17 month old toddler never slept thru the night ...

by Tanya
(Calgary, Ab, Canada)

Question: Hi, my son is 17 months old and has never been a good sleeper. in the last two months, it has gotten a lot worse! he wakes every 45 minutes to every hour and a half. it is very rare that he sleeps for more then 2 hours at a time.

i had to switch him to a toddle bed last week because he tried to climb out of his crib. he is not sleeping better or worse since the bed switch. he eats great during the day, and naps one hour and a half nap during the day. he has a good routine at night, but even if it differs it makes no difference.

i have tried to take his nap away, and that makes life even worse! i have tried super lazy days and very active days, the active days are the worst! he cries and stays up all night!?

he still has a bottle at night, only for bed and nap times. i have tried to take it away and he gets very dehydrated as he will not drink anything! so the bottle stays for now... i have tried water in the bottle and he screams!!! then he also wont drink anything, milk included. he has never been a soother baby, he like to play with them but wont suck on them.

he is a very happy boy during the day, and i cant seem to figure out what the problem is. we have tried some homeopathic calmers for babies and they help while he is on them, but as with all medicines you can only use them for so long. we have talked to his ped about this and he seems to just want to medicate him and not find the problem, and i am not comfortable with that. i am 12 weeks pregnant with my second baby, and really would love to get a good sleep. please help!! thanks! Tanya

Heidi's Answer: Hi Tanya, What you mention about lazy and active days - very good idea of you to have tried that! - and the fact that the active days are the worst will be our first hint. He may simply be a child who needs to be very well rested before sleeping well.

On the other hand, you say that he is a very happy boy during the day. This does not point to him being overtired. But it can be his happy/good way to be able to cope with the overtiredness.

Combined with the need to be far from tired to sleep well, there is often the need for strict regularity (which you may have).

So, the first thing to do is to fine tune his schedule a bit to make sure it's his best fit. You don't mention all details of the schedule so you may already be doing part of what I suggest:

Is the nap at a set time during the day? Is his bedtime at a set time?

Either way, start with choosing a set bedtime which is not too late. Anything between 6.30-7.30pm suits most toddlers at this age. Even if he doesn't seem too tired when it gets later, if you manage to get him to sleep by then, that is good.

The nap of 1,5 hour yu have is good. I'm supposing it is in early afternoon, maybe around 1-2pm?

Have you tried squeezing in a short nap mid-morning?

If a mid-morning nap sounds out of the question ('no way you will get him to sleep then') then leave it out. But then have his afternoon nap a bit earlier, and choose the earliest night time bedtime you can.

Otherwise, do have him take a quick nap around 10am. Then nap at 2pm and night at 7pm.

Remember, I am giving you these times as indications, not absolute numbers. You still have to adapt to your own schedule and to what feels right for your son. The bottom line is that he goes to bed early at night, long before being over-tired.

OK to leave the bottle in for now. But, do try to dilute it gradually. He won't take water, but maybe he will have milk that is diluted. Add just a tiny bit of water at first and only add a bit more after a good couple of days.

At the same time, up his food and drink uptake, spread during the day when possible. That will help avoid the dehydration if he drinks less at bedtime and also any hunger that make the milk more important to him.

More than food, these bottles are now more an important part of the bedtime routine. Which isn't horrible, it's good to have positive sleep associations.

But, thinking of his teeth for example and to avoid keeping/developing a hunger feeling at bedtime, it will also be good to wean from them. But no hurry, as we said, the bottle stays for now. Diluting gradually will help and also this: introduce a new activity in your bedtime routine.

It should be something he likes very much, something that will replace his bottle in a while.

This can be cuddling up with you in the sofa for a book. Sit down together on his bed for a few songs, you sing or put on a CD together. Look at some pictures of family or friends. You perform a (short, quiet) puppet show ... just think of a special thing you can add, fun for both of you, that you can always do in the same place, doesn't take too long, ...

Then make the bottle a 'quick duty to get over with' without giving it much attention. Then draw all attention to the new bedtime activity.

So this schedule and bedtime routine are the two main action points for now.

Besides that, check for any hidden causes of his waking up, sometimes simple things as being too hot or too cold, a wet diaper, teething, too much noise (street/neighbors), too much or too little light, ...

And also, could he be going through a separation anxiety phase? Maybe that's what triggered the sleep getting worse two months ago? See if you recognize the daytime signals.

Let me know how this all goes to start with (just post a comment below).

You haven't mentioned how he wakes up. Does he call out for you or cry straight away? Or is he awake but quiet? This will also help me advise further on the awakenings.

In any case, you will want to consistently keep the awakenings as short as possible, switch on no extra light, he does not leave his room and keep interaction as minimal and boring as possible.

And put him down in the same way as when he first goes down (except for the bottle). If you usually put him down asleep, you can work on gradually putting him down less and less deeply asleep.

And lastly, if you know more or less when he will wake (or keep a log of all his awake times for a couple of days) you can go to him 5 minutes before you expect him to wake. Be very quiet, gently grab his hand, or place your hand on his tummy ... whatever you know comforts him.

This way you may be able to help him sleep through that awake moment. Or at least keep the awakening minimal. This will not always work and probably not from the first time but with practice this can become very efficient.

For full details on each technique and an overall approach to sleeping through, you may find my No-Tears Sleeping Through the Night guide useful.

Good luck,
Kindly,
Heidi