If I leave my child to cry it out, will she be psychologically damaged?
Rachel: Absolutely not. I get this question so many times, and once we’ve talked it through, mothers usually feel a lot more confident. Leaving a cold, hungry, unloved child to scream for hours is abuse. That’s completely different to putting loving boundaries in place and teaching your babies and children to sleep, which is what they need. It’s important that parents leave their babies to settle for a few minutes, and not get up to them at the first squawk.
My six-week old baby boy is waking up almost every hour during the night, wanting to be fed. What can I do to help him, and us, sleep a bit more!
Rachel: The most important thing with a newborn is that at every feed time results in a full tummy. If you are breastfeeding, very often babies go to sleep on the first side, and mums think ‘oh – he must be full’. But usually that’s not the case. If they go to sleep, take them off and wake them up. If they won’t wake up, sit them up and wind them, then lay them on their back and take their nappy off. Normally, this will do the trick. Then put them back on the breast. Always offer both breasts at every feed. If they have full tummies, a clean nappy and their wind brought up, they should settle. You can also try laying your baby on their side, tucked in nice and firmly, supported by a rolled up blanket. While the trend is to lay babies on their backs, some do find it hard to sleep like this, but will settle if placed on their sides.
Dr Rania: It sounds like your baby is cluster feeding or grazing on small amounts of milk throughout the night. This may be due to your child going through a growth spurt and will help the supply of breast milk increase. Also, some of these feeds may be for comfort. You can consider introducing a dream feed, of either expressed breast milk or formula. This is a feed given around 10 or 11pm, by bottle, where a baby takes a larger volume, so stays satisfied for longer and wakes up less often for feeds.
I thought that at three months, my daughter would be sleeping 12 hours straight, but she’s still waking up a couple of times in the night to be fed. Is this normal?
Rachel: A three-month-old baby may still need a feed last thing at night – at around 10pm to 11pm-ish. Or, some mums go to bed early and let their babies wake them in the early hours for that feed. But a normal healthy baby will not need two feeds a night. At this stage, it’s become a habit for them to wake. And the only way to break it is with controlled crying. I would let them shout for a little while, then go in and pacify them with a pat. The important thing is, not to get them out, and not to feed them. They can actually cry on and off for an hour or more on that first night. It’s not easy – but it really is just a matter of training them to settle.
Dr Rania: Some three-month-old babies still need to wake up overnight to feed, but your daughter is at the age where she can be encouraged to sleep through the night. Have you tried doing a dream feed? If this doesn’t help, then you should consider weaning her at four months old, as the introduction of solid food will help satiate her and she should sleep for longer.
How do you encourage a willful toddler to stay in their bed all night?
Rachel: I’m a great believer in reward systems, because at age two or three, children do want to be good and they want to have rewards. But, you have to be firm as well. Talk to them about how they are going to behave at bedtime. Then, read them one or two stories (and stick to it – they will always ask for more) and you must keep putting them back to bed. If your child keeps on getting out of bed, you can shut the door to create a boundary. If the child can open the door, he or she may continue to get out of bed. If this happens, keep putting them back to bed, be very firm, and add a reward system strategy. If this doesn’t work, you have to get really tough – and perhaps take something away that they really like, say a favourite television programme. It is exhausting at first – but if you remain firm and consistent, you will win in the end.
Dr Rania: I can fully relate to this as my daughter was one of these. It’s difficult, but the right place to start is with a bedtime routine, that is predictable, relaxing and helps your toddler realize that it’s time to go to sleep. This could be a bedtime story, some lullabies or combination of these. If your toddler wakes up during the night and leaves his bed, you should be firm and always give the same message: take him back to his bed every time, tell him quietly that he must stay on his bed until the morning and avoid over-stimulating. There are several methods of sleep training, which do get harder the older a child gets. You must find a method that’s right for you and stick to it without giving your toddler mixed messages.
