which makes us feel alert.

“By establishing a regular sleep routine, without mobiles or tablets, children will sleep better, perform better at school, and be happier and healthier as a result,” she stresses.

“Concentration and the ability to learn can be severely affected by lack of sleep, so I urge children and parents to put down technology at least 90 minutes before bedtime.”

The research also showed one in 10 parents feel unable to ensure their child gets the sleep they need. However, child sleep specialist Andrea Grace has these tips to help school-age children get a good night’s sleep: TEN LITTLE STEPS TO THE LAND OF NOD SCREENS OFF. Turn all screens off at least half an hour before bath time and don’t have TVs or computers in the bedroom.

ROUTINE IS VITAL. A consistent bedtime routine will help your child feel safe, and ready to sleep, although Andrea warns that parents with more than one child must be organised.

EARLY HOMEWORK. Try to get homework done well before bedtime. It’s nice to have quiet time together before bed, chatting or reading.

NO STIMULANTS. Avoid fizzy drinks, chocolate or other foods containing stimulants. Encourage your child to have a nourishing evening meal which is rich in carbohydrate and protein.

GIVE THEM A COMFY BED. Make sure your child’s bed and mattress are comfortable, and they have the right amount of bedding for the room temperature.

ATTENTION PLEASE! During the preparation for bed, give your child or children your fullest possible attention, and try not to take telephone calls.

“As well as feeling safe, children need to feel loved in order to sleep well,” explains Andrea, “so show your child how important they are by giving your time, even if that time is being shared with siblings.”


This article was written by Lisa Salmon from Derby Evening Telegraph and was legally licensed through the NewsCred publisher network. Please direct all licensing questions to legal@newscred.com.

Sleep Tight! Sleep Solutions for Preschoolers

download (2).png

When adults experience a particularly stressful day, they have coping strategies in place to wind down before bed.  Some rely on herbal tea, some choose a good book, some get lost in a favorite show, and others pour a glass of wine. 

Did you know that preschoolers are also prone to experiencing stress throughout the day?  The difference is that they don’t necessarily know how to cope with that stress.  When the lights go down, the stress creeps in.

Preschoolers spend a fair amount of time each day engaged in fantasy play.  They get lost in a world of princesses, superheroes, construction sites, and even monsters.  And they truly enjoy every second of it.  Fantasy play gives preschoolers a chance to try on new roles and gain mastery over new, and sometimes scary, information.

But it’s difficult to simply leave it behind.  Cognitively, preschoolers struggle to separate real from imagined dangers.  Just as adults struggle to process the stress of the day, preschoolers are flooded with things they learned at school, on the playground, in books, and on TV.  They can’t just turn off their imaginations the minute the clock strikes seven.

Add to that the fact that somewhere between the ages of 3-4 most kids become aware of the fact that there are real dangers in this world (strangers, cars, dogs, getting lost, etc.) and it’s no wonder some preschoolers struggle to settle down at night.

Not to worry, there are ways to decrease nighttime stress and improve the bedtime transition.

 Establish a routine:  Preschoolers need between 11-14 total hours of sleep per day.  Preschoolers experience less stress when they have some control over their environments and they know what to expect.  Keep the bedtime consistent and create a relaxing bedtime routine that works for you.  Put a sign on the door with pictures of the various steps of the routine so that your preschooler knows exactly what to do each night.

Confront daytime stress:  Not only do preschoolers have their own stressors, but they also pick up on ours.  Factor in 10 minutes at the end of the day to sit and talk about worries and stress.  Label it for them.  Although it seems like they move on quickly, preschoolers are prone to carrying big feelings around.  Help your child verbalize her worries at night to ease into a relaxing bedtime routine. 

Tell a relaxing story:  A great way to ease your child into sleep is to tell a five-minute relaxing story.  Turn out the lights, lie down on the floor next to the bed, and weave a story that helps your child drift off into positive imagery.  It might be a walk on the beach, a picnic in the park, or a trip to a magical garden.  Allow your child to help choose the destination and then tell the story in a quiet voice.

