Sleeping FAQ: 18-24 Months – Night Waking

My 18-month-old son rarely sleeps through the night and eats little in the day.

My son only sleeps through the night (he will wake at approx 6am) when he is about to experience a cold or virus (usually 2 days prior). The doctor has stated he is prone to allergies etc, minor illness appears to be quite common approx every 5 weeks.

He wakes on average 3 times per night (Until recently it could be 6/7). He eats very little although quite often. He refuses meat, eats little fruit and veg [I have therefore introduced Innocent smoothies] and has little interest in food in general.

He is an extremely active child, ‘a hard work baby’ as his grandma calls him, rarely sits still, always on the go. He attends nursery 3 afternoons per week (1.30pm – 6pm) and is regarded as the most active child there; others appear sedate in comparison. I work 30 hours per week, childcare is shared with grandma. I always put him down for his morning nap, although two nights per week, grandma completes the bedtime routine: bath, change, bottle, bed approx 7.30pm (this appears to make no difference to his waking night).

On a typical day he will eat a slice of apple,1/4 piece of toast, few mouthfuls of yoghurt, 1/2 slice of bread, 1/2 oz cheese, 4 grapes, 10 organic puffs, slices of orange, sausage roll, raisins, 1/2 slice bread, 1/4 cereal bar, 6 grapes.

He will have an Innocent smoothie made with 4ozs juice at 8am, 10.30am 4ozs cows milk diluted to 10oz with water, 12.30pm Innocent smoothie, 2pm water, 4.15pm diluted juice, 6pm water, 7.30pm 10ozs full fat organic milk, 10.30pm 2ozs organic milk diluted to 10ozs, 3am the same, 6am the same.

I would be grateful for any advice you may be able to offer with regard to increasing his solid food intake and improving his sleeping pattern. I assume, perhaps wrongly, that his lack of unbroken sleep during the night results from this.

In order to increase your son’s appetite for solid food he will need to decrease his fluid intake. As his milk is watered down, the amount of fluid he is receiving in the course of the day and the night is around 58 fluid ozs. He will not be hungry whilst he takes in this much fluid.

There are two case studies of Gina’s which would be worth looking at to see how excessive fluid and/or milk intake affects appetite and the range of foods a child will accept. P54 Benjamin 23 months in The Contented Childs Food Bible and p135 Rachel 17 months The Complete Sleep Guide.

Obviously you are aware that your son does not eat much and so give him milk and Smoothies to help this. Cutting back will take time and patience. The amount of fluid which he is drinking throughout the night is affecting his appetite throughout the day. Cut back on the amount of fluid he receives in the day first as this should help to increase his interest in food.

Begin by offering him his first drink of cows milk at 10.30am diluted only to 8ozs and over a period of days reduce this down until he is receiving 4ozs of milk undiluted. This should be from a cup and he could be offered a piece of fruit to have with it as a healthy snack. Before offering a smoothie at lunchtime prepare a small healthy meal of cheese pieces, slice of bread and grapes. If he eats these then offer the smoothie or begin to replace it with a small amount of yogurt.

To begin with keep the portions small as too much on a plate will overwhelm a small child. Once you feel he is hungrier at mealtimes begin to widen the range of foods. Try easy things such as pasta and rice which can be made colourful with small diced pieces of vegetables, or sauces made from vegetables and offered with grated cheese. It will take time and thought to find things to tempt him. Make each meal as attractive as possible and keep the portions small. It is very tempting once a reluctant eater shows interest, to start giving bigger portions or to keep offering more. Don’t push him too hard, but once he says he has had enough and wants to leave the table don’t give him anything else until his next meal or snack time. If possible eat one meal a day with him and offer him the same food as yourself. The social aspect of meals is important. Your son may be more willing to try different foods if he sees yourself and grandma enjoying them.

Decide when your son is to have his main meals and snacks. He should have set times rather than eating small amounts throughout the day. If he refuses what is offered to him then remove it and do not give him an alternative. Tell him he can have something to eat at his next meal or snack time. You may well meet with resistance from him to this change in his routine but it will help him be hungry at mealtimes, especially once his fluid intake has decreased. Although it will take time to widen his tastes he will begin to eat more at mealtimes when he is not so full from fluid.

