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Bedtime routines

Bedtime Rituals

by Laura W. Nathanson, MD, FAAP
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Good bedtime rituals are those that help babies and children fall asleep. Great rituals are those that spare the loving adult from having to keep putting the child back to sleep at frequent intervals during the night.

Babies and young children are highly attuned to what feels normal and what feels strange. This awareness gets very acute when it comes to falling asleep. Good bedtime rituals create a safe, normal feeling, so your child drifts off into dreamland without protest.

However, falling asleep at bedtime is not the only time that your little cherub falls asleep. The natural sleep cycle produces brief awakenings every few hours during the night. If your child is used to falling asleep at bedtime while nursing, or in someone's arms, those brief awakenings are going to feel like bedtime all over again. So bring on the breast, bottle, pacifier, music box — all the ingredients of the original bedtime scenario.

Great bedtime rituals avoid this fallout. With a great ritual, your child falls asleep naturally, without adult interference. This means that when he briefly awakens during the normal sleep cycle, he'll feel content and safe and be able to fall back asleep without the help of a grown-up. He'll regard it as normal to do so, because that is how he went to sleep in the first place. This way, you'll all be getting an uninterrupted, good night's sleep, which is best for everyone.

A sleep-deprived adult is often not quite with it — impatient, clumsy, and zombielike. Adults in this state not only can trigger terrible accidents (forgetting to put down the crib rail; leaving the baby on the changing table before returning to bed; falling asleep in a bad position and smothering the baby), but can also become chronically irritable, which of course the baby will sense. A baby who senses that his caretaker is irritable will feel unsafe and abnormal and will likely cry, or worse, scream, for unbelievable lengths of time. You can see how this can become a vicious cycle.

How to Create a Great Bedtime Ritual

Here are some guidelines for creating great bedtime rituals:
  • Between two and four months of age start putting your baby into the crib, bassinet, or onto the family bed while still slightly awake, and after, not during, a feeding. He will fall asleep naturally, without being "put to sleep" while being held, nursed, bottle-fed, or sucking on a pacifier, and it will begin to feel normal for him to fall asleep on his own.
  • Find a "sleepy song" that all the loving adults, no matter how vocally limited, can sing. The sleepy song should be the last grown-up step in the bedtime ritual, a signal to the baby that it's time to fall asleep. The song should be slow and calm, with a very restricted range of pitch, something that the adult can get through over and over again as the baby calms down and relaxes. "I've Been Workin' on the Railroad" is a good one — though likely to put the singer to sleep more rapidly than the baby!
Music: Using a CD, music box, or other type of technically generated music player is not the best idea as it's likely to backfire at some point if it breaks, is lost, or the power goes out — which could mean a long, long night!
  • As the baby matures, add more steps to the bedtime ritual, always performing them in the same order and always ending with the sleepy song. For instance, by eighteen months, the sequence might be: bath, diaper and pajamas, bedtime book, sleepy song. By three, two of the steps need to be potty and drink of water. If you're including prayers, they can come right before the sleepy song.
  • Make sure your child gets enough physical and social activity during the active hours of the day so he's tired enough to sleep when bedtime comes. More daytime naps than appropriate or TV watching as a substitute for play can make all your bedtime efforts go for naught.
  • Make the two hours before bed calm, low-key, and cozy. It's not a good time for bouncing, running, chasing, screaming, or playing flying baby!
Finally, there's the bedtime story and the night-light to consider.

Bedtime Stories: Browse the Bedtime Books at Barnes and Noble, and you'll find choices for every age, in regular format, or as board- or cloth-paged books. Several are also available in Spanish. For the very young, here are three classics.

Goodnight Moon by Margaret Brown, Clement Hurd
Good Night, Little Bunny : A Touch-and-Feel Bedtime Story by Jane Yolen, Sam Williams
Time for Bed, by Mem Fox, Jane Dyer

For children under a year, of course, reading aloud means admiring how well they're chewing on the cloth or cardboard pages. Toward the end of the second year, it means letting them turn the pages, while you say a few admiring words about the pictures as they fly by. Only at around three will "reading aloud" take on its typical definition — at about the same time they ask you what job you had when you worked on the railroad!

As for books that reassure children about monsters and things under the bed, I'd wait until the child gives voice to such a fear first. No sense putting ideas in their heads. Just don't say goodnight to the Green Oozy Thing in the closet on your way out.

Night-Lights: For young babies, a soft simple glow is ideal, as anything too interesting may keep them awake. Night-lights at this age are mostly for adults, so that they don't get lost while checking on the baby in the wee hours.

For children who are two and older, night-lights can start to be interesting, a way of telling your child, in the nicest possible way, that "Yes, now it is going to be dark in here." Some of the more creative lights can remain a favorite for years — for instance, one that emits a pattern all over the ceiling and walls, imitating a starry sky, complete with constellations.

Cloud B produces some good ones, such as a "twilight" lady bug and sea turtle. One reviewer noted that her eleven-year old used the starry sky to track the movements of the constellations throughout the seasons! Another reported that her nearly-adult daughter and friends loved them as gifts.

And here is the moral in this last anecdote: Try hard to keep up some kind of bedtime ritual until your child is fully grown up and moved out — or at least until high school! It's a great way — and sometimes the only way — to stay in touch and keep things normal.
     
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    Meet Our Expert
    Laura W. Nathanson, MD, FAAP
    Pediatrician
    Pediatrician Laura Nathanson grew up as Laura Jean Walther, in Lakewood, Ohio. She obtained her BA, magna cum laude, from Harvard. After earning her MD from Tufts School of Medicine, she went on to a Residency in Pediatrics at Boston City Hospital.

    She completed her Pediatric Residency at Children's Hospital of Michigan, and then a Fellowship in Peri-Neonatalology (the care of premature and high-risk newborns). She is Board Certified in both Pediatrics and Peri-Neonatology.

    She, her husband, and their daughter settled in San Diego California in 1981. Over the next twenty years, Dr. Nathanson worked full-time at El Camino Pediatrics in Encinitas, CA. She also wrote a monthly column and occasional features for Parents Magazine and served as contributing editor to Healthy Kids, a publication of the American Academy of Pediatrics. In every year of full-time practice, she was named by her peers as one of the "Best Doctors in America." She is also the author of The Portable Pediatrician.

    After her husband died following a tragic misdiagnosis in 2003, she wrote a layperson's guide to reading one's own medical record, What You Don't Know Can Kill You!, in order to catch and correct careless errors before they become fatal.
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