If you have not already done so, please read Blog Posts 1 through 5 that describe how sleep is important and beneficial. I will post specific information for parents and children based on my book, “Healthy Sleep Habits, Happy Child.” Please do not be put off by my book’s length. This is a reference book. Read only the topic of interest to you.
Some parents do not recognize or accept the fact that they are causing sleep problems in their child. For example, they might usually keep their child up a little too late but do not appreciate that this late bedtime is creating sleep problems in their child. Instead, they make false excuses for their child’s sleep problems and/or ‘treat’ the sleep problem with the latest fad remedy, such as melatonin (Blog Post 143).
At every age, there is a handy excuse available to parents to distract them from their own accountability. Some parents use extreme fussiness/colic (birth–6 months), teething (6–12 months), separation anxiety (12–24 months), “terrible twos” (24–36 months), and fears (36–48 months) to falsely ‘explain’ why their child is not sleeping well instead of reflecting on their own behavior.
Also, some parents may strongly believe in popular, but false ideas, regarding sleep problems in children. Here are some examples of false beliefs:
Fake News 6: ACQUIRING A NEW MOTOR SKILL Disrupts Sleep
I routinely asked the mothers in my practice who were pediatric Physical Therapists or pediatric Psychologists if they were aware of the belief that when a child achieves a new motor skill (sitting without support, standing alone without support, walking freely without support, and so forth), the child’s sleep is disrupted. They all said “Yes”. Then I asked them, did this occur with your child? They all said ‘No”.
Fake News 7: MY CHILD IS AN ‘OWL’; Late Betimes are OK
Based on melatonin measurements, all young children are ‘larks’.
See: Blog Post 70
Fake News 8: “IT’S A PHASE”; My Child Will Outgrow Sleep Problems
Some children, especially with mild to moderate sleep issues might, or might not, sleep better when older. More severe sleep issues persist and/or cause mental health problems later. Some busy childcare providers who don’t want to spend a lot of time explaining or talking about normal baby fussiness or sleeping problems shut down the parents’ concerns by saying, “It’s only a phase, it’ll pass.”
Fake News 9: DREAM FEEDS Help My Child Sleep through the night.
Sleep comes from the brain, not the stomach. Children born with birth defects of the stomach or gut must be fed slowly and continuously to grow before surgery is attempted. They are never “hungry” in the middle of the night, but they have normal night awakenings just like children who are intermittently fed. They awaken at night because they have normal light sleep phases that reflect the brain’s output for sleep.
See: Blog Post 144
Fake News 10: BED SHARING IS BEST; I Will Be Better Bonded to My Child
See: Blog Post 82
Bed sharing is not safe; see: https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2022-057990/188304/Sleep-Related-Infant-Deaths-Updated-2022
Hi Dr. Weissbluth,
Our daughter, Gigi, 16 months old, is recovering from a cold for two weeks now. We confirmed with a pediatrician that it is not RSV, COVID mod an ear infection.
We have been putting her down routinely at 5:30/6 since her cough has started and her naps have gotten shorter (1 per day for max 1 hr). She wakes coughing sometimes 30 minutes at a time, but always gets herself back to sleep and wakes for the day at 6/6:30. Until last night she had no trouble falling asleep, but she refused to lie down and “slept” seated all night. She was still awake and bobbing when we went to bed at midnight.
She refused to nap today and we left her crib for an hour crying.
We put her down at 5:30 tonight and she is still seated and bobbing 1-1/2hr later. Worried she is cumulating sleeplessness and don’t know how to get her to lay down when it was never an issue before. Is it worse to intervene and break what was a healthy sleep habit or do we leave her to try and figure it out? Just worried about the unknown and how long this could take.
Thank you in advance
Usually, for most, but not all, viral upper respiratory infections, the worst symptoms are gone by 24-48 hours but some symptoms (like occasional coughing) might linger for about 10 days. Typically, the child is much better by the 5th day. If, during the day, your child is playing, socializing, eating, and her overall behavior suggests that she is not in much discomfort and appearing mostly well, than it might be safe to ignore this cough.
Currently, at 5:30pm, after soothing and you are leaving the room, and she then or shortly thereafter coughs; what do you do?
Hi Dr. Weissbluth, thanks for the quick response. When she coughs we leave here. The only time we have intervened when she has coughed, it has been because it resulted in her throwing up (needed to change the sheets, her clothes etc.). So far last night and tonight she has not coughed while seated in her crib. Her disposition all of yesterday and today was happy/social/etc. You would not know she didn’t sleep last night. For the past 3 hours she seems to be in a cycle of dozing off while seated, waking self while seated, crying and so on/forth. Do we let her stay in this pattern for another night in a row?
Thank you,
When was she last seen by her pediatrician?
Please take her temperature. Does she have any fever?
Is it a moist, wet cough or more a dry or hacking cough?
Do you hear any wheezing sounds or noisy breathing, especially on exhalation?
When she is not coughing does she have any rapid breathing, difficulty breathing, or effortful breathing (showing her ribs or depressions above her clavicles when she inhales)?
Last seen by her pediatrician on Monday. We have been monitoring fever daily with a rectal thermometer. Fever was mild tonight at 99.7. When it’s been over 100 these past two weeks we have given her Tylenol, per pediatrician recommendation.
Cough is wet. Noisy breathing/snoring has been happening since she got sick but it’s been on the inhale at her nose. She shows no intense signs of difficulty or labored breathing. Pediatrician asked us to watch for same symptoms you suggest so we’ve been more careful monitoring since Monday. Her physical conditions do not seem to have changed since seeing the pediatrician.
It appears that watchful waiting is the best strategy, for now, to see that her good sleeping pattens return when the respiratory symptoms abate.
Is this acceptable?
As an update, when Gigi seemed to be “sound” asleep seated, so not bobbing but hunched over. My husband went to lie her down which he managed to do successfully without waking her. She slept soundly for 4 hours then woke with a cough and is now again in the same cycle of seated dozing while seated, awakening self while seated, crying etc. for the past two weeks she has consistently woken herself by coughing but has always managed to get herself back to lying down. Last night and tonight she has refused. Still seated.
Apologies, missed the response in between. Will continue with watchful waiting. “Slept” from 2AM to 6AM seated unfortunately. Hoping it resolves soon.