Provide a happy thought:  Many kids worry about having nightmares.  Ironically, worrying about the possibility of nightmares increases the likelihood of nightmares.  Leave your child’s room on a positive by whispering a happy thought in her ear.  “Have a nice dream about fairies”, gives your child positive imagery to hold onto as you leave the room. 

Provide reassurance:  Preschoolers are prone to separation anxiety at night.  It’s lonely in there when the lights go out!  They might fear for their safety or wonder when you will return.  Developmentally, most children don’t understand the concept of time until somewhere between ages 5-6.  Provide reassurance that you will see your child in the morning and you will check on her before you head to bed.  “I can’t wait to play with you tomorrow morning,” reminds your child that sleep is temporary.

Do your preschoolers struggle to get to sleep at night?  What strategies work in your house?


This article was written by EverydayFamily from Everyday Family and was legally licensed through the NewsCred publisher network. Please direct all licensing questions to legal@newscred.com.

How to Get Kids (of Any Age) to Sleep


Getting your baby to sleep through the night is a major win—but it can be just the beginning of an ongoing battle for bedtime. From toddlers fighting lights-out to overscheduled teens racing against the clock, there’s always something stealing kids’—and parents’—rest. Here’s how everyone can get the heck to sleep.

Toddlers (Ages 2 to 4)

The Battle: They’re stalling.

Preschoolers are infamous for delaying bedtime by begging for one more kiss or one more story. It’s one of the many ways they test their parents’ limits. “They know exactly which buttons to push and how much to push them to get their parents’ attention,” says Iqbal Rashid, MD, assistant professor of sleep medicine at UCLA. But stalling reduces lights-out time, meaning less total sleep (which can make your toddler even crankier in the morning) and less time for your child’s brain to convert what he learned that day into a long-term memory. “Your 3-year-old is going to function better at preschool the next day if he’s able to make those neural connections at night,” says Brooke Nalle, a pediatric sleep consultant at the Seleni Institute in New York City.

The Fix: Make a bedtime chart—and stick with it.

A standard routine can reduce the chaos of bedtime: “Repeating the same three or four activities in order every single night will help keep kids on track,” says Jodi Mindell, PhD, professor of psychology at Saint Joseph’s University and associate director of sleep medicine at Children’s Hospital of Philadelphia. Establish the routine with a chart on which you check off tasks like taking a bath, brushing teeth, and reading a story, so when your child asks for a last-minute Lego session, you can kindly point out that—oh, well!—it’s not on the chart. Maggie Strong, a mom of three in Charlottesville, Virginia, has another trick to keep her 3-year-old from stalling endlessly: bedtime passes (index cards decorated with stickers). “One pass is for the bathroom before bed, and one is for a hug,” says Strong. “Once she uses the passes, she can’t leave her bed again.” Bedtime passes can also provide extra motivation for kids to stay put: If they don’t use the passes at night, they can redeem them in the morning for a small treat. That stash of toys from the dollar store will be so worth it.

The Battle: They go to bed but refuse to stay there.

There’s nothing like waking at 2 a.m. to see your toddler peering at you in the dark. Many little escape artists leave their rooms because, suddenly, they can. Blame the independence that comes from moving from a crib to a “big kid” bed. “It takes a high level of development to understand the imaginary boundaries of a bed,” says Mindell. Other kids wake up and can’t fall back asleep without Mom’s help. “Parents tell me, “I have to hold my child’s hand so he can fall asleep, and then he’s up every other hour at night looking for my hand,”” says Nalle.

The Fix: Make them comfy sleeping on their own.

It’s tempting to let your kid crawl into bed with you. “But if you give in, you reinforce that behavior,” says Rashid. Quietly walk your child back to her room. It might take a few painful nights, but it’s important to be consistent, says Rashid. (If she really won’t stay put, you can install a safety gate in her bedroom door to discourage wandering.) Try finishing the night with “sweet talk”—recapping your favorite parts of the day or talking about what you’re looking forward to—“so you end on a positive note,” says Harvey Karp, MD, author of the Happiest Baby on the Block books.

