Talk: Helping your Child Get a Good Night's Sleep
By Paul M. Fleiss
The subject of child sleep is of interest not only
to parents but also to scientists. Entire medical conferences are
organized around the fascinating subject of sleep. Medical journals
regularly publish the latest scientific data on child sleep. Unfortunately,
not all "scientific" studies on sleep are correct, and
not all self-appointed sleep experts give accurate, child-nurturing
information. Too often, cultural biases regarding sleep predominate
over genuine biological facts.
Many of the so-called "sleep problems"
that parents report in their children are actually the result of
rigid and unreasonable expectations that are based on unnatural
and unrealistic myths about how children are supposed to be. The
incorrect advice on sleep that is found in so many childcare books
is based on such expectations.
Babies, however, cannot be tricked into yielding
to unreasonable expectations. The baby's refusal to cooperate with
feeding schedules and rigid "training" indicates that
these expectations are unnatural and don't meet the baby's biological
needs. There are several mistakes that parents commonly make in
the attempt to help their child sleep. Many childcare books, including
new titles, recommend these things. They fall under the category
1. Don't ignore your children's cries. After all,
they may be sick, in danger, or in pain. Babies and young children
are emotional rather than rational creatures. They can't comprehend
why their cries for help are being ignored. Even with the best of
intentions, ignoring children leads them to feel abandoned. The
result will be insecure, unhappy children. You cannot "spoil"
children by responding to their cries. "Spoiled" children
are those who don't know what to expect from their parents. They
are often alternately punished or praised for the same activity
at different times.
Infants cry for a reason. We may not always know
what the reason is, and we may not always be able to solve the problem,
but we can always try. If a baby cries at night, it may be because
he or she is hungry, thirsty, sick, uncomfortable, agitated, lonely,
or frightened by a nightmare. Whatever the problem, the fact that
the babies cry indicates that they are unable to solve their problem
alone and require the assistance of their parents.
Expecting babies or young children to "self-soothe"
is unreasonable. Responding to children's cries, comforting them,
and trying to help them overcome whatever it is that is bothering
them is not only effective, it is the only proper way to help them
2. Don't let children "cry it out". Many best-selling
childcare books actually instruct parents to let children cry themselves
to sleep, suggesting that this will teach children how to "self-soothe".
Wiser parents and doctors find this an unacceptable and self-defeating
practice. While babies may learn to cry themselves to sleep, this
practice also seems to have the undesirable effect of teaching babies
that they cannot trust their parents to respond to their needs.
It also inculcates low self-esteem. Children who cannot trust their
parents are emotionally unbalanced. They are abandoned children.
To some degree, they will be psychologically impaired and may manifest
this by being clingy, needy, whiny, and demanding. Even though it
is in direct contradiction to the unfortunate advice given to parents
in the 1950s and 1960s, the best way to help your children become
secure, independent, and emotionally balanced people is to respond
to their needs rapidly, intelligently, and with care.
If you believe your child is crying simply because
he or she is fussy rather than because of a "genuine problem",
carefully evaluate why your child might be fussy. Eliminate from
your child's day stressful things that induce fussiness. If your
child sleeps alone, lie down and stay with your child until he or
she is asleep. Your presence will be reassuring and calming.
3. Don't expect your infant to sleep through the
night. Any sort of "training" to make babies sleep through
the night is unnatural and possibly dangerous. Infants are biologically
required to feed several times during the night. They do not and
should not engage in adult sleeping patterns. Infants should be
expected to sleep lightly for several short periods throughout the
night. Older children, however, will generally sleep through the
night without any "training".
4. Don't give children drugs of any kind. Never
give children Phenobarbital, Valium, or other sleep-inducing medications.
These brain-altering chemicals are dangerous on their own and can
quickly become addictive.
5. Don't give your children alcohol in any form
or quantity. Some misinformed parents mistakenly give their infants
and children small amounts of bourbon, whiskey, scotch, gin, beer,
or wine, thinking that this is an acceptable method to induce sleep.
Other parents apply small amounts of alcohol to the gums while babies
are teething. Alcohol will not help children sleep but rather will
result in restlessness and agitation. Alcohol is inappropriate and
unacceptable for infants and children.