Once you begin to see an improvement in his daytime eating and reduced the amount of fluid he takes begin to do the same with the fluids given at night. Cut back on both the milk and the water used to dilute it until he is being given 1 oz of milk diluted with 1-2 ozs of water. Again you may have some disturbed nights as he will no longer be settling himself with a large drink. If this is being given in a bottle it needs to be replaced with a cup once down to a small amount. To get him to settle without any drink at all you will probably have to put some controlled crying into place and have a few more disturbed nights until he learns how to settle back to sleep without the need of a drink. When you have managed to eliminate the night feeds replace his bedtime bottle with a cup. This will bring his daily fluid intake more in line with a child of his age who needs 2 pints. This amount includes all milk, juice, soups, jellies, ice-cream, fruit and vegetables.

You may find that once his appetite improves his active behaviour may begin to settle as well. Children who are missing vital nutrients from their diet can display signs of hyperactivity.

Sleeping FAQ: 18-24 Months – Night Waking

My daughter of 18mths wakes in the night, sometimes for 2hours but does not cry out for us.

My daughter has for some months began waking during the night, never at the same times, for anything up to two hours. She doesn’t cry but she talks and sometimes shouts out. Sometimes we will go in to her and tell her to shush and go back to sleep or we just leave her. This happens regardless of whether she has had a good/bad lunchtime nap and regardless of whether she talks for a while before falling to sleep at night. It also doesn’t matter if has eaten a lot during the day or little. She is always in bed by 6.45pm. Her afternoon nap is rarely more than 1hr – 1hr20. She settles for this nap at 12.30am.

Many children around this age seem to go through phases of waking at some time in the night for no apparent reason. You are dealing with it well by largely ignoring her as she is not at all distressed. By going in to her too often you may find that she begins to call for you so, unless she starts really crying, stay out of her room. If her chatting and shouting is spasmodic it may mean she is dozing on and off during this time.

You have already looked at your daughter’s daytime sleep and eating habits to see if you can find a reason for her night-time waking. You should also look at how much physical activity she takes during the day. Now she is walking, your daughter will need to have plenty of time outside in a safe place where she can run, climb, swing and generally let off steam. Being out in the fresh air for an hour or so each day could improve her sleep at night. Even if you or her grandparents cannot take her out to the park, a short walk to the shops is fine. If you are concerned about her walking in the streets use reins to keep her safe beside you.

At this age a toddler is very inquisitive. Walking along an ordinary road can be a great adventure for her. She will stop often to examine the smallest things. Be patient and allow her to go at her own pace so she benefits both physically and mentally from her explorations.

If you do not already take her to classes for swimming or baby gymnastics see if it is possible to find one locally. Both these activities will give her plenty of exercise and she will probably enjoy them immensely. At your daughter’s age, it is a good idea to go to one or two classes of a physical activity each week and this can also be an enjoyable experience for you, or her grandparents.

Sleeping FAQ: 18-24 Months – Lunchtime Nap

My daughter of 19mths has suddenly stopped sleeping at lunchtime. How can I get this nap back?

My daughter of 19mths has always settled with no problem by 1pm for two solid hours, sometimes slightly longer, always woken by 3pm. Suddenly she stopped sleeping at lunchtime and is also taking longer to settle at night. She is in bed just before 7pm and sometimes still awake chatting but not crying at 8pm. She seems to be awake earlier than normal in the mornings although not much before 6.45. Until this began to happen my daughter had always slept until 7am or mostly later, sometimes 7.30/8am, with the two hours at lunchtime. The worse she sleeps in the day, the worse it is at bedtime; although she is not waking at night, she is waking earlier in the mornings. I believe this could be since we paid a day trip to family where she was settled in her travel cot for lunchtime nap, she would not sleep and cried hysterically for 1.5 hours despite cuddles from myself and husband, she eventually fell asleep on my husband’s chest which is the first time since she was days old that she has not been put down and fallen asleep on her own. This was a week ago. I truly believe she is overtired although she is not miserable; she is also eating lots more than normal so possibly a growth spurt. I am 17 weeks pregnant and need to rest at lunchtime! Today she did not have a nap at all just chatted from 12.50 till 2.15 when I went and got her. Other days she is settling around 1.30pmand I wake her at 3pm.