Big Kids (Ages 5 to 10)

The Battle: Your sleep schedules are completely out of sync.

Says Rashid, “Some of us are morning larks, and others are night owls, and sometimes there’s a mismatch in the family.” You might have a third grader who wants to party past 9 p.m. and sleep through breakfast, messing with your “Early to bed, early to rise” motto. Or you might be a night owl, but your kids are cock-a-doodle-doing at 5 a.m., stealing your precious prework shut-eye.

The Fix: Shift the schedule—then keep it consistent.

“You can try to shape their schedule so it’s more in line with yours,” says Nalle. Gradually push back (or bring forward) meals, baths, and bedtime, first by 15 minutes, then 30, then 45, then 60. This can be a month-long process, but it could help oversleepers perk up earlier or buy you an extra hour of z’s in the morning. Some families invest in blackout curtains to shield their kids’ rooms from early-a.m. sun. For kids who might be tempted to bounce on your bed as soon as their eyes open, Mindell suggests putting a night-light on a timer and saying, “When the light switches on, that’s when you can wake us up.” Until then, they can quietly play in their room or watch TV. Once you develop a schedule that works for everyone’s sleep needs, it’s crucial to stick with it, even on weekends, says Nalle. “If kids really want to sleep late, let them do so on Saturday, but by Sunday, return to your regular wake and sleep times.” Exposure to sunlight resets your body clock, so taking a brisk walk on Sunday morning or having breakfast in the sunniest spot in the kitchen should keep everyone on schedule.

The Battle: Their nightmares wake everyone up.

As children get older, “fears can become a big thing,” says Karp. “They start listening to your conversations and hearing the news. They realize there’s an entire world out there.” If they were scared by something they saw on TV, says Rashid, kids can reconstruct it during sleep in the form of nightmares, which usually happen in the late-night-to-early-morning hours. Nightmares are not to be confused with night terrors, which typically happen an hour or so after kids zonk out—though they are frightening to watch, kids usually don’t remember them in the morning.

The Fix: Use night “magic”.

Sleep deprivation and poor-quality sleep are common causes of both nightmares and terrors, so first make sure your child is getting enough rest. Then use creativity to fight the demons. For younger kids, Karp suggests putting “magic” water in a bottle and spraying it at night to keep monsters away. Rashid recommends that older children write down nightmares in a notebook, in as much detail as they can remember, but with alternative, happy endings. For example, if your child dreamed she was drowning, she could write an ending in which she becomes a mermaid. If nightmares are constantly getting in the way of daily functioning, consult your pediatrician to see if something else—like bullying—is going on.

Tweens and Teens

The Battle: They’re over-scheduled and skimping on sleep.

With soccer, debate team, band practice, and dance—not to mention endless homework—it’s no wonder tweens and teens are constantly sleep-deprived. Plus, raging hormones and social stresses, like fitting in with friends and dating, can keep teens up at night. “Anxiety trickles into bedtime,” says Nalle. “Whatever they were carrying around all day suddenly floods their minds.”

The Fix: Hack the routine.

Puberty shifts the internal clock toward a later sleep time, says Rashid. So instead of trying to enforce a too-early bedtime, adjust schedules however you can. One mom drives her daughter to school in the morning rather than waking her for the earlier bus, which gives her daughter an extra 45 minutes of sleep. Others find that if their kids do homework during lunch or even before school, it means they get to bed by 11 p.m. rather than 1 a.m. To de-stress after busy days, teens can try showering 30 to 45 minutes before bed, flipping through a magazine, or doing 10 minutes of meditation (the free Headspace app can help) to clear their minds for better sleep.

The Battle: They’re staying up late, staring at their screens like zombies.

The phenomenon of teens staying up all night watching YouTube and Snapping with their friends has been called “vamping,” as in acting like a nocturnal vampire. The screens themselves add to the problem: The blue light beaming from phones and tablets “is strong enough to block a good chunk of melatonin, the hormone that makes us sleepy,” says Jess P. Shatkin, MD, author of Born to Be Wild: Why Teens Take Risks, and How We Can Help Keep Them Safe. Sleep deprivation is particularly dangerous to teens because it blurs their ability to concentrate, which can lead to risky behaviors like drowsy driving or drug and alcohol use, says Mindell. And a 2017 study in the journal Development Psychology found that children with TVs or video-game consoles in their rooms did worse in school and weighed more.

