November 2009 Dr. Mama Question
Dear Dr. Mama,
I have a 9 1/2 month old girl who is having a hard time sleeping BY HERSELF. We are guilty of picking her up in the middle of the night and taking her to our bed when she cries out. But now that has turned into an almost every night routine. We’re rocking her to sleep or she will fall asleep on her last bottle. Last night, we put her down about 7:00 and she was up crying 30 minutes later. The end result was Chloe sleeping in the bed with us. What should we do? Cry it out method? We have tried patting her on her back but that just seems to make her more upset. Now that she can stand up it’s even worse. Help!!
Exhausted in El Cajon
Dear Exhausted,
I’ll bet you are! And believe me, Chloe is too. The good news is that you can fix this problem pretty quickly and as soon as you do everyone in your house will be much happier. If you’ll give me 5 days max, we can have your little girl sleeping through the night.
One of the greatest truths I learned in my pediatric training was this: There are two things you can’t force a child to do; eat and sleep. Having said that, you can create good sleep habits and regain your sanity.
First, create a consistent routine. Choose a convenient bedtime and stick to it. For this first training week try to keep your little girl’s life as predictable as possible. Don’t try this when you’re away on vacation, visiting Grandma, or sleeping in the family room because your bedrooms are being painted. You will basically be creating a sleep “habit”, in much the same way you created the up-and-down habit you described. This works best when the environment and routine are familiar and repetitive.
Next, after making sure she’s had a good supper, and giving her a final bedtime bottle, choose a brief, quiet, pre-crib activity like a story or gentle lullaby. This is NOT the time for an active game. (Important note: Don’t put Chloe in the crib with a bottle of formula, or any fluid other than water. Sugars in the milk or juice will remain in her mouth all night, decaying those important first teeth.)
Then, say a gentle goodnight, put her in the crib, and leave the room, closing the door. Yes, very likely she will cry. Loud. She will be shocked at this new turn of events. She’s not used to falling asleep without your help. Now, here comes the hard part: let her cry for 10 minutes. Yes, I said 10 minutes. You will need a watch or a clock for this, because each minute will seem endless. Move away from the door, it will be easier. Go wash the dinner dishes, it will be easier. Do whatever you need to do to tolerate 10 minutes. After 10 minutes, one of two things will happen. Either she will have fallen asleep, or she will still be mad. If you can still hear her crying, go quietly to the door and let her hear your soothing voice. Repeat your goodnights or coo to her for a moment. DO NOT go into the room. Then walk away again for another 10 minutes. Repeat until she falls asleep. The first night this may take up to an hour. Be strong. Remember how long it took to create the old habit. Have confidence that you’re improving your quality of life AND hers.
Later, she may wake up as in the old days. If she does, go to the door, gently reassure her, and close the door. Do not go to her or pick her up. She is fine — she just needs a chance to learn the new rules. Again, let her cry for 10 minutes before reassuring her through the closed door. Repeat until she falls back to sleep. Repeat this step as many times as necessary.
I’ll be honest, this technique is not easy at first. You will want to comfort your little girl. You’ll feel guilty and want to pick her up. You will want to feed her. Keep in mind, you are NOT being selfish. You are teaching her an important skill: putting herself to sleep. Remind yourself that she will be happier and healthier when she is getting a good night’s sleep. It will get easier. By night 2 or 3, she will cry for half the time she did on night 1. By night 5 she will sleep through the night. You have my ‘Dr. Mama guarantee’.
Two important reminders before you start: Your baby must be safe in her crib. Make sure it is a safety approved model and the mattress is lowered to an age-appropriate level. Remove any toys or pillows that could hurt her. Also, you must follow the plan. Leaving out any part of it will sabotage your efforts.
For YOUR family this should work well. In less than a week, you can all look forward to sleeping through the night.
Sweet dreams!
—Dr. Mama