6. Don't watch television just before going to sleep.
Infants and children are fully drawn into the fantasy and chaos
of television programs in a way that adults cannot appreciate. Children
are unable to distinguish between reality and fantasy as presented
on television. As a result, they may outwardly appear calm but inside
may be very agitated and emotionally distraught. Even seemingly
calm and happy television programs can have the same effect.
7. Don't play computer games before going to sleep.
8. Don't fight just before going to sleep. Do not
fight with your children and don't fight with anyone else in the
house. Being emotional creatures, children are far more affected
by the negative emotions aroused by conflicts than adults. Adults
may brood longer, but children are more deeply affected by emotional
If you find that you regularly have to battle with
your child to get him or her to go to bed, you will already have
learned that battling does not help. Rationally determine why your
child resists going to bed. Is it because your child is simply not
sleepy at the prescribed bedtime? Is it because you have neglected
to provide your child with pleasant bedtime rituals?
9. Don't feed your children right before putting
them to sleep. Food requires time to digest. While sleeping, however,
digestion does not progress in the same way it does when we are
awake. It slows and even stops. The result is gas, cramps, and stomach
pain. None of these conditions induce a restful sleep. We should
not, however, confuse eating with breastfeeding. Breastfeeding promotes
sleep. Infants and young children who are still nursing should be
allowed to nurse as often as they want.
10. Don't "train" your child to sleep
by regulating feeding times. When in good health, a baby will signal
when he or she needs to feed. Feeding should never be governed by
a time schedule. The idea, currently promoted by some childcare
book authors, that babies can be "trained" to "sleep
through the night" by restricting, regulating, and managing
feeding is unrealistic and cruel. When an infant wants to feed,
it is because his or her body requires nourishment. Depriving an
infant of nourishment when he or she needs it is, frankly speaking,
abusive. Even the American Academy of Pediatrics is very worried
by the rise of so-called "parent-directed" feeding schemes
as alleged methods of "training" infants and children
to sleep through the night.
A newborn breastfed infant will usually want to
nurse every one to three hours. There may sometimes be one stretch
in 24 hours where he or she might go five to six hours before wanting
to feed. Remember that breastfeeding is much more than feeding:
Infants may be hungry, thirsty, frightened, loving, dreaming, or
sick when they want to be placed at their mother's breast. They
may be there a long time or sometimes for just a quick little kiss
on the nipple. Whatever the reason, they should never be denied
access to it.
Infants and children cannot be "trained"
to sleep. They should not be treated as if they were circus animals.
Infants and children have differing sleep needs and sleep patterns.
They both require the safety, security, and emotional sanctuary
of responsible parents, and also frequent nursing. Not all infants
are alike, however, and the amount of nursing that your infant needs
cannot, therefore, be precisely predicted or regulated. There is
an association between nursing and sleeping, but only insofar as
an infant will sleep best if he or she is assured of a constant
supply of mother's milk. Sleeping with your infant so that he or
she is close to the mother's breast is the ideal way of ensuring
that the baby gets the optimal amount of sleep.
Positive Bedtime Rituals for Optimal Sleep
Sleep problems are usually caused by unrealistic
expectations of parents. They may also be caused by a lack of soothing,
pleasant, and reassuring bedtime rituals. Bedtime should be one
of the most enjoyable parts of your child's day. Effective rituals
calm the mind and relax the body. They strengthen the bond between
parent and child and thereby strengthen the family unit. If your
child is having trouble falling asleep or is troubled by waking
up during the night, incorporate some or all of the following bedtime
rituals into his or her daily routine.
1. Lullabies. Lull your child to sleep with soothing
music. A lullaby ritual is a proven way of helping babies and children
to fall asleep. Parents have been singing their children to sleep
since the dawn of time. Even animals lull their offspring to sleep
with special vocalizations. The deep purr of the mother cat has
the effect of lulling her kittens to sleep. It may be, therefore,
analogous to the lullaby of humans.