How do you make night-time toilet trips as uneventful as possible?
Rachel: I always advise parents to lift children last thing at night, before they go to bed, to put them on the loo, without even waking them up fully. That way, their sleep won’t be disturbed later on and hopefully, there won’t be a need for them to get out of bed.
Dr Rania: Try to make these as quiet as possible, by doing very little or no talking and keeping the lights dim, so that your child does not wake up fully and hence find it difficult to get back to sleep.
My two-year-old wakes up at 5.30am, no matter what time he goes to bed, and has dropped his daytime nap – how can I ensure he's getting enough sleep?
Rachel: 5.30am is too early – and children have to learn to stay in their bedroom and not get up. It really does come down to explaining this to children, and sending them back to bed when they come in to wake you. Look for special clocks where a rabbit’s ears pop up, or the sun comes up when it’s time for them to wake up. For a two-and-a-half year old, that’s a good way to explain things. Then they know if it’s too early for them to be getting up. Again, be firm and consistent and things will improve.
Dr Rania: Different children will need a different number of hours of sleep. It is normal for some two year olds to drop their daytime nap. If your child appears energetic, is meeting his developmental milestones and does not seem to be suffering from lack of sleep, then simply stick to a regular bedtime, follow your bedtime routine and don’t worry.
My toddler still needs a nap in the afternoon, but it's getting later in the day and is affecting the time he'll fall asleep at bedtime – should we drop the nap altogether?
Dr Rania: You should keep at least a four-hour gap between the time your toddler wakes up from his afternoon nap and his bedtime. If he’s beginning to fall asleep later each day, you should wake him up earlier and not allow him to sleep as long as he wants. He will eventually outgrow the need to have this afternoon nap, and by doing this you will help wean him off it. Hopefully, he’ll go on to have an uneventful night’s sleep.
How can I encourage my 14-week-old daughter to take a nap in the afternoon? She’s fine in the mornings, but I can’t seem to get her to settle for that afternoon session
Rachel: As long as babies have a good morning sleep, they only need a little nap in the afternoon. So, around 45 minutes or half an hour in the mid-afternoon is just fine. In Dubai, you generally find that mums are really busy at this time of day – collecting their other children from school and so on. Do bear in mind that it’s fine for a baby to have a nap on the go. As long as the baby is contented and happy, and they are going to bed well, they are getting enough sleep.
Dr Rania: Some babies find it difficult to settle down for a nap if they’re over-stimulated. You should try to encourage her to nap as soon as you notice her signals for sleepiness. Once a baby is crying and irritable, they have gone past the stage of falling asleep easily. You may need to give her the lunchtime feed a little earlier and try to help her nap after that.
The expert panel
Rachel Waddilove, author, maternity nurse and baby sleep expert
With a career in maternity nursing and child care which has spanned more than 40 years, mum of three and grandmother, Rachel Waddilove, is not afraid to buck the trends. As an advocate of controlled crying and starting babies on solid foods before they hit six months, she admits her no nonsense approach doesn’t suit everyone. ‘I’m a bit of a toughy I’m afraid,’ she tells us. ‘The trouble is that there are so many different ‘methods’ out there these days, that young parents are often blindsided and common sense gets lost along the way.’ It is this straight-talking which has led her to assist A-listers like Gwyneth Paltrow and Minnie Driver through their baby sleep woes – and her latest parenting book, Sleep Solutions, is out January 17.
Dr Rania Ayat Hawayek, specialist paediatrician at Infinity Clinic
Originally from Dubai, Dr Rania Ayat Hawayek completed her medical training at King's College London in 2001. Rania has experience in general paediatrics, as well as accident and emergency, haematology, infectious diseases and neonatology. She is a member of Royal College of Paediatrics and Child Health and has a masters in nutrition. She believes that to achieve and maintain overall wellness of a child, one needs to look at the child as a whole, focussing not only on their medical condition, but also on the family and social aspects of their life.