The Fix: Remove the temptation.

Make it a family rule that everyone’s phones and tablets be put to bed—that is, plugged into a communal charging station—on the kitchen counter at least 30 minutes before lights-out, suggests Mindell. To make sure stealthy teens don’t hide their laptops under the covers, some parents switch off the household Wi-Fi, making it harder to get online. Alyceson Weinfeld- Reyman, a mom of two in New York City, literally takes matters into her own hands: She takes her 16-year-old son’s phone away at 10:30 on weeknights and keeps it in her room so he can’t grab it back.

You can also help wean teens off that sleep-stealing screen glare by enabling the “grayscale” function on Androids and Night Shift mode on iPhones (both found under Settings) and adding the f.lux download to computers. All three reduce blue light, so melatonin is allowed to flow, says Shatkin. To help transition from the digital world to the dream world, encourage bedtime rituals (drinking decaf tea, reading) to prep for sleep. “Bedtime routines aren’t just for toddlers,” says Nalle.


This article was written by Michelle Ruiz Andrews from Real Simple and was legally licensed through the NewsCred publisher network. Please direct all licensing questions to legal@newscred.com.

What To Do When a Child Can’t Fall Asleep


Bedtime can be difficult for everyone, but a parent’s job is really quite simple:  put the child in bed.

The rest of it – the falling asleep part – is all on the child. Although it can be hard when falling asleep is out of your control, there are things you can do to help when your child can’t fall asleep.

Routines are critical

We all know routines are important in life. Routines get athletes ready to perform, they get singers ready for the stage, and they can also help anyone from infant age to adulthood get ready for bed. But it’s not just the snack, bath, and story that is part of an important nightly ritual. You must also consider the daily routine that can affect a child’s ability to fall asleep.

Is he getting enough physical activity during the day? Don’t let weather or a busy schedule be an excuse for avoiding exercise. Get your kids moving whether it’s inside or outside in order to keep their bodies active. Remember how fast they crash after a day at the zoo or amusement park? That can happen every single day if you keep them active, even in moderate amounts.

Is your child getting proper nutrition? You are what you eat isn’t just a saying, it’s reality, so the better the fuel you’re putting into your child’s body, the better it will help him sleep. Similarly, caffeine is a stimulant drug, and should always be avoided when it comes to children.

Start everything earlier

If the nighttime drill lasts long into the evening, there’s no point in ruining your sleep too, so start the process a whole lot earlier. It doesn’t mean you have to publicly announce that everyone’s going to bed earlier, it just means you’re going to get an earlier start on things. If your child doesn’t fall asleep for an hour after leaving the room at 8:00 p.m., maybe you need to leave the room at 7:30 p.m. instead. Find the method that works best for you.

In order to kick all of this off, you may need to shortchange your child some much-needed sleep by waking him earlier in the morning, just until the new system pays off and starts working. It may seem cruel to do so, but getting your child’s body in a better rhythm for a stronger sleep schedule will help everyone in the home. 

Follow your instincts

I’ve read from experts who warn not to sing, snuggle, or coddle children to sleep. But I also know from experience that children sleep better with an adult next to them, so when all else fails and you’re at the end of your rope, do what you think is best for your child. After all, it’s not like you’ll be caving in and holding their hand until they’re asleep when they’re 16 years old.

Your child wants to be comfortable, and you do, too. So you’ll have to find your own proper balance between being firm, being comforting, and not giving in to every whim. Implementing a rewards system might offer just what you need in helping your child long-term.

Before you know it, you’ll all be sleeping like, well, you know.


This article was written by EverydayFamily from Everyday Family and was legally licensed through the NewsCred publisher network. Please direct all licensing questions to legal@newscred.com.

