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Part 1
Every parent has despaired of their toddler's night waking, no matter where the toddler sleeps and no matter the circumstances surrounding the desperation. Although there is great disagreement regarding whether infants should be able to sleep through the night, the expectation that toddlers can and should sleep through the night without waking parents is generally well accepted—with this expectation being what is presented as the “healthy” outcome by many health professionals.
Recent research, however, shows us how incorrect this expectation is as science tells us that it is normal for toddlers to wake at night well into their second year. Thus, to understand toddlers and what they need during nighttime care, we need to be sensitive to the “why” of their needs, abilities and experiences, and to look for “what” drives behaviours.
The same concerns are important at bedtime. Knowing why a toddler is resistant to going to bed or unlikely to remain in bed when they wake at night is key to helping toddlers and parents create a healthy, happy sleep environment. Herein we offer some insight into the whys and whats of toddlerhood and then some practical suggestions about helping infants, and their parents, sleep.
Toddler Sleep Around the World
One of the primary concerns that parents raise, especially in many Western cultures, is that toddlerhood is the time when independence must be learned and parental responsiveness may hinder this development. Let us first assure you that the benefits of responsiveness to your child do not end in infancy, but rather responsiveness to distress remains key to secure attachment and positive social and emotional outcomes for children (for a review, see Grusec, 2011).
If you have been bed-sharing or co-sleeping, often parents worry that continuing this practice into toddlerhood will lead to negative outcomes for the child. But is this supported? Around the world, toddlers regularly sleep with their parents, and not just out of necessity. In Bali, children regularly sleep with their mothers until the age of 3 (Diener, 2000). Mayan children also share their mothers’ bed and often nurse throughout the night until 2-3 years of age (Morelli et al., 1992). Among the Ifaluk of the South Pacific, children sleep alongside their parents until about 3 years of age (Le, 2000). In Japan, family members traditionally sleep in the same room, with many children even sharing their parents’ bed (Fukumizu et al., 2005), and children traditionally sleep with some adult (e.g., grandmother) until adolescence. In Sweden, approximately half of children aged 4-5 are bedsharing with their parents at least part of the time (Welles-Nystrom, 2005).
Even in North America, long-term outcomes associated with bedsharing outside of infancy are consistent with normal, healthy development (Barajas, Martin, Brooks-Gunn, & Hale, 2011). Notably, at age 5 there were no cognitive or behavioural problems associated with bedsharing between the ages of 1 and 3 in a US sample of low-income families. Being responsive or even bedsharing will not inhibit and could promote your child’s independence or emotional growth. Regardless of your sleep arrangements, the following sections should help you navigate your toddler’s sleep and help you all find solutions to any sleep problems you may encounter.
Knowing your Toddler
Toddlers are often misunderstood as they try to meet their own needs and the needs and expectations of family and society. Toddlerhood is a time of emotional, biological and social change as the transition from babyhood to a new level of independence and growth occurs. It is a time matched only by adolescence in terms of challenging developmental changes for your child and necessary challenges in childrearing for parents.
Why Sleeping Can Be Hard: For toddlers, energy abounds. Toddlers want to ‘do it’ themselves; they love to show you, tell you, direct you and ask you; and most of all, they love your company. So why would a toddler want to walk away from the excitement of being with you to go to sleep? Well, they often don’t! Thus, they do not make or maintain that transition without support and guidance. It is completely normal for toddlers to wake during the night. They wake and may reach out for teddy, or something comforting with smells of mom. Toddlers may call out; this is termed “signalling.” Some toddlers signal once a week, others once a night or numerous times a night, and some not at all (Weinraub, Bender, Friedman, Susman, Knoke, Bradley, et al., 2012).
A waking toddler is a common concern for parents, with research showing that over half of children older than 1 are waking regularly (Scher, 2001), and at least one-third of all parents of toddlers report having a 'significant problem' with their child's sleep (Armstrong, Quinn, & Dadds, 1994). So, worrying or being concerned about your toddlers’ sleep is not unusual. However, just as in infancy, guiding them toward settling and providing comfort at night can help them return to sleep without negative consequences. Not responding can leave toddlers anxious or unsettled. Most important to remember, a waking toddler is NOT being naughty; they are trying to communicate something with their behaviour. Many parents respond to toddlers’ waking with discipline (Armstrong et al., 1994), yet there is no indication that this is helpful in promoting sleep or positive development.
Sure, sometimes it is ‘in code,’ but with gentle kindness and a sense of someone being there for them, toddlers can find sleep.
Posts in Sleep Series:
Baby Sleep Training: Mistakes “Experts” and Parents Make
'Let Crying Babes Lie'? So Wrong
Simple Ways to Calm a Crying Baby
Series Co-Authors
Tracy Cassels, University of British Columbia, www.evolutionaryparenting.com
Sarah Ockwell-Smith, babycalming.com
Wendy Middlemiss, University of North Texas
John Hoffman, uncommonjohn.wordpress.com
Kathleen Kendall-Tackett, Texas Tech University, http://www.uppitysciencechick.com/sleep.html
Helen Stevens, Safe Sleep Space
James McKenna, Mother-Baby Behavioral Sleep Laboratory, University of Notre Dame, www.cosleeping.nd.edu
References
Alfano, C.A., Ginsberg, G.S., & Kingergy, J.N. (2007). Sleep-related problems among children and adolescents with anxiety disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 46, 224-232.
Barajas, R.G., Martin, A., Brooks-Gunn, J., & Hale, L. (2011). Mother-child bed-sharing in toddlerhood and cognitive and behavioral outcomes. Pediatrics, 128, e339-e347.
Cain, N. & Gradisar, M. (2010). Electronic media use and sleep in school-aged children and adolescents: a review. Sleep Medicine, 11, 735-742.
Cantor, J. (1998). "Mommy, I'm Scared": How TV and Movies Frighten Children and What We Can Do to Protect Them. New York: Mariner.
Feshbach, N.D. (1987). Parental empathy and child adjustment/maladjustment. In N. Eisenberg & J. Strayer (Eds.) Empathy and Its Development (pp. 271-291). Cambridge: Cambridge University Press.
Grusec, J.E. (2011). Socialization processes in the family: social and emotional development. Annual Review of Psychology, 62, 243-269.
Mindell, J.A., Telofski, L.S., Weigand, B., & Kurtz, E.S. (2009). A nightly bedtime routine: impact on sleep in young children and maternal mood. Sleep, 32, 599-606.
Owens, J., Maxim, R., McGuinn, M., Nobile, C., Msall, M., & Alario, A. (1999). Television-viewing habits and sleep disturbance in school children. Pediatrics, 104, e27.
Smith, H.A. (2006). Parenting for primates. Cambridge, MA: Harvard University Press.
Thompson, D.A. & Christakis, D.A. (2005). The association between television viewing and irregular sleep schedules among children less than 3 years of age. Pediatrics, 116, 851-856.
Weinraub, M., Bender, R. H., Friedman, S. L., Susman, E. J., Knoke, B., Bradley, R., Houts, R., & Williams, J. (2012). Patterns of developmental change in infants’ nighttime sleep awakenings from 6 through 36 months of age. Developmental Psychology, 48, 1511-1528.
Welles-Nystrom, B. (2005). Co-sleeping as a window into Swedish culture: considerations of gender and health care. Scandinavian Journal of Caring Science, 19, 354-360.