Music affects the deepest structures in the human
brain. Therefore, the choice of music is important. Babies respond
best to soothing, quiet classical melodies -- Mozart, Brahms, or
Debussy. Soft classical music has the effect of focusing the attention
and inducing a deep state of relaxation and calm. Bach composed
his famous Goldberg Variations for this very purpose. If you are
a pianist, you may even want to try playing a few relaxing pieces
Children are naturally musical and will have no
hesitation in revealing their favorite bedtime songs. Many children
will prefer to sing to their parents. The soothing effect of music,
especially that produced by the human voice, is ideal for lulling
your child to sleep.
2. Bedtime stories, tales, and poems. Reading or
telling stories and poems to your children while they are curled
up in bed is another important and effective way of inducing sleep.
Reading to your baby and child has long-term benefits as well. Children
whose parents read to them grow up to be adults who read. Naturally,
scary tales or stories that might agitate your child are best avoided
As with music, children have favorite stories and
poems. While it is good for parents to introduce new stories and
poems, many children seek the comfort of an old favorite. The child's
mind seems to take comfort in repetition.
3. Daily exercise. A good night's sleep is the culmination
of a day's activities. Therefore, what the child did (or did not
do) during the day will affect how he or she sleeps. One simple
and beneficial way to ensure a good night's sleep is to make certain
that your child gets adequate exercise every day, preferably in
the morning or afternoon. One is never too young or too old for
healthy exercise, and the best form of exercise is walking. Playing
outdoors is also a good form of exercise. Take your child for a
good walk every day.
4. Sunshine. Exposure to morning sunshine is said
to trigger brain chemicals into establishing the normal diurnal
cycle. Try taking your child on a morning walk in the sun for a
restful night's sleep.
5. Adequate magnesium in the diet. A nutritious
diet is necessary at all times and for every reason imaginable,
but it's especially important for healthful sleep. Magnesium has
been called "nature's muscle relaxant". The best sources
of magnesium are green leafy vegetables, salad, and "green
foods", such as the various algae and seaweed products now
available. A green drink or a fresh green salad for mother in the
evening when she's breastfeeding will help impart to nursing babies
the magnesium and other nutrients babies need for healthful sleep.
Weaned and weaning children also benefit from a diet rich in salads
and other green things.
6. Chamomile tea. A warm cup of chamomile tea is
a time-tested remedy for sleeplessness that really does work. Taken
without any sweeteners, a small, soothing cup or even just a few
sips of chamomile tea will help both mother and child relax. It
is very important to mention, however, that black tea and Japanese
green tea contain caffeine and should be avoided.
I don't recommend hot milk or hot cocoa at bedtime.
The commercially available hot cocoas on the market today are filled
with chemicals, sugar, and additives. Even by itself, cocoa is loaded
with drugs such as theobromine, a xanthine compound similar to caffeine.
Such substances are not helpful at bedtime. While infants thrive
on mother's milk, and generally fall asleep after nursing, hot cow's
milk before bed is not the same thing, especially for older children.
While a glass of warm milk is often recommended
at bedtime, it's not advisable even though it contains Tryptophan
(an amino acid with tranquilizing or sedative effects). Milk may
be a possible source of allergy and increased respiratory mucus,
which can cause a stuffy nose and restlessness. Additionally, cow's
milk requires prolonged digestion and is, therefore, not compatible
with restful sleep.
7. A warm bath before bed. A nice warm bath (or
shower) before bedtime is a delightful, relaxing, and healthful
way of inducing sleep for children as well as adults. A nightly
bath soothes the body, cleans the skin, invigorates the respiratory
system, and relaxes the mind. Try adding a few drops of lavender
oil to the bath. The rich aroma will induce deep and restful sleep.
I always advise parents to avoid giving their children
bubble baths. Bubble baths irritate and dry the skin and may also
irritate the urinary tract and thus increase the need to urinate,
further disturbing sleep.
8. Bedtime attire. Changing out of one's clothes
and into special attire (or no attire) for bed is an effective ritual
for focusing the mind and inducing sleep. It is most likely unimportant
whether your child sleeps in a nightshirt, pajamas, or in the nude.
Weather conditions will determine what form of attire, if any, is
best at any given time of the year. It is important only that your
child does not sleep in his or her clothes. Sleeping in clothes
is not only unsanitary and unhealthy, it also deprives a child of
the psychological benefits to be gained by establishing a clear
demarcation between wakefulness and sleep.