Four Ways to Help Children Fall Asleep

Dr. Kyle Pruett, clinical professor of child psychiatry at Yale School of Medicine and member of The Goddard School Educational Advisory Board, offers four ways to help children fall asleep.twenty20_633d5703-2356-457f-8730-d07b63f9a0d7

  1. Improve the odds of bedtime going smoothly by not starting the lessons until the child reaches four to six months of age. Starting too early will teach your child to cry, not to sleep.
  2. Be patient and give the process time to work. It takes adults an average of 20 minutes to fall asleep, even though we’ve done it thousands of times, and that’s when our sleep hygiene is working reasonably well. Many adults, especially parents, need a bit more time to fall asleep. Keep in mind that children may experience similar challenges.
  3. Some crying is nearly universal at bedtime. Putting your child to bed when already asleep to avoid the crying might cause him to be disoriented when he wakes up in the night, which he will surely do. You’ll be up yet again because he hasn’t learned how to put himself back to sleep, just to cry for you.
  4. Through your routine, children will learn what happens next, so put them down when they get drowsy, sit down near them, using occasional light touch and your voice to soothe when the pacifier pops out and they have to put out the effort to find it, which is just what you want to them to be able to do in the middle of the night. It’s the wise parent who then says goodnight softly and leaves the room. Some crying may ensue, so wait for a few moments beyond what you think you can stand, then go back in briefly to reassure the child (and yourself) in the softest voice and touch you can manage. In a matter of weeks, research reassures us that your small student will be on the path to being able to fall back to sleep on his or her own.

O To Be Dry! On Bedwetting and Kids

Guest Post by Dr. Jack Maypole

Back when I was 4 or 5 years old, my mother was baffled by a spatter pattern of stains on my day-glo 1970s era orange plush rug. Day after day, more spots  appeared.  Until late one night, my mother came across me sitting up in bed, apparently still asleep, peeing gloriously across the floor like a lawn sprinkler.  I was not so much a bedwetter as “one who wet from the bed.”

For many children and families, however, bedwetting is no joke. Bedwetting can be a profound bummer, cause of untold stress in a household, source of frustration for parents, and a basis for anxiety or low self esteem in a child.

Bedwetting occurs when someone pees in the bed, presumably while asleep. Bedwetting is deemed ‘enuresis’ (from the Greek, ‘to make water’) when a child aged five years or older repeatedly, and unconsciously, empties their bladder during sleep.  Health care providers will make a distinction between ‘primary enuresis’, for a child who has never achieved regular overnight bladder control, versus ‘secondary enuresis,’ for kids who had nighttime dryness for 6 months or more, but who began wetting the bed for some reason. Both are challenging. I’ll focus on primary enuresis here.

A wee bit of physiology may be helpful before we go, so to speak. By the age of two, children begin to master control of their bladder muscles, allowing them to pee at will when awake.  By the age of four, greater than 98% of children will have achieved daytime dryness. Nighttime dryness develops eventually, and sometimes much later in some kids.  (see the nice table I lifted here:)

%Kids Dry by Day % Kids Dry by Night
2 yrs 25


2.5 yrs



3 yrs



At age four, about a quarter of all children still wet the bed with some regularity. That is a lot of pullups! By 7 years, about 5-10% of kids still have accidents, and that number drops to about 4% by age 10. As a rule, those older, persistent bedwetters will achieve regular bed dryness (i.e. bladder control overnight) at a rate of about 15% per year. Depending on who you are, that can be reassuring…or not. More on that in a bit.

Enuresis happens when a child has a bladder whose capacity cannot keep up with the nighttime urine production.  Ideally, a child awakens from sleep and goes to the loo when they feel Nature’s call. In the majority of cases, kids with enuresis are profoundly deep sleepers. In addition, children with enuresis may  have smaller than usual bladders or slower-to-develop bladder muscles.  Simply, they fail  to rouse from sleep in spite of signals sent to the brain from nerves in the bladder reporting peepee overflow is imminent.

