My almost two year old wakes up every night and bangs his head.

by Anne
(Oregon)

Question: My almost two-year-old has never been what I would refer to as a "good sleeper". He was sharing a room with his older sister until he was about ten months old so we were a little more indulgent with him about going back to sleep because we didn't want to sacrifice her sleep too.

He wakes up between 1:00 and 2:00 a.m. every night and then again at about 4:00 a.m. and then at 6:00 a.m. We have taken the side off of his bed because he is big enough to get over the rail. It seems to help during nap time for him to get up after his nap instead of yelling for us.

At night sometimes I hear him whimpering or crying a little and if I go in and pull his covers back over him and pat his back he will usually go back to sleep easily however he will also wake fully up and either scream and yell and bang his head against the side of the crib (he's done this since he was around eight months old)or he'll get out of bed and walk over and stop right outside our bedroom door and then bang his forehead on the floor outside of our room and cry. Sometimes he requests milk, sometimes he asks to get in our bed, and sometimes he throws a raging, fit where he doesn't seem to be very awake and he flails his body all over the place and doesn't want to be up or down and there is no real getting through to him.

He will eventually go back to sleep but sometimes it takes up to an hour. We discourage him from sleeping in our bed (we have a double bed and there really isn't room--my husband and I do not sleep well with him in our bed). I end up rocking him in the rocking chair to get him settled down and then put him in his bed but sometimes this is followed by him repetatively getting out of bed. If he doesn't go to sleep before I leave then he tends not to stay in bed.

At about 4:00 a.m. when he comes in we usually allow him to have a glass of milk and he drinks it and goes right back to sleep and usually sleeps until 6:00 a.m. Sometimes he skips the 4:00 a.m. wake up and just wakes up for the 1-2:00 a.m. wake up.

We have a new pediatrician who told me that I should shut him in his room and invest in earplugs but I'm uncomfortable with that idea. He does a lot of head banging when he gets upset and especially at night. This morning he had a big bruise on his cheek and frequently has knobby bruises on his forehead. The same doctor told us to just let him bang his head and walk away because that was a fit behavior and shouldn't be given attention--we aren't going to that doctor anymore, one visit seemed sufficient. Our former pediatrician has moved away but she didn't really have any suggestions either; she said that kids grow out of it.

I would like to get a full night of sleep but I am really writing for my husband's sake because he's really affected by the sleep loss. He said that his left eye has been twitching for 2 weeks and he doesn't know if he's coming or going. He can't function at work because of the lack of sleep--we're at the point where we're not being able to get back to sleep sometimes for an hour after he wakes up.

Our son goes to bed around 8:30 p.m. We have a bedtime routine of a bath, jammies, stories, a white noise machine that plays the ocean sound, a soft blanket that he sleeps on and adequate blankets on top, there is a low-light night-light in the bathroom and we leave his door partially open so he has some light to see. He doesn't have a great deal in his room. He sleeps with a small stuffed animal but honestly he has never had an attachment to a particular animal, toy, blanket, etc. He never used a pacifier and does not suck his thumb. In all honesty I'm not sure that he has any self comfort methods.

Please help us if you can.

Thank you,
Anne

Heidi's Answer: Dear Anne,

I know the head banging is worrisome, but it may be a bit of consolation that it is actually quite common in babies and toddlers, and specifically in boys. About 20% of all children actually head bang. It usually starts somewhere between 6 and 12 months and goes between 2 and 3 years old. Of course, knowing this does not solve your problem but still it is good to realise that your son is not doing something totally weird.

Specialists have a number of possible causes for the head banging:

- self soothing
- asking for attention
- self relieving of pain
- under stimulation or over stimulation
- getting rid of stress or frustration built up during the day (typical in terrible-two temper tantrums)
- a disorder like autism but this is most rarely the case

Often it's a combination of these (except for the last one)

What you write at the end of your question gives us a very important hint:

"In all honesty I'm not sure that he has any self comfort methods."

So the fact that he doesn't use any other self soothing methods, may really point to the fact that he started head banging because the rhytmic motion (very much like being rocked or sitting in a swing or rocking chair, ...) helped him self comfort and relax.

Now that he is clearly into 'terrible twos', it also helps him get more attention during temper tantrums and helps get rid of the frustration of not being able to tell you precisely what he wants or needs (typical cause of tantrums at this age).

The advice your pediatricians have given you - basically to ignore it - is indeed the classical advice that is given. The point of view is then that 'the child' is doing this only to get more attention, pretty much like so many toddlers also typically cry and scream, no getting through to him, flail their bodies on the floor - things you also see - some throw up, some tear up toys, ... when throwing a tantrum. It's 'not fun' to say the least but it is totally normal.

BUT:

- there are more loving and much more efficient ways to deal with this behaviour than simply ignoring. You then make an effort to understand why he's doing it (typical toddler frustration and self soothing and will be able to help accurately)

- when the head banging is excessive and the child harms himself (beyond simple bruises) seriously, then by no means should it be ignored - and a helmet is sometimes prescribed.

---> Continued at Head banging in toddler