As pediatricians, one of the most common concerns we hear from parents is, “My child won’t go to bed.” At the end of a long day, the last thing parents want is bedtime drama. Often parents will try an “easy” fix (lying down in their child’s bed, bringing the child into the parents’ bed, letting the child fall asleep anywhere and moving her later) just so everyone gets some sleep. These fixes may help in the short-term, but often lead to long-term issues. It is best to begin with a bedtime routine at a young age. And, as with all things, consistency will pay off.
Most toddlers and preschoolers need 11-14 hours of sleep in a 24-hour period. We recommend picking a bedtime that fits your family routine, taking into account the time you need to wake up and the length of time your child still needs for a nap. Once you settle on a bedtime, decide what to include in your routine. Bath? Brushing teeth? Changing a diaper, putting on pajamas? Stories? Choose an order for the components of your routine, and stick with it. Very soon your children will expect it and enjoy it. Some of the most wonderful times we have had with our children (Dr. Kaseta has four kids and Dr. Gannon has six kids) are the quiet games, reading and chatting before bed.
Some children will resist sleep because they feel a bit out of control. They do not really want the day and/or time with you to end. You can give them some control by allowing them to make choices about the activity. For example: Do you want to read two or three books? Do you want to read on the couch or in your bed? Do you want to play two rounds of “I spy”? They do not have control over whether it is bedtime, but they can have some control over the parameters. We encourage no TV or lighted screen activities within one hour of bedtime as it is too stimulating to the brain and may hinder falling asleep. Additionally, there should not be televisions or other electronics in children’s bedrooms. These can often become sleep props and prevent children from learning to fall asleep on their own.
When the routine is finished, you say goodnight and leave the room. Children can be allowed to play quietly or read in their bed after you leave. As long as they are in their beds, you have done your part. Initially, this may not go smoothly – there may be some resistance and tears. If there is resistance from your toddler, here is what we found works best: do not engage with him if he comes out saying he is thirsty or can’t sleep. Just do whatever you were doing, pretending he is in bed. Eventually, if you are consistent, he will learn the routine and learn that there is no attention (positive or negative) after you say goodnight. Again, be consistent. It is easier for children in the long run if they know what to expect.
Bedtime routines really work - but they must be consistent. It is hard work, but it is worth it! Remember - if you break the routine and let them come into your bed, or stay up, or engage with them when they come out, you will have to start over again.