Milly is a 3.5 year old girl, who had finally driven her parents to the point of reaching out for help. They were tired, frustrated and unsure how to make things better. Milly had never been able to sleep in her own bed, and would often be left to fall asleep in front of the TV late at night, before being moved into her own bed. Only to wake a couple of hours later and be crying out for mum and dad, often being awake for an hour or two at a time, and unable to go back to sleep unless mum or dad slept with her, or she slept in their bed. Mum and dad had not a night in their own bed since she was born, and were ready to have their own space, and not be awake for hours during the middle of the night.
She would sometimes fall asleep late afternoon for a nap, but would then cause havoc come bedtime, and would often not fall asleep til 9-10pm.
In terms of diet, Milly didn’t eat particularly well. She didn’t like fruit or veges much, and was never particularly interested in breakfast. She was having 2-3 bottles of cow’s milk each day, including when she first woke up. She also had troubles with constipation.
This painted a really clear picture for me, and could easily identify what we needed to change, both in terms of diet and sleep.
If we take a look at her diet, at 3.5years of age, having over 600mls of cow’s milk a day was way too much dairy. It can cause iron deficiency anaemia as the calcium displaces iron, and also most likely the biggest cause of her constipation (and Milly was actually diagnosed by her paediatrician with iron deficiency shortly after we began working with each other). The reason she wasn’t interested in breakfast, was because she had just had a big bottle of milk. So step one was to cut down to only one bottle a day, and in the evening. She could have yoghurt and cheese etc. as other forms of dairy throughout the day, total volume of ALL dairy not exceeding 500mls.
By making this small adjustment, mum and dad quickly reported how her appetite changed, and she was much more interested in food, and were able to introduce more fruit and veges into her diet. This would also help with constipation by increasing the fibre. She was prescribed iron supplement therapy from the paediatrician, but I’m sure once her iron stores have been replaced, she will be able to sustain her own levels simply by cutting out the high intake of dairy.
Now the sleep was the next biggest thing we needed to tackle. Essentially, the reason Milly was waking up and crying out for mum and dad, is that, like all humans, we wake up and stir after sleep cycles, but during these wake ups, Milly would realise that the conditions weren’t the same as to when she first fell asleep. I.e., she went to sleep in the lounge room, but would then wake up her dark bedroom. Or she would go to bed with mum next to her, and wake up and mum would be gone. This is obviously disconcerting for any child, and can understand why she was upset. We needed her to learn to fall asleep in her bed, and that it was a safe place, so that when she woke, she knew where she was, and was able to fall back to sleep independently.
At her age, there is a huge behavioural component to her situation, so we decided to use a combination of rules, rewards, and role play to help mum and dad gain control over bedtime. Rewards can be a huge success for children, but they need to be used in the right way when it comes to sleep. Setting sleep rules was a joint process between mum, dad and Milly, to make her feel like she had come input and control over bedtime, rather than mum and dad just making up all the rules.
Role play can be hugely helpful too, by using a teddy or doll, and allowing Milly to practise the sleep rules and see how clever teddy is at sleeping too.
We also needed to adjust her routine, and not allow that afternoon nap, as she is too old to have a nap, as it was interfering with her bedtime. Rather we were going to bring bedtime forward from 9pm to at least 7:30pm if not earlier.
Mum and Dad were clearly guided on how to implement all of the above- the Rules, the Rewards, the Role play and the change in Routine, and came up with a really good method to help Milly fall asleep independently. There was very little crying involved in this whole process, mum and dad supported Milly to fall asleep independently, through gradual withdrawal. After two weeks working with Milly’s parents, they were so happy to report all of the positive changes. Milly was happier, less grumpy throughout the day, falling asleep in her own bed, staying in her bed the entire night, and going to bed by 7-7:30pm. Mum and dad had their evenings back, not to mention their bed. They too, felt way more rested, and happier in themselves.
If you are reading this, and you too, would like some guidance on how to help your toddler sleep better, then reach out. Sleep is equally important for parents as it is toddlers, and when you reach the point of wanting things to change, it’s a good sign of your exhaustion.