Part 3 – Toddlers (1-3 years)
by Julia Gaines MD, FAAP
Welcome to the Wild and Wooly Ways of Toddlers
Toddlerhood is an interesting time, to say the least. Your sweet little baby has been replaced by this perfect little person with their own opinions, agendas, and priorities. What used to be the simple act of dressing your child now is a daily hurricane because your little angel WANTS TO WEAR THE RED SHOES AND I WANT TO PUT THEM ON MYSELF AND I WANT TO PUT THE SHOES ON BEFORE THE SOCKS and on and on until you just want to let the child go naked and unfed and unbathed until they’re five rather than have one more fight over something. Well, we don’t call it the Terrible Twos for nothing.
This is just a bump in the road of growing an independent human being. Tremendous cognitive and neurological changes are happening in front of your eyes. Toddlers literally learn something new every day. In order for them to learn, they have to experience which means they get into everything, are a constant danger to themselves, and often resist any assistance from their parents. In fact, they frequently try to boss their parents around. At the same time, they often have significant stranger and separation anxiety which can result in lots of clinginess. This is a perfect opportunity to take the first steps in teaching your child how to self-soothe and control their anxieties. They’re not good at it at this age, of course, which is why they need lots of instruction. Take time during the day to remind them that they can sleep in their own bed and to praise them when they do.
It might not surprise you that toddlers often have sleep problems. Frequent night awakenings, night terrors, bedtime fears, bedtime resistance, toddlers do it all. Even the previously good sleeper will sometimes have a backslide now if their schedule is disrupted by travel or illness. Toddlers need 12-14 hours a sleep in a day. By 18 months, most have dropped down to one substantial nap and heaven help you if they don’t get it.
- By this age, toddlers should be sleeping consistently in their own bed in their own room. It’s not fair to let a child sleep with you when it’s convenient for you and then send them to their own bed when it’s not (such as when one parent is out of town – think what message you’re sending). If you as the parents have decided that you want your family to all sleep in the same bed, go for it, but don’t expect your child to be easily moved out anytime in the near future.
- A consistent routine is VITAL at this age. Toddlers depend on routines to know what to expect and any disruption tends to put them in a tailspin. You might have noticed that this morning when you put the milk IN THE WRONG CUP I WANTED THE PINK PRINCESS CUP I CAN’T GO ON LIVING when you weren’t paying attention. Bedtimes and bedtime routines should only be altered for illness, natural disaster, or if George Clooney comes for dinner or you will pay for it for the next month.
- Toddlers should fall asleep in their own bed by themselves. This does not mean that they fall asleep in front of the TV and you move them later. It also does not mean that they only fall asleep if you lay down with them. This is a major step down that path to independence. They will fall asleep every night of their life; they need to learn how to do it on their own. After all, you’re not planning on spoon feeding them for the rest of their lives, are you? If your child is otherwise a good sleeper, you can wean them off needing a parent with them to fall asleep by gradually withdrawing – start by laying with him, then sitting next him in bed, then sitting in a chair, then moving the chair away gradually. Boring, but usually successful. If you have more extensive problems, please talk with your provider.
- A healthy toddler absolutely does not need anything to eat or drink in the middle of the night. Okay, she can have some water if she wakes up with a nightmare, but otherwise, the kitchen should be closed. If you feed her in the night, you are training her to wake up as well as training her to eat for comfort which just opens a whole other can of worms.
- Children this age often do have night time fears. I encourage the use of a comfort item such as a blanket or stuffed animal (the parent should not be the comfort item!). Really sell the idea that the lovey will keep them safe at night and stock up on them so you can wash it when it gets gross. I’m not a huge fan of night lights as humans really do depend on a dark environment to cue them when to sleep but it’s better than an hour of looking for the monsters under the bed. If you use one, try to still keep the room as dark as possible (lower wattage bulb, put in the behind a dresser, etc.). The light should not move, flash, change colors, sing, or do anything but be light. You’re trying to get the kid to sleep, not recreate Hyde Planetarium.
- Make the room environment the same each night and throughout the night. Imagine if you went to sleep in your bed and woke up on the kitchen floor. You might have a hard time going back to sleep, right? For kids, that’s the same thing as falling asleep to music and having the parent sneak in and turn it off in the night. If it can’t go all night (and possibly forever), don’t start it.
- And while we’re on this, please do not put a TV in your child’s bedroom. Children with TVs in their bedrooms have more sleep problems, more behavioral problems, poorer school performance, more problems with obesity, poorer health, you name it. Just please don’t.
For safety reasons, I encourage parents to leave toddlers in a crib as long as possible. However, if you need the crib for a new baby or if your toddler is climbing out of the crib, it’s time for a “big kid bed”. They will likely fall out of that big kid bed more than once, so put the bed in a corner and either put the mattress flat on the floor or put some padding next to bed. The guard rails help, but kids seem to find a way regardless. Of course, now your little one is free in the room, so make sure that room is toddler-proof. You don’t want them wandering around the house in the night, so either block the door with a baby gate or put a door knob cover on the inside door knob. You must be able to get in the room quickly in case of emergency.
Fortunately, the toddler years don’t last forever. If you are still experiencing sleep problems or other behavioral problems, please speak with your child’s provider. Everyone deserves a good night sleep so you can enjoy your stubborn, quick-tempered, fascinating little whirlwind for the miracle that they are.