My daughter eats three meals a day, having her protein meal at lunchtime. This is something such as beef stew and dumplings, with mixed vegetables. After this she will have cheese biscuits spread with cheese spread. For tea she will eat pasta with a sauce followed by yoghurt. All her food is home made. My daughter rarely has biscuits or sweet things. She does not really eat fruit apart from the occasional piece of banana but loves her vegetables. She drinks around 11ozs of milk in the day and about a beaker and half of water in total, given throughout the day.

At this age sleep needs can begin to change. When first learning to walk your daughter was really tired with all her efforts in the morning, and ready for a good lunchtime nap. Now that she is probably a competent walker she is not using up so much energy in trying to keep upright and so is less tired.

Despite the problem possibly starting originally with a refusal to sleep in a travel cot, this side of the problem has not remained. Your daughter is content and chatting in her cot, so is resting as much as her body needs at this time. It would seem she is just not tired enough to sleep.

As you are in the early stages of pregnancy you may be feeling tired and so not taking your daughter out and about so much. Now that we are in the middle of winter, it is a good idea to make the most of the short days by going out in the morning. If you have to leave some housework undone, do so. You can catch up in the afternoon as darkness falls so early. If you batch cook, and so have frozen meal portions for your daughter, lunch won’t take too long to get ready once you come in around 12/12.15pm. You may even be able to set your cooker to automatic so all you will need to do is cook some green vegetables for her once you are back. Try to get out for at least an hour, letting your daughter have some free running in a safe place.

Continue to put your daughter down for her nap. She may be moving to a time of only needing 1.5 hours of actual sleep in the day. Gina does say that most babies will need two hours sleep midday until they are two years of age. But she recognizes that some can also suddenly cut back on their sleep at this age. As your daughter is happy in her cot at lunch-time and taking a while to fall asleep it would appear that she is one of those children who does need less daytime sleep. Try putting her down around 1.15pm and see if she settles herself quicker at this later time. Providing she remains content and not crying at this time don’t worry too much about it. Take a break yourself and put your feet up.

By cutting her lunchtime sleep back to 1.5hrs your daughter should settle earlier in the evenings.

Make sure that after her bath is a quiet time of day. Running around and getting a “second wind” will not help her settle to sleep well by 7.15/7.30pm. Aim to have her in bed half an hour after coming out of the bath.

Toddlers can seem to change overnight from one phase to the next. It can be frustrating and worrying but, if your daughter is managing to cope with less sleep in the day, than that is a sign of her growing up a little.

Getting out into the fresh air on a daily basis if at all possible does really help toddlers of this age, who have amazing reserves of energy. They may need to be in a buggy for shopping trips but ensuring that they have enough time to run free in a park, garden or fields on most days will help them sleep better. Winter time can be difficult with small children. Just getting them ready to go out takes twice as long as in the warmer months of the year. This can make it seem too much of an effort, especially by the afternoon. Make sure she is dressed suitably for the park which may be damp and muddy. The best option is an all in one suit which is waterproof and lined with fleece to keep her snug. This, with a pair of wellies, hat and mitts should keep her warm but allow her enough freedom to move. If she is allowed to jump into puddles, climb up frames and slide down again she will be getting all the exercise she needs. This will all help her eat a good lunch and she will be far more likely to sleep well at naptime.

Sleeping FAQ: 18-24 Months – Lunchtime Nap

My 18mth daughter settles well when with her grandparents for this nap but screams and cries when she is at home.

My 18mth daughter has all of a sudden started to resist being put down for her lunchtime nap. She is ready for this nap as she seems quite tired at lunchtime. I have bought lunchtime forward to 11.45pm so that she goes down at 12.30pm. Grandparents have no problem with this nap, it is just at home she screams and cries and is difficult to settle.

As your daughter’s grandparent’s care for her during the week, her routine with them is familiar to her. If you care for her at weekends the novelty of Mummy being with her may be contributing to her sudden resistance to being put down for a nap. Ask her grandparents to tell you exactly what they do each day. They may have a little routine with a special song or phrase which signals to her that it is nap time. If there seems to be nothing different between the ways in which they and you put your daughter down for a nap, you may like to start a little routine.