Genetics matter, too.  Lest we wrongly blame our offspring for willfully soaking their bedsheets (which, BTW is almost never the case. Quite the opposite!), note this well. Often, there is a strong inherited correlation between enuresis and other family members having had the problem. Enuresis exists in 44% of children when one of their parents has a history of same. When both parents have such a history, the rates of enuresis in their kids soars to 77% (Compare that to a rate of  15% in kids when neither parent had the problem. Wow!).  Fortunately, even for kids whose relatives did not gain control until later (e.g. middle or even high school) most will respond to treatments and interventions to overcome the problem.

Take home point #1: the vast majority of bedwetting kids are physically and psychologically normal.  Less than one percent of children with nighttime enuresis have some sort of anatomic, physical, or systemic disease or condition.  Better yet, many of these children and families can manage the challenge competently in tandem with their child’s primary care provider.

What to do?

Whenever I get a question or query about enuresis –be it from a weary parent, a bewildered first grader, or a frustrated tween–It is key to treat the topic with respect, and to provide a family with some perspective. Namely, that this is an embarrassing but surmountable problem, and that it is incredibly common (to the tune of some 5-7 million children in the U.S. Or, ask Sarah Silverman).  Even simple reassurance can provide some relief.

Further, research and my experience confirm that kids and families do better when the issue is addressed by engaging the child and assessing her goals and concerns (versus talking over her head while she sits in a room). A healthy four year old who wets the bed may not require extensive intervention (yet), but may do well with reassurance and a few behavioral approaches (see below). An eight year old, by contrast, may be desperate to stop bedwetting yesterday, and be unwilling or unable to sleep over at friends houses or to go to sleep away camp . For school age kids, for example, it’s best to have sibs step out of the room for a second, and then, have a conversation. Enuresis is a tender, private subject.  Teasing probably isn’t a good idea. Humor needs to be used delicately. I can’t say that enough.

As one author aptly writes, it can be helpful for kids to think of achieving nighttime bladder control as analogous to riding a bike. Coaching, persistence, positive reinforcement and a good attitude (by all!) will get you there…eventually, with reassurance and support along the way.

The Ins and outs

To evaluate a child with enuresis, it all starts with a thorough history. Each child needs to be considered individually on the basis of their age, development, medical and family history, and lifestyle.  A clinician and family will need to review a variety of questions about a bedwetting child’s behavior, possible medication use, daily routines, food and fluid intake as well as voiding and stooling patterns.  Certain medical conditions, such as diabetes, seizures sleep apnea or known sleep disorders may exacerbate or trigger bedwetting and require additional evaluation and collaboration with a specialist.

Constipation bears special mention here, as backed up poop in the large intestine can be a trigger for poor bladder control. For many families, a constipation plan needs to be built in to an enuresis plan from the start. You gotta be regular to be dry.

Life of Pee

A diary of a child’s fluid intake and output done over a week or two can be quite illuminating. Some children tend to drink very little over a school day, and thus arrive home thirsty. Hydrating from late afternoon to bedtime can put quite a load on the system, and can be a setup for nighttime accidents.  Further, parents should record their observations about when kids have accidents at night (once? more than once? early or late?).  This input may assist in shaping which/when interventions work best.

A primary provider can perform a complete physical exam and recommend any testing accordingly. For most cases, a simple urinalysis will suffice while ruling out most concerns for badness (including diabetes, or urinary tract infections).  Imaging, such as obtaining ultrasounds or Xrays, is rarely needed.

Round One of interventions for all children with enuresis is a combination of examining daytime drinking patters, applying pre-bedtime fluid restriction and scheduled bladder emptying. Put simply: 1) children should be encouraged to drink consistently over a day; 2) last call for a child for a beverage should be 60 minutes or more before bedtime; 3) there should be two pre-night-night toilet trips, at 30 minutes before sleep and just before sleep. An emptier tank helps!

Along the way, remember two truths for all children with enuresis. Positive reinforcement works.  And, punishment and anger have no place as they can sabotage a child on many levels. Period.  Families find more success when they recognize adherence to the Dryness Plan with smaller, more frequent rewards. Only getting a prize for a dry night can take a while! Kids can be praised or receive simple treats if they do a good job with adjusting their fluid intake, or hitting the bathroom as requested. Certainly, dry nights should be recognized accordingly. Conversely, setbacks are commonplace and are to be expected. Despair not! Parents have to be on-board, engaged, and consistent. Kids can’t be expected to do this alone. Optimism, support, and a can-do attitude will go much farther. It’s not easy, and it requires teamwork.

