18 month old wakin through the night

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18 month old wakin through the night

Postby allisonomar79 » Tue 30 Apr, 2013 9:45 pm

Hi ,
I am having trouble getting my 18 month old to sleep through the night and we are both
Exhausted with the constant waking up. We put my son to bed at between 8-8:30pm,
He settles himself to sleep reasonably well but then he wakes again at 11pm , 1am and 3am
Roughly for milk, we have tried giving him a drink of water instead but this doesn't help and also,
Patting him a bit which helps sometimes to resettle him, but not always. Any ideas?
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Re: 18 month old wakin through the night

Postby NgalaOnline » Wed 01 May, 2013 6:59 pm

Thank you for your post. It sounds as though your son has developed a sleep association with using night time milk feeds to help him fall back into a state of drowsiness or to help him return to sleep when he rouses between sleep cycles. Night time bottles can become a strong sleep association (or a learned way of getting drowsy and falling to sleep) for many toddlers. Removing this sleep association is often quite challenging for the toddler and the parents for a period of around several days to a week. The majority of parents do find, however, that once the night time bottles are stopped that their child's sleep and settling does dramatically improve, and many toddlers will begin sleeping through the full night. Many parents also find that their child's daytime appetite for food will also improve. After a year of age typically children do not require night time feeds for their nutrition. When children have a sleep association that they can not provide for themselves (such as sucking on a bottle to fall back to sleep) it means that they do not know how to rouse briefly between sleep cycles and then resettle themselves into the next cycle of sleep, without calling for their parent to come and provide thing that they associate with falling to sleep. Once this sleep association is removed and the child has learned to do some other soothing things for himself (such as rolling over, sucking his fingers, stroking his hair or his sheets, or cuddling a teddy) the child will be able to briefly rouse in the night and then settle himself back into more sleep without the need to fully rouse and call for you.

There are a number of reasons for which it is a very good idea to stop the night time bottles. Night time bottle feeding in toddlers has been shown to be strongly related to an increased incidence of dental decay, as saliva production (which is the mouth's way of cleansing itself) drops off dramatically during sleep. Bottles cause the milk to be distributed around the teeth in a way that promotes decay and milk contains a lot of natural sugars which bacteria feed off. If a child falls asleep with a bottle in his mouth the milk often remains pooled in parts of the mouth, bathing the teeth in the milk. Bottle feeding whilst lying flat is also linked to an increase in ear infections, as the milk can drain into the child's Eustachian tube. In addition to this, children who consume more than 600ml of cow's milk in 24 hours are found to be at increased risk of iron deficiency anaemia. This results from a number of reasons, one being that calcium is known to inhibit the uptake of iron by the body, and also the fact that children who do consume excess amounts of cow's milk often have a reduced appetite for solid foods. Cow's milk has also been found to cause microscopic amounts of bleeding within the GI tract and this contributes to the iron deficiency anaemia experienced by children who consume more than 600mls of cow's milk per day. Many parents whose children consume a lot of fluid via bottle during the night find that their child will also be more likely to wake due to a very wet nappy. Receiving many calories through night time milk feeds can also condition a child to feel hungry in the night even though they do not truly need these feeds, in the same way that we would begin to develop an appetite in the night time if we got into the habit of waking to have snacks during the night.

It is very likely that the first 3-4 nights of trying to settle and resettle your child during the night without a bottle will be quite challenging and involve not a lot of sleep. Many parents find they have the best success if they can prepare themselves mentally and physically for these initial nights of a new way of settling. Ways of preparing yourself may include waiting until a weekend, resting during the day, reducing other responsibilities during the day at that time, and having some support present to help you with the night time settling. Parents also find it helpful if, when their child rises in the night, if they can get up and dress themselves warmly and then be prepared to remain out of bed until the child has gone back to sleep. Many parents find this to be less frustrating than continually having to get themselves out of bed. This approach will mean you need to be able to have some rest during the day. At 18 months your child is likely to understand more than he is able to verbalise, so it is beneficial to give a brief and simple explanation to your child about what will be happening in the night as you settle him to bed. Some parents will do some sort of ritual with the child about removing the bottles from the house, such as posting them in a letterbox, planting them under a "bottle tree", donating them to a "bottle fairy" or exchanging them in some way for a new toy. On the night you begin this new way of settling, it will also be very beneficial to put your son to bed awake, not have him going to sleep with a bottle at the beginning of the night. After 12 months of age it is best for your child to use a cup or sippy cup during the day, for reasons of dental health and also limiting the amounts of fluids being consumed, and for this reason you might find it best to remove the bottles from the house altogether.

