How To Get Kids to Sleep Through the Night

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Even though I am a surgeon and not a pediatrician, I often ask the parents and caretakers of my patients if their kids sleep through the night. As one would predict, often parents of toddlers and preschool aged kids immediately tell me how “exhausted” they are because their little ones wake every night!

The reason I ask if a child sleeps through the night is because medically healthy children should sleep through the night when they are not acutely ill, coughing, with a fever, ear infection, experiencing a GI bug/diarrhea/vomiting, etc.

If a pretty healthy kid is waking up most nights, then I know to ask more questions to find out why. First, young children who always have a stuffy nose, congestion, and a runny nose, are most likely the ones that also have poor sleep and wake in the night. These same children may have all those nose problems because they have the "Milk and Cookie Disease" Disease” or MCD: too much dairy and/or sugar in their daily habits, and of course, drinking milk close to bedtime every night, leading to acid reflux, nasal congestion and cough, all of which interferes with normal easy breathing through the nose and causes sleep disturbance. 

Most toddlers are allowed and in fact given milk at bedtime as a routine that parents simply carry over into the second year of life, even though the American Academy of Pediatrics and the American Dental Association recommend stopping this routine, because of the risk of cavities.

After asking thousands of parents why they still allow their kids to drink milk at bedtime, the answers are usually always the same:

  1. My kid loves and wants their milk before bed.
  2. Milk is good for you!
  3. If my toddler wakes at night and cries, he/she must be hungry so I give them more milk.
  4. But he/she is my “baby,” and loves his/her bottle. I don’t want to make my child cry.
  5. I know I should stop but I don’t want to be the mean one.

You get the picture. During the first year of life, no question that when babies wake and cry, they likely need to be fed, by nursing or bottle 

Some parents are blessed with those lovely babies and toddlers that sleep all nightThen there are those of us who struggle. 

I stopped nursing Claire around 10 months and giving her a bottle at bedtime after 12 months. She was a great sleeper if we kept to her routine of consistent nap times during the day and bedtime in the early evening. After 12 months, we used the "Ferber Method to train her to sleep all night, and I stopped feeding her, even if she woke in the middle of the night and cried. I will save some fun and challenging stories about sleep training for another blog.

What I have learned is that when toddlers wake in the middle of the night, many parents give them a bottle. It is not unusual that these children would quickly drink 6-8 ounces of whole milk in the middle of the night, probably drink the bottle laying down, then fall back asleep. 

Of course anyone who has ever been woken up in the middle of the night has only one goal—to get back to sleep! So it’s is absolutely normal for us as adults to do whatever necessary in a short amount of time to get a crying toddler back to sleep. Unfortunately, having a stomach full of milk may lead to acid reflux, more congestion, runny nose and coughing, which then wakes the child again.

Often parents confirm that a child may wake 2-3 times per night, and I can’t tell you how many parents are grateful to me once they get to sleep through the night again, simply by stopping bedtime milk. 

Once the milk is in the stomach, it changes from neural pH to a highly acidic liquid as it warms to our body temperature. By the way, not only does this cause a runny nose, cough, congestion and wakes your child, many kids wake up with sour/nasty/bad breath! 

What is really helpful long term is to train and teach young toddlers to “self sooth” and learn how to fall asleep from an awake state, like all humans do, instead of relying on “sucking” to fall asleep. Many children use pacifiers, which is fine if you choose to do so. I have never woken up in the middle of the night hungry, and while I have heard adults describe that, and even met parents who state they find their school aged children up in the dark eating or snacking, this is quite rare and should be discouraged.  

If the nose is stuffy, PLEASE USE A HUMIDIFIER OR DIFFUSER in your child’s bedroom every night and add essential oils if you want to be “fancy.” Having the air conditioning or heat on, and given climate change and recent record breaking “cold” weather across the northern hemisphere, the nose will be stuffy as long as there is not enough humidity. 

If your child wakes frequently due to choking, snoring, or gasping for air from loud snoring or pauses, please talk to your pediatrician, check to see if your child has huge tonsils, and ask if you should be given a referral to an ENT or a pediatric ENT.

Additional factors that interfere with sleep include too much sugar, too much screen time, not having a regular sleep schedule, lack of daylight or physical activity, a room that is too hot, iron deficiency causing restless leg, obstructive sleep apnea, drinking too much liquid and bed wetting, and others. A sleep study can be done to assess children for possible sleep disordered breathing or obstructive sleep apnea. 

To have a healthy child and support normal development, we must help them get high quality sleep which requires both enough sleep time and uninterrupted sleep without waking frequently.

May you and your child have sweet dreams tonight!

Revised from: When Toddlers Wake at Night.

MCD Sleep

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