9. Ventilation. Be sure that the room in which your
child sleeps has adequate ventilation. A stuffy, overheated room
is unhealthy and not conducive to restful sleep. If it is hot and
dry inside but cold and wet outside, the result may be a stuffy
nose and the inevitable difficult sleep patterns this brings. Our
need for fresh air is just as strong during the night. The old-fashioned
screened sleeping porches of older houses were a rational and beneficial
answer to the need for fresh air at night during good weather.
10. Massage. Humans thrive on touch. Sadly, it's
been shown that, if deprived of skin-to-skin contact, babies may
become sick and die. We never outgrow our need for human touch,
and it is especially important for infants and children. Massaging,
stroking, patting, or even just running your fingers through your
child's hair tells your child at the deepest level that he or she
is loved and safe. Gently massaging your child as he or she lies
in bed is a lovely way to strengthen the bond with your child. Massage
is also a perfect way to relax your child's body and mind. A back
rub with a few drops of lavender-scented oil is a great way to end
your child's day.
11. Planning for tomorrow. As your children lie
in bed, quietly make plans with them for the next day's activities.
Reinforce the idea that tomorrow will be a good day.
It does not really matter what you say at this special
time before sleep, as long as your words are positive, supportive,
and loving. The underlying message is that you love your children
and that they are important to you. No matter how old they are,
your children will hear this underlying message. These reassurances
are vital to your children's emotional well-being. Frequent reminders
of your love will help them to become secure, balanced, self-assured,
12. Physical affection. Touch, hold, cuddle, kiss,
and hug your child before saying "good night". These classical
physical demonstrations of a parent's love for a child are enormously
important. It is also important that parents overcome their inhibitions
in this area. Children need physical affection and bodily contact
with their parents and other adults for their mental health and
It's especially important for fathers to lavish
uninhibited physical affection on their sons. Roughhousing isn't
enough. Boys particularly need comforting body contact and generous
displays of physical affection from their fathers. Holding, hugging,
kissing, and massaging your child is as beneficial to the parent
as it is to the child. While physical affection should not be limited
to bedtime, bedtime is an ideal time for this healthy contact.
13. Cosleeping. For most of human history and in
most human societies today, parents sleep with their children. This
is not because they do not know any better or because their economic
circumstances prevent them from having separate beds. Sleeping with
your child is simply the most effective way of helping your child
get a good night's sleep. It strengthens the bond of love and safety
between caregiver and child. It's also important in helping your
child to develop into a loving, balanced, self-confident, self-reliant
Researcher James J. McKenna, professor of anthropology
and director of the University of Notre Dame's distinguished Mother-Baby
Behavioral Sleep Laboratory, has confirmed the importance of cosleeping
in his many studies and publications. Professor McKenna cites important
medical research that demonstrates that adults who coslept with
their parents during their childhood are more likely to be more
secure, have greater self-esteem, and be more independent.
Some doctors claim that cosleeping increases the
risk of sudden infant death syndrome (SIDS). What they fail to mention
is that, according to the study that yielded this controversial
finding, there was a slight increase in SIDS only for babies whose
mothers smoked. Mothers who go to bed drunk or intoxicated by narcotics
are also hazards to their child's health. Clearly, the real problem
in such circumstances is irresponsible parents. Cosleeping itself
isn't the problem. Objective studies consistently show that as long
as the parent is a responsible nonsmoker, as long as the mattress
is not too soft, and as long as the baby sleeps on its back, cosleeping
isn't only perfectly safe but safer than forcing the infant to sleep
Babies are simply too little to sleep alone. Babies
should, therefore, sleep beside their mother. Additionally, sleeping
has the interesting effect of regulating the infant's breathing
patterns and body temperature in a healthy way. It permits the child
to enjoy the security and comfort of body contact with its mother
throughout the night and to breastfeed whenever he or she needs
to, without crying.
If you find that you're uncomfortable about having
your child sleep in your bed, you should examine your own feelings
carefully. Depriving your child of the security and reassurance
of sleeping with a responsible adult is not an appropriate response
to this anxiety.
