You have followed your baby's lead for a whole year (or more!) and there seems no sign that this child will ever sleep 'all night'. You are wondering 'what have we done wrong?' You are facing pressure from everyone, including your partner, that it's time to make changes, even if that means tears (for you as well as your child).
This can be a disastrous age to leave babies to cry it out, as separation anxiety is at a peak at about 12 months. And, after all the work you have done teaching your baby to trust you, the light is just around the corner (honestly!), even if you do nothing at all but continue to respond to your baby with love. By offering comfort, whatever the reasons for night waking at this age, you will move through challenges far more quickly as your little one feels secure, than if you create bed-time battles. However, if you are exhausted and fractious, you will feel better to know you can make changes sensitively without leaving your little one to scream.
To do this, it helps to understand what is waking your toddler, so you can solve his (and your own) sleep problems:
1. Separation anxiety
From your toddler's perspective, as he falls asleep, he is temporarily 'leaving you'. As he moves through the developmental stages from crawling to walking to running and developing language, your child's world is expanding at an incredible rate. This can be overwhelming so it's natural for him to want to be close to his secure base – you! Also, when you have a baby, you are constantly attending and responding to their needs. As these needs become less intense when your baby becomes a mobile toddler, it's easy to let him 'get on with it.' This is fine but it can mean that without little refills to his emotional tank through the day (cuddles, eye contact and focused attention), he will express a stronger need for connection at bedtime. He may also be experiencing separation such as childcare for the first time, so it is perfectly natural for him to want to catch up on time with you at bedtime.
What helps: Be patient with your clingy toddler - you can encourage independence but pushing your child beyond his limits will usually result in more clingy behaviour. Sit in your toddler's room and cuddle or hold a hand on him as he falls asleep – this will elicit relaxation hormones that will help him reach a deeper sleep. One lovely ritual is to lead him through a relaxation exercise by quietly saying goodnight to each of his body parts and telling him to feel them becoming heavy and sleepy. Start at the toes, move to the legs, knees, tummy and so on, up to 'goodnight, sleepy eyes'. If he talks, remind him in a quiet, calm voice that it is sleep time.
Please don't try to force your toddler to self-settle before he is ready as bedtime should be a calm and welcoming space, not a time of stress. Not only does a stressful bedtime make little ones even more resistant to going to sleep in the first place, it can result in them waking more due to elevated stress hormones that make it difficult to relax and sleep soundly. Try to see the time spent helping your little one fall asleep as an investment in your relationship as well as a healthy way to encourage sound sleep.
2. Dreams and nightmares
Toddlers have lots of REM sleep so now dreams and possibly even nightmares can influence sleep (and night-waking). Young toddlers will be processing all of their amazing development in light sleep – this is when you find them waking up chatting or pulling themselves up in the cot then waking. They don't want to wake up but their busy brain is practicing the new skills they are learning. And, as imagination comes on board, your child may wake from a scary dream.
What helps: If your little one is frightened, respect her fears – they are real to her. Hold her and reassure her, 'I am here, you are safe.' Stay with her as long as she needs you to help her relax, whether this means waiting until she falls asleep or cuddling her back to sleep in her bed or yours. A nightlight or, for an older toddler, a dream-catcher (to catch scary dreams) may help her feel more confident about going to sleep if she has experienced nightmares. And do consider the role television can play in creating frightening images and scary noises to a small child: try to finish boisterous games early in the evening, turn off the television and create a calm, quiet time before bed.
Although you are sure to be told 'teething begets teeth' (and that is all, so it's no reason for disturbed sleep), some toddlers seem to have an awful time, especially as they cut molars. The first set will usually appear between 12 and 18 months, and the 'two year old' molars can erupt around two (but for some children this may be a bit sooner or as late as almost three years).
What helps: Lying flat means more circulation to the head and jaw area and this can create more pressure and pain for teething infants. There is also more saliva during teething to gag on and cause waking. So a simple solution is to elevate your toddler's head – either with a folded towel under the mattress or, if you have an older toddler (over 18 months) and feel comfortable about his safety, you can give him a small pillow (try this during the daytime to see how he manages).
4. Food intolerance
Food additives are present in ever-increasing numbers in almost all processed foods and these can dramatically affect sleep patterns. Some children can also become restless after eating foods containing salicylates. These are naturally occurring chemicals which are found in otherwise healthy foods such as berries, grapes, apples, citrus and tomatoes, as well as in some processed foods.
What helps: If you suspect food allergies or intolerance, seek professional help from a dietician and try eliminating suspect foods. Lots of parents find that cutting out foods high in salicylates can make a difference within a few days. To find out more about this and helpful professionals, check out the Food Intolerance Network.
5. Bladder awareness
As connections between brain and bladder develop, your little one can be woken by the sensation of a full bladder. In other words, your little one may be waking to wee. Or he may be passing large amounts of urine so could be waking from the discomfort of a cold wet nappy.
What helps: If your child is now going to the potty during the day, a simple thing to do is a 'dream wee'. Just before you go to bed, lift your sleepy tot and carry him to the toilet. Sit him there and in a quiet voice say, "do a wee." Keep the lights dim, snuggle your child and tuck him back into bed. With luck, he will arouse without waking fully, wee in the toilet and go back to sleep – until a reasonable hour.
Pinky McKay is an internationally certified lactation consultant and best selling baby care author of Sleeping Like a Baby and Toddler Tactics. Pinky is holding seminars in Melbourne on Toddler Tactics and Baby Sleep; book here. See Pinky's books (also available as audio) at her website at www.pinkymckay.com.