Dear Dr. B,

  I have a two-year-old son who
  recently started waking up in the
  middle of the night, for no particular
  reason. It started when we were
  visiting family out of state, and we
  attributed it to a new-bed-new-
  time-zone issue, so he was
  coddled during those nights. But
  now that we're back home, he is
  still waking up every night. My
  husband or I simply go into his
  room and put him back in his bed –
  it's not even like he needs something besides the assurance that we are still around! So, how do we get him to sleep through the night again? Is this a force-him-to-cry-it-out-and-he'll-learn kind of thing, or just something he'll grow out of and we just need to suck it up and be the parents he needs us to be?? 

Signed , MD

Dear MD,

All toddlers wake up during the night but they usually go back to sleep unless something is bothering them such as a full diaper, pain from teething, discomfort, the fear of being alone or a bad dream. The trick is figuring out what the cause might be and then attempting to resolve it.

If you think your child is waking up because he is afraid of being alone or being separated from you, it is best to reduce the attention he receives during these times and to encourage him to stay in bed and go back to sleep by himself. By coddling him, you may be sending the message that he should be afraid of being alone and you may be rewarding the anxious behavior.

On the other hand, it is not uncommon for children at this age to develop fears of the dark and nightmares. At age two, children begin to develop active dreams which can be scary since they also have difficulty distinguishing between fantasy and reality. If your child is having bad dreams, it is important to address his fears and give him creative ways to cope with them on his own such as a special night light or items that he can use for “monster protection”.

Toddlers are also creatures of habit and any change, no matter how small, may create a new pattern of behavior that, if rewarded, will continue. In order to break your child’s pattern of waking up in the middle of the night, try explaining the concept of night time and day time. You can do this by simply telling him that he should not get up from bed until "it's light out". At the same time, make the night time wake up calls less rewarding for him by gradually reducing the amount of attention he receives during those times. For instance, the next time your child wakes up in the middle of the night, you can remind him not to get up until "it's light out" and put him back to bed with minimal eye contact or affection. The next night, simply peek your head in the room and tell him “You’re okay. Mommy’s here but you need to go back to sleep until it's light out.” During the final stage, reassure him from the hallway that you are there and tell him once again to go back to sleep until "it's light out". In the mornings, point to the window and say, “Now it’s light out, this is when we get out of bed.” Always praise him for staying in bed at night.

One way to reinforce the concept of day time and night time is to buy a special children’s clock (see below) that changes color when its time for sleep and when its time to wake up. These clocks provide children with a visual and concrete way to learn when to stay in bed and when its time to wake up.

Expect your son to cry during the night when you do not give him the same degree of attention that he received in the past. Don’t prolong the interactions by going back to reassure him again. By going back in, you will be rewarding the crying instead of teaching him to soothe himself. Also consider making positive changes in his bedtime and/or morning routine by giving him an extra dose of coddling and special one on one time which may help him cope better with the mommy/daddy time that he will be missing during the night.

Whatever you decide to do, it is important to be consistent and to continue what you started because anytime you revert back to helping him during the night you will be increasing the intensity and duration of the waking behavior since he knows that this behavior sometimes gets results. The best analogy to use to understand why its important not to inconsistently reward an undesirable behavior is to think of a slot machine— you keep playing with the hope that "this time" you will win.

Best of luck,
Dr. B 

Dr. B has a doctorate in school psychology specializing in early childhood development. If you have a question that you would like to ask Dr. B, send it to myshort@mommyshorts.com with the subject header ASK DR. B.