- Head lice/ Sklice co-pay coupon
- Should you give tylenol before the shots? / vaccine reaction discussion
- HAND FOOT MOUTH (and butt) VIRUS
- Skin fold irritations
- The Poop series: Chapter #1 Baby poop
- Strep Throat
- Nurse Judy' Blog
- Tips for giving medication
- What to expect from the 2016/17 flu vaccine
- Colds/coughs/congestion 2017 (symptomatic treatment/when do you need to be seen?)
Friday, May 22, 2015
Sleep part 3/ leaving the crib behind
You are sound asleep but suddenly sense that something is amiss. Sure enough you look over to the side of your bed to see one of your children inches away quietly staring at you. Sound familiar? Once your little one is no longer confined to the crib, nocturnal visits can be a nightly affair if you don’t nip this habit in the bud.
There are a variety of signals that will alert you that it is time to move the kids out of their crib. At some point every parent is going to have to deal with this transition. My daughter Lauren learned to climb out of hers at a fairly young age. The day she proudly called me into her room to show me how she could balance on the crib rails was my signal that her crib days were gone. She wasn’t even two. Alana would have stayed in her crib forever, but she eventually got big enough that it was just silly.
It is important that the new bed be low and safe. There are all sorts of toddler rail options that can keep kids from falling out. Some folks keep the mattress on the floor for the first couple of weeks. Once your kids are out of the confines of the crib there is always a normal bit of an adjustment. The main issue though is not falling out of bed, it is new found freedom to wander out of the bedroom. Even if they used to be a good sleeper, many kids may need a little help learning to stay put. If your child discovers that they need to show up in your bedroom several times a night, it can get exhausting.
Once you have the marvelous luxury of getting an uninterrupted night’s sleep, it doesn’t take long to forget how disruptive it can be to be woken frequently throughout the night. If you make a plan and stick to it, you can get through this transition with minimal disruption. As noted earlier, both of my kids had the unnerving habit of silently entering my room, coming to my side of the bed and just staring at me until I work up. It didn’t usually take long until I was jolted out of a deep sleep. (Interestingly, my dog would do the same thing if she needed a middle of the night pee.) Children have a myriad of reasons for getting out of bed.….scary shadows, strange sounds, they are thirsty, they can’t sleep and so on and so forth. Let them know right from the start that except for an emergency, they need to stay in bed. Be consistent with your expectations. Be present as needed but say nothing other than “shhh, it’s night time.” If they get out of bed, just keep taking them back. SHHHH, night time! For the first week you may find yourself doing this dozens of times. Say nothing else. “Shhh night time.”
Night time is not the best time to reinvent your bedtime routine. Creating an improvement plan with your child as a key member of the team has to take place earlier in the day when they have your attention. Talk about how important sleep is. Read bedtime books. The library is full of great ones. Tell stories about other children who are learning to have good sleep habits. I like telling stories about the “cooperative” and the “not so cooperative” child. The troublesome child gets into all sorts of trouble and everyone is grumpy. The positive role model figures out a way to stay in bed. Everyone is proud. yada yada yada….. Make the stories nice and silly to keep them engaged. Problem solve with them ahead of time for ways to manage their issue without getting up.
Thirsty? Let’s have a little sippy cup of water next to the bed. Lonely? This is the perfect time for a special new stuffed animal or favorite blanket. Alana not only had several special blankets, but she started sleeping with an old soft green sweater of mine. That sweater stayed in her bed for years. Scary shadow? Lets turn on and off the light and figure out exactly what it is that is making that shape. Creaking noise? Let’s identify what is making that sound. Is it a bird? Maybe it is a branch scratching against the window.
Thinking about monsters? Do NOT look under the bed to make sure the coast is clear, that would lead them to believe that a monster lurking in the room is a possibility. Tell them that really smart kids have amazing brains and good imaginations. Try to do some exercises using that power. Draw the scariest monster that you can think of, then add a pair of polka dotted underwear on the scary monsters head. Now put a lollipop in their hands; there, they turned them from scary to silly.
For kids 3 and older who are going through a phase of getting out of bed a lot you might consider doing a one week exercise. Once again, find the moment when they are receptive (not bedtime) and talk about the fact that bedtime routines needs to be better.
Have them help you pick out 14 little (don’t need to be expensive) age appropriate toys or treats. Wrap them up like presents. Every night your child has 2 passes. If they need you for anything, they need to turn in one of the passes every time they get out of bed. Any unused pass can be redeemed in the morning for one of the prizes. (Of course, for older kids, a trip to the bathroom that does not require your assistance doesn’t use a pass.) At the end of the week, any unclaimed prizes are given to another child who needs a treat, or put away for a later time. It is important to know that in the immediate time frame they are missing out on any prizes that they didn’t earn. I have seen this work well for kids who are old enough to reason. Be clear that the earning prizes for staying in bed has a firm expiration date. One week only.
If you don’t want to fuss with prizes and passes, that is fine. Focus on appropriate rewards and consequences.
Reward: if you get a good night's sleep, plan a special activity. Make sure you give lots of positive attention. “You let me sleep and only got out of bed once. I am proud of you. We are all rested, lets do something fun.” Some kids do well with a sticker chart.
Consequence: You kept waking me up during the night. I am tired and grumpy. I don’t want to do a special activity.
There are some very creative toddler clocks that will help your child know when it is okay to get up and when they need to stay in bed. Just google “toddler clocks” to see some of the varieties.
As I noted in last week’s post, you may want to have a chime on the door that alerts you that you may have a wanderer.
Posted by Nurse Judy at 9:34 AM