Creativity and practicality help, too. Some parents find double sheeting the bed helps for middle of the night wetting events. Placement of absorbent padding on the top sheet allows for quick removal in case of an accident, and avoids the need to remake the bed in the dark.

For children ages 6-7 with enuresis, so-called ‘dry-bed’ training may be helpful.  By tracking when accidents occur, parents can try using alarms at night to do overnight trips to the bathroom.  Kiddos do not have to be fully awake to pee (but just enough to aim at the toilet, of course). Over time and in some instances, this technique trains children to rouse to the signal of their need to go.  The downside of this approach? Some kids (and their parents) feel underslept the next day.

For children 7 and older, additional means may be necessary. Enuresis alarms, such as the unfortunately named  Potty Pager, function by vibrating or beeping when a sensor is triggered by wetness in a child’s underwear.  Alarms that beep seem to rouse kids better than those that simply vibrate. The alarms can be expensive (a hundred bucks, or more), and only some are covered by some insurance. But, alarms do work and parents can review options with their child’s primary care doc.

Take home point #2: Over a couple of months, enuresis alarms can be effective in 2/3 of children 7 and up who use it, and about 1/2 stay dry when they stop using it.  Hence, alarms may need to be reapplied for kids who resume bedwetting for retraining (don’t throw them away!).

Medication may be an option for the Over 7s who do not respond to the above interventions, and/or who may use meds for special occasions.  Medications do not ‘cure’ enuresis, but enhance the ability of the bladder to retain urine while they are in use.  Consequently, kids may have bladder control on meds, and return to having accidents when they discontinue them.  And, parents need to review with their child’s provider the potential side effects and set up a plan to monitor their use if they opt to use them.  I recommend using combination of medications and bedwetting alarms when done with support with a consulting provider.  Some children use medications episodically, such as during sleepovers or time away at camp. This may allow kids who have grown self conscious or isolated to normalize their lifestyle and regain some confidence.

And so, here’s to pleasant dreams, dry nights, and persistence. Raise your glass and toast to hanging in there, but don’t drink your beverage within 60 minutes of bedtime, please.

Your Preschooler and Sleep

Sleep troubles are among parents’ most exasperating experiences with their preschoolers. There are so many considerations in how parents decide to respond when sleep goes off the rails: is this the first child, is the mother or the father more (or less) distressed and do they agree that it is a crisis, the gender of the child (we tend to be more secure in handling kids of the same gender as the parent) and the parents’ sleep habits. There is also a new aspect of sleep that differentiates preschool sleep from toddler sleep: dreams.

Toddlers do dream, but for preschoolers, because of their exploding language and imaginations, dreams are more interesting and powerful and can wreak havoc on a previously good sleeper. When I hear of a sudden deterioration in sleep, dreams are my first suspect. If that’s the case, the child may fall asleep okay, but erupt in the second half of the night.  The child will need reassurance that the dream woke her up, is over now, was not real, will not come back and can’t hurt her. If the child is fighting sleep from the beginning, it is still good to check if the child is afraid to sleep because of dreams. Otherwise, it’s more likely a separation issue (perhaps triggered by something in the family’s life). Then, the parents are in for a tough time of re-structuring calming pre-sleep rituals (reading stories and face massages are good), insisting on the five-minute ‘sit with you’ rule (use a timer), reassuring the child that they’ll be fine and a few sleepless nights of walking them (in a calm, boring way with few words) back to their bed, taking turns if it burns one parent out. I discuss this in greater detail in my book, Partnership Parenting, and there is always your pediatrician to help if these measures aren’t sufficient.