Make the time just before her nap quiet and low key. Find a story she enjoys and read this to her just before putting her into her cot. Sing her the same song each time you settle her and remind her that you will see her as soon as she wakes. If she does cry when it is nap time, and you feel that she is tired and ready for a sleep, put her down and leave the room for 5-10 minutes. If she continues to cry then return briefly, reassure her that you are there and then leave again. It may take a few weeks for your daughter to settle down again for her nap when being cared for by you. Providing you are consistent in the way you manage this time of day your daughter will realise that when you are caring for her she will be put down for her nap in the same way as her grandparents do.

Sleeping FAQ: 18-24 Months – Lunchtime Nap

My daughter, aged nearly two years, has started to have inconsistent naps at lunch time, often remaining awake in her cot chatting for 1.5 hours. This began after a period of illness where she lost her appetite. Following the afternoons when she does sleep well, she will not settle to sleep until 8pm in the evening and, on the afternoons when she doesn’t sleep well, she is a total nightmare as she is so irritable.

My daughter aged nearly two years has started to have inconsistent naps at lunch time, often remaining awake in her cot chatting for 1.5 hours. This began after a period of illness when she lost her appetite. Following the afternoons when she does sleep well, she will not settle to sleep until 8pm in the evening and, on the afternoons when she doesn’t sleep well, she is a total nightmare as she is so irritable. Her habit of hitting me is escalating despite my efforts to resolve it. 

I am at my wits’ end. I wouldn’t mind her dropping the nap if she wasn’t a complete horror in the afternoon as a result. She looks exhausted and definitely needs this sleep. I am due my next baby in 6 weeks and need to get it sorted. Do you think this is just a phase? What should I be aiming for at this age? I admit she might not be getting the exercise she needs due to the weather and my pregnancy.  However, yesterday morning she had two hours at a soft play place and ran herself ragged – but still she did not nap even though she was desperate and told me all afternoon that she was tired!

My daughter takes three good meals a day and drinks cow’s milk from a beaker.

The daytime sleep needs of this age group can vary tremendously. Some toddlers still need a two hour sleep at lunchtime until well over the age of two whereas others will cut back quite a lot, needing only a short nap to keep them going throughout the afternoon without becoming over tired. A toddler’s needs can change quite suddenly so it can be difficult to know quite how to handle a sudden shift in your daughter’s sleeping patterns.

Your daughter appears to need a shorter nap but is not quite ready to drop it completely.  We would suggest that you still put her down in her cot at lunchtime, at around 1pm/1.30pm, but call it rest time and not sleep time. Draw the curtains but leave them open slightly, to allow a little light in the room. Play a cassette of gentle nursery rhymes that your daughter likes, making sure it will play for an hour.  Use the same cassette for the first couple of days and, after she gets used to settling in her cot for rest time, you can vary the recording you play for her.  You may find that some days she will sleep and others she won’t.  If she has had a very hectic morning she will be more likely to sleep but do not allow her more than one hour.  If she has not gone to sleep within an hour we would advise that you get her up, otherwise she may become frustrated laying awake any longer than that.

Once your daughter gets up you should establish a further period of quiet time, as this will be helpful when the new baby arrives. If your daughter enjoys listening to stories you could spend time together curled up, on either a sofa or your bed, and enjoy looking at a pile of books together. Make this a cosy time, snuggling together under a blanket so she gets the idea of being quiet. If she is not that good at listening to stories for any length of time, you could try the distraction of a video or DVD, but make sure you both sit and watch together. You may need to be firm about her staying on the sofa or bed for this quiet time but, if you use this time to take a rest yourself, she will be more likely to remain close to you.

On days that your daughter does not sleep you will need to ensure that her afternoons are not too exhausting. Find some quiet activities which you and your daughter can enjoy together.  Have a supply of play dough and art materials such as scrap paper, coloured pens and glue sticks.  Your daughter can help with cookery sessions, for which you can use instant cake mixes. Also, try to get out for a short walk each afternoon. Changing her scene and occupation throughout the afternoon may help her be less irritable with you.

It may take a couple of weeks to establish a new routine for your daughter but, if you are persistent and consistent, you should be able to create a quiet period each day. If your daughter does start to nap for a shorter time on a more regular basis, play around with her bedtime a little to find the best time to put her down so she settles to sleep with in 15-20minutes. She may settle quicker if she is put into her cot at 7.15pm.