It is very likely that your child will protest for a few nights and feel angry or confused regarding the removal of the bottles. This is normal and understandable. Your child is happy with the current sleep association and has no understanding about why this needs to change. It can be helpful to remind yourself that you are making this change not to be mean, but because you know it will have many positive benefits for your child and your whole family. A lot of the crying that your child may show will be related to the fact that he is feeling tired but does not know how to handle the sensations of tiredness and go back to sleep without the provision of his usual sleep association. Most parents find that the first 3-4 nights are the most challenging, and that the child then begins to settle much easier without any or as much protesting. Usually, if you are able to be consistent, significant change is noticed within a week. It is important to provide a child with comfort and reassurance if he is becoming distressed.

You might find that your child continues to cry and protest at the change during the transition even when you are with him providing reassurance, but persisting through this whilst supporting him can help to bring the change more quickly. If you find that your child is too upset about you leaving the room when he is trying to settle himself, you might find it is less stressful for him (even if he does still cry or protest) if you remain with him. You may like to sit on a chair or on the floor near his cot. He may be soothed by you providing some hands on support such as patting or stroking. If this calms him, you can provide this soothing for several nights, then aim to draw back and stop this hands on soothing over several nights. Other toddlers may be aggravated or stimulated rather than soothed by hands-on settling, and for these children it is helpful if you can just remain as a calm source of reassurance and support near his cot during his time of protesting, until he falls asleep. It is best not to converse with him, give eye contact, or engage in games of lying him down constantly if he keeps standing up. Just remaining nearby, "sssshhhing" and occasionally giving a brief verbal cue such as "sleep time" or "lie down" can help to make the transition less stressful for your child. If your child does stand up repetitively it is best to mainly ignore this and wait for the child to lie himself back down even if this takes a while. You can lie him down after ten or fifteen minutes but if he leaps straight back up again it is best to go back to ignoring it again for a time. It is best to approach these periods of night time resettling with the expectation that the first few times may take as long as an hour or two for your child to go back to sleep, and that this could even occur more than once in the same night. If you are able to persist through though this it is very likely that the protesting periods will reduce and stop within a few days, and that improved night time sleep will follow.

I hope this information is helpful. Please call the helpline if you would like more information or support.
This information is general in nature and should not be used as a substitute for the personalized assistance that can be received from the Ngala Helpline by telephone.

For families residing in Western Australia you can also contact the
Ngala Helpline
Telephone 9368 9368 or 1800 111 546 for country access
Available 7 days a week, 8am to 8pm
or request a callback online http://www.ngala.com.au/Ngala-and-You/Ngala-Helpline/Contact-Ngala-Helpline-Online

For helplines in other Australian states please follow this link
http://www.ngala.com.au/You-and-Your-Family/Web-Based-Resources
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Re: 18 month old wakin through the night

Postby SarahPearl » Mon 20 May, 2013 8:10 am

Hello,
My 18 month old son has been sleeping in a single bed since he was 13 months old. We had no problems at all with the transition either. He has slept through the night since he was 6 months old, but in the last month he has been waking up to 7 times a night. He is really hard to settle too. He freaks out when i leave the room too. He used to sleep in til 7am but now it's a stretch to keep him in bed til 6am. I'm so exhausted. We want to have another baby soon, but I don't think I can be pregnant and getting up so many times in the night.
Please help!
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Re: 18 month old wakin through the night

Postby NgalaOnline » Tue 21 May, 2013 10:17 am

Hi SarahPearl

Thank you for your post. It is quite common for babies and toddlers who were previously sleeping well to experience periods of sleep regression. These periods often come following illness, teething, travel, new developmental milestones or occasionally the emergence of separation anxiety. During times of illness or teething it is common and normal for children to need extra support with sleep and settling. Unfortunately, if the new ways of settling (such as cuddling, feeding, bringing into the parent's bed etc) last more than a few days they will often become a sleep association that the baby continues to wake and seek.

It would be helpful to look at what has changed in the last month, and the way that your baby is now falling to sleep. If he is requiring external associations in order to fall asleep (such as rocking, patting, going into your bed, being given a bottle, or being gotten out of bed) it is likely that he is rousing between sleep cycles when he comes into lighter periods of sleep and expecting the presence of this sleep association in order to be able to fall back to sleep. It also sounds as though he may be experiencing some separation anxiety. Separation anxiety is very common with children around 18 months of age - it is a phase that often lasts around 2 - 3 months. It is likely that he is starting the day before 6am as he is waking frequently between sleep cycles seeking his new sleep association, and often by morning it is very difficult to resettle children if they wake as they have had enough sleep to be able to stay awake. It is likely that if you are able to get him settling and resettling independently again you will find that he may start sleeping for longer again in the morning.