If your child needs the security and comfort of
cosleeping, support that need and find a loving and compassionate
way to meet it. You will find that sleeping with your child is as
natural and as simple as I have described it. It may be hard for
you at first, but you will find that sleeping with your child is
comfortable and reassuring for you as well. Not only will you have
the security of knowing that your infant or child is safe, but your
child will also know it and will be much less likely to cry during
I should mention that not all children want to cosleep.
Even those children who do express a need to cosleep, generally
only do so for a few years. Often around age six or seven, children
may express a desire to sleep by themselves. This desire should
be supported lovingly.On occasion, older children may express the
need to sleep with their parents or another responsible caregiver,
such as a grandparent or an older sibling. This desire should also
be lovingly supported. McKenna cites authoritative studies which
show that boys who coslept between the ages of six and 11 had higher
self-esteem than boys who did not. Cosleeping fosters a more independent,
confident, and intimate adult with higher self-esteem. Since one
of the goals of good parenting is to foster these positive qualities,
cosleeping is obviously one of the best and easiest ways to achieve
By meeting the emotional and physical needs of your
child in an intelligent and compassionate manner, you will provide
your child with the security he or she needs to get a peaceful night's
sleep. By avoiding the things that hinder healthful sleep and by
actively promoting and enjoying the things that foster restful sleep,
you'll fortify your child's emotional well-being. You will also
strengthen the bond between you and your child and thereby strengthen
the family as a whole.
For More Information
Brooke, H., et al. "Case-Control Study of Sudden Infant Death
Syndrome in Scotland, 1992-5". British Medical Journal 314
Jackson, Deborah. Three in a Bed: The Benefits of
Sleeping with Your Baby. Great Britain: Bloomsbury, 1999.
Lewis, R. J., and L. H. Janda. "The Relationship
between Adult Sexual Adjustment and Childhood Experiences Regarding
Exposure to Nudity, Sleeping in the Parental Bed, and Parental Attitudes
Toward Sexuality." Archives of Sexual Behavior 17 (1988): 349-362.
Liedloff, Jean. The Continuum Concept. New York:
McKenna, James J. "Cultural Influences on Infant
and Childhood Sleep Biology, and the Science That Studies It: Toward
a More Inclusive Paradigm." In: J. Loughlin, C. Marcus, J.
Carroll, eds. Sleep in Development and Pediatrics. New York: Marcel
McKenna, J. J., et al. "Bedsharing Promotes
Breastfeeding." Pediatrics 100 (1997): 214-219.
McKenna, J. J., et al. "Sleep and Arousal Patterns
of Co-Sleeping Human Mother/Infant Pairs: A Preliminary Physiological
Study with Implications for the Study of Sudden Infant Death Syndrome
(SIDS)." American Journal of Physical Anthropology 83 (1990):
McKenna, J. J., and S. S. Mosko. "Sleep and
Arousal, Synchrony and Independence, among Mothers and Infants Sleeping
Apart and Together (Same Bed): An Experiment in Evolutionary Medicine."
Acta Paediatrica (Supplement) 397 (1994): 94-102.
Sears, William, MD, and Martha Sears, RN. The Baby
Book: Everything You Need to Know about Your Baby - From Birth to
Age Two. Boston: Little, Brown and Company, 1993.
Sears, William, MD. Nighttime Parenting. Franklin
Park, IL: La Leche League, 1984.
Small, Meredith. Our Babies, Ourselves: How Biology
and Culture Shape the Way We Parent. New York: Anchor Books, 1998.
Thevenin, Tine. The Family Bed: An Age-Old Concept
in Child-Rearing. Garden City Park, NY: Avery, 1987.
Also see the following articles in past issues
"Sleep with Me", no. 91;
"The Truth About Nightwaking", no. 76;
"Tossing and Turning over 'Crying It Out'", no. 74;
"That Family Bed...Shhh!" no. 53, and
"An Informal Sleep Survey", no. 35.
Paul M. Fleiss, MD, MPH, is assistant clinical
professor of pediatrics at the University of Southern California
Medical Center and is in private pediatric practice in Los Angeles,
California. He is the author of numerous scientific articles published
in leading national and international medical journals.
This article, reprinted here in its entirety with the permission
of the author, was originally printed in Mothering Magazine Issue
96, September/October 1999 .