Milestones Matter: From Crib to Bed

Generally, the goal is to keep your toddler in a crib as long as possible. You’ll know it’s time to transfer them to a bed when they become persistent in trying to climb out of their crib, are simply too big or too active or are beginning night time potty training. By three years old, most children have made the transition. Once they are potty training they will need to be able to access the bathroom. Children rely on routine and rituals, so any major shift can be difficult—don’t rush into this change before it becomes necessary. Although crib climbing and toddler escape artists can be cause for alarm, so is the idea of a roaming toddler during the middle of the night.

When you decide the time is right for your child, place the new bed in the same place their crib was. If possible, include your child in the selection of their new bed or bedding. Add to the excitement by encouraging your child to show off their “big kid bed” to friends and family members. Some children are very attached to their crib while others readily adjust to the change. Be considerate of all the pressures your child is facing at this stage to “grow up,” and how those feelings may play into their reaction during this transition.

Don’t automatically give up if your little one has trouble adjusting. Persuade your child to give the new bed a chance. If you feel that the switch was too soon, try bed rails or encourage your child to select a new “lovey” to snuggle up with in the “big kid bed.” Give this transition several nights’ tries. In extreme cases, you may have to take a step back and try again later without presenting it as a failure or punishment.

Sleeping Through the Night

A good night’s sleep is essential for both you and your baby.  The sooner your little one is sleeping well through the night, the sooner you can return to a beneficial sleep routine as well.

Newborns tend to wake frequently during the night until they reach about three months of age.  This is when most babies begin to sleep for longer periods of time and develop a regular sleep pattern.  By six months of age, most babies are able to sleep through the night, which can be anywhere from five hours on.

To help your baby reach the “sleeping through the night” goal, be sure to establish consistent bedtime and naptimes.  Also, develop a bedtime routine that will be repeated in the same order, at the same time each night.  Consistency is the key in helping your baby develop a healthy sleep pattern.  Find appropriate activities for your baby’s bedtime routine that will help her become calm and relaxed. If a certain activity, such as bathing, seems to be too stimulating, consider moving that activity to another time of day.

It’s also okay to wake your baby in the morning or rouse her from a nap if she is sleeping longer than you would like.  This will help her establish a healthy sleep schedule and to wake at the same time each day.

Putting your baby down to sleep when she shows signs of drowsiness, but is not yet asleep, will help her learn to fall asleep independently.  This is advantageous to helping her fall back to sleep if or when she wakes during the night.  Rather than crying for you to hold or feed her, she’ll be able to quietly fall back to sleep on her own.

Don’t be discouraged if these techniques take a while to work or don’t work for your baby.  Each baby’s needs are different and there are various sleep training techniques available.  Consult your baby’s doctor for other suggestions and remember to remain positive and consistent.

Sleep Patterns in Children

Children’s sleep issues are among the more challenging developmental stages for parents to master.  But biology is on the parents’ side in this one, because sleep patterns mature over time just like other developmental skills.

  • Polls tell us that one-third of American children and their parents sleep together some or most of the time before children start school. Co-sleeping varies hugely by culture and ethnicity. So think about what you want to do, and discuss the pros and cons with your pediatrician.
  • Make sure your crib is safe (locking rails), that your older child’s ‘big bed’ has side rails, and if you are co-sleeping, that there is plenty of room.
  • The human brain is active during sleep, but the deepest sleep is typically at the beginning of the night.  Babies spend more time than older children in stimulating REM sleep, with eye movements and irregular breathing. Don’t worry about all that action in your child’s body – it too is growth.
  • Start them young – do not ignore the importance of naps, watch for the yawn, and start bedtime early in the evening.
  • The transition from crib to bed is also a time of sleep pattern changes, but most kids want it to work.
  • To instill good sleep habits remember that consistency matters so much:
    • Bath Time
    • Goodnights
    • Tuck and Talk Bedtime Story
    • Lullabye (yours are best)
    • Goodnights

This all sounds well and good, but it is a rare family that hasn’t had to handle some sleep trouble along the way.  If your family is trying to re-establish a lapsed routine, stay calm and reassuring.  We almost all need more sleep than we get, and it is a tremendous gift to our children to teach them how to sleep well.