If a child wants to be close to their parent at night one approach that works for some parents is to put a small mattress on the floor next to the parent’s bed and allow the toddler to come and sleep on that mattress during the night if he is seeking proximity. If your child leaves his room during the night and you would not like him to begin sleeping on a mattress in your room, calmly walking him back to his room each time he wakes is a good idea. Some parents find that they are able to stop a child coming continually into their room overnight by putting a baby gate across their child’s doorway and calling out verbal reassurance when their child gets up, however other parents find that this does not work for their family. Sleep associations can often be broken in a period of around a week or so with toddlers if a consistent approach is applied.

Ideally it is best if the baby can come up into their brief awakening between sleep cycles during the night - open their eyes and feel that nothing has changed since they went to sleep and that there is nothing they require to go back into sleep except things that they can do for themselves (such as sucking his fingers, stroking his hair or his sheets, cuddling and animal). If you can identify what you are doing to help your toddler get drowsy or to fall asleep (either at the beginning of the night or during his wakings in the night ) and work towards eliminating this type of settling, it is likely that your child will be able to learn ways of resettling himself without needing to call for you each time he rouses.

It is very likely that removing the current sleep associations will result in a few difficult nights with reduced sleep for you all. Many parents find that the first 3 - 4 nights are the most difficult but that if they can be consistent there is often significant change in settling behaviours by the end of a week. There is likely to be some protesting and it is likely to take quite some time (such as an hour or so) to get your child to go back to sleep during the night, possibly more than once in the same night. It is normal for your baby to protest at the changes, as the current arrangements are working for him and he does not understand why they need to change. A lot of the protesting will also result from the fact that your baby is feeling tired but is unsure what to do with those sensations or how to return to sleep without his usual sleep associations until he is able to learn something soothing he can do for himself.

If you are currently providing in-arms settling out of the cot or providing him with a bottle to fall asleep then it is often helpful to provide a transition period where you give in-cot hands-on settling to help your child learn to fall asleep in his cot with some extra support. This may involve patting, stroking or rubbing him in his cot. After a period of doing this type of settling for a few days to a week you can then begin to slowly withdraw this type of settling over another several days to a week (such as stopping before he is asleep, then just sitting with a still hand on him but not patting, then sitting near his cot without touching him, before moving further away from his cot over several nights). If he is having night time bottles it is best to eliminate them completely at this age. Some children are aggrevated or overstimulated rather than soothed by hands-on settling, and in this instance it may be best to just sit near his cot and "sssshhhh" him and provide him with reassurance through his protesting, rather than touching him. You can tell the baby "shhh" or "sleep time" occasionally but it is best to avoid eye contact, conversation or repetitively lying him down. This sends a message that you are nearby, that he is safe and can go to sleep - but that it is not playtime right now. Once the baby has begun settling well for a few days and you feel his anxiety about settling to sleep has reduced you can then begin moving yourself closer to the door by a metre or so at the beginning of his settling over a period of several days or a week. Once you are in the doorway you can begin making short excursions from the chair which you then begin to extend. Some babies are comforted by their parent calling out to them from the doorway or a nearby room, just so that they know their parent is nearby. This approach does take patience and persistence, but many parents find that if they are able to be consistent it is a successful way of supporting their baby to begin settling and resettling independently which results in improved sleep.


It is best to prepare yourself as much as possible for the first 3-4 nights to be quite challenging. Resting during the day, beginning at a weekend, having support available and reducing other responsibilities at this time helps many parents to get through the first few days. It is also helpful to remind yourself that you are making changes as you feel that improved sleep will benefit your baby and your whole family. If your baby is distressed then it is important to remain nearby and give reassurance, even if he does still cry or protest.

I hope that this information is helpful. Please ring the helpline if you would like more information or support.
This information is general in nature and should not be used as a substitute for the personalized assistance that can be received from the Ngala Helpline by telephone.

For families residing in Western Australia you can also contact the
Ngala Helpline
Telephone 9368 9368 or 1800 111 546 for country access
Available 7 days a week, 8am to 8pm
or request a callback online http://www.ngala.com.au/Ngala-and-You/Ngala-Helpline/Contact-Ngala-Helpline-Online

For helplines in other Australian states please follow this link
http://www.ngala.com.au/You-and-Your-Family/Web-Based-Resources
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