The most common of these medical causes are:

Acid Reflux and Gastro Oesophageal Disease (GER)

This condition is when the contents of an infants babies stomach come up the food pipe and cause a variety of problems. The most obvious symptom is milk coming back up and being vomited or dribbling out. Unfortunately there are some potentially serious side effects such as resistance to feeding, iron defficiency anemia, irritiability, and failure to put on weight.

IF you suspect that your baby is suffering from this condition try to avoid acidic foods and keep him or her upright for the first 20 minutes after feeding. You can also let your newborn sleep at a slight incline as this can help reduce night wakings. Needless to say, if you suspect that this is a problem, please consult with your pediatrician.

Sleep Disordered Breathing

Some babies who habitually snore may suffer from obstructive sleep apnea syndrome, in which the upper airways repeatedly collapse or partially collapse. This can force your baby to wake up. Other symptoms of obstructive sleep apnea include labored, irregular breathing and tossing and turning during the night.

If your baby is suffering from this condition, you should definately get your pediatrician to check it out as this condition can cause cognitive, health and developmental issues later in life. Moreover infants that suffer fromt his are more likely to be at risk from Sudden Infant Death syndrome (SIDS).

In addition to these conditions it may be worth considering if your child is suffering from an ear infection, urinary tract infection, fever or cow’s milk allergy.

Hi xxxxxxxxxxx,

It is quite normal for toddlers to go through phases of resisting napping.
These often accompany developmental milestones such as learning to walk.
The best thing that you can do is try and establish a naptime routine.

If she doesn’t have a night time routine, start with that. 10-15 minutes
before she goes to sleep go through a consistent set of soothing activities
that lead to sleep. When you have her associating her night time sleep
routine with going to sleep, you can try and implement a mini version of the
same routine for her naps.

If you go through the same set of activities at the same time every day then
the routine will act as a signal for sleep. Don’t worry about the timing at first.
Get the routine in place and then slowly move the nap time in 15 minute or 30 minute
increments.

I know it sounds simple but it really can work wonders. Give it a go and let me
know how you get on. Above all try and be consistent,

All the best,

Sarah

I thought I would share my brief reply with you all:

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If she is not displaying signs of tiredness during the day, then she is probably getting enough sleep over the course of 24hrs. In this case, you either need to get her up earlier or accept a later bedtime.

Try and provide her with mental and physical stimulation during the day but as long as she is happy going to bed and is not overtired then it really does not matter if she prefers to entertain herself for a while. I would
recommend that you start to withdraw your presence gradually now. Move the chair a little farther away each night. If she protests do it more gradually.

Try not to use a night light as she will be more likely to fall asleep quickly if it is dark. If she complains about being scared, remind her that you will be right there with her.

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It is worth mentioning that there may be many reasons that your toddler won’t sleep immediately. Lack of tiredness is only one reason. Many toddlers wont sleep if they have reached a developmental milestone, and its also possible that if you have recently been teaching your toddler to self-soothe, that he or she has not fully developed the skill of falling asleep quickly. Be consistent, keep bedtime quiet and appropriate for sleep and in time your toddler will learn this valuable skill.

…………

In the meanwhile, the first thing you must do is
associate a bedtime routine with her sleep time.
You can move the bedtime later. Get her to agree
to the exact routine and plan it out with her. Do
some drawings with a box for each stage and tick it
off together when you have done each stage.

Complete as much of the routine as possible in her
bedroom and do not let her go back downstairs once
you have started. If she does not want to go to her room,
try and make the first activity in the routine
something that she really enjoys doing. Be patient.
She will resist at first and it may take a few days
but if you are 100% consistent she will soon get the
idea. Do not negotiate with her and ignore any tactics
that she tries.

As far as signs of tiredness go, if she starts to
get hyperactive, you have let things go too late.
Start the routine when she is still calm.

Do not let her watch television in the evening. Studies
have shown that it will reduce the quality of sleep and
make it harder for her to fall asleep.

…………………….

Bedtime battles with toddlers are very common and I hope this brief post helps if you are in the same
position. You would also be wise to make sure that your toddler does not nap late in the afternoon
and that he or she gets plenty of mental and physical stimulation during the day. It will also help if you can manage to get your toddler to agree to co-operate. Sometimes giving your toddler some control like choosing their story or pajamas can make them feel more co-operative and less like doing battle.

At around 12 weeks maybe a little later, you should consider trying to teach your baby some heathy sleeping habits. The following are some of the things that you should consider implementing:

A Consistent Bedtime Routine
Keep your bedtime routine relatively short (30 minutes max) and make sure that it is consistent and calming. You should do the same sequence of events every night, in the same location and under the same conditions. Babies with a well designed consistent bedtime routine sleep longer and better with less night wakings.

Develop Regular Naptimes
Try to put your baby down for naps at the same time every day. You should also have a mini routine for naps that only lasts for about 5-10 minutes. The same principles apply as for the bedtime routine.

Make Sure that Your Baby is Safe and Comfortable
This means make sure that your baby continues to sleep on his or her back and is not in danger of becoming entwined in the bedding. Make sure that your baby is kept at a temperature that is neither too hot nor too cold.

Do Not Provide Inappropriate Sleep Onset Associations
This means not nursing your baby to sleep, rocking your baby to sleep, using a pacifier until sleep, driving around the block with your baby in the car etc. You can use these devices but stop before your baby falls asleep or you will have created a sleep crutch that is hard to break and you will almost certainly have problems with night wakings further down the road.

Wait for Your Baby to Self Soothe
When your baby wakes in the night, try and wait for a couple of minutes before rushing to his or her assistance. Obviously if your baby sounds very distressed attend immediately but otherwise give him or her a chance to slef soothe and fall asleep on his her own.

Put Your Baby to Bed Before He or She is Overtired
An overtired baby will not sleep as well and will have more night wakings.


If you have found these tips helpful, sign up for my free baby and toddler sleeping problems report

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Thanks for your e-mail. I will certainly do my best to help. First of all let me say that short napping is quite a common problem and that it often accompanies developmental milestones. Your baby will undoubtedbly grow out of this phase but I know from first hand experience what you are going through.

There is one possibility that I think you should immediately investigate. If your daughter is not feeding or drinking well, she may be suffering from GER acid reflux. This could easily explain her premature waking. It could also be that sitting up reduces her discomfort. Take her to your G.P. to check this out and in the meanwhile you could try angling her mattress at an incline.

Assuming that this is not the problem, the most important thing that you can do is provide consistent bedtime and naptime routines. I can not stress how important this is. The routine need not be long but it should provide consistent cues for sleep. You must do the same set of rituals every time and you should try to keep sound,smell and location consistent.

If you are not already implementing naptime and bedtime routines, then I recommend that you watch for the signs that your daughter is getting ready to sleep and start the routine then. Try not to get too hung up on the actual time of the naps. Once your daughter has established a strong link between these rituals and sleep, you will be able to move her nap and bedtimes by by gradually implementing the routines at a
different time. I know that it is difficult to believe that a naptime and bedtime routine can make a real difference but please believe me when I say that your child will sleep longer, better and with less night wakings if you consistently apply them.

The Wake To Sleep method can be effective but you should tailor it to the sleep patterns of your individual child. If you still have use of your video monitor, note how long it takes before she starts to stir. If this is only after 30 minutes, then go in after 20 minutes and partially arouse her with a very subtle touch. Do not let her see you. If she actually wakes up, then try and go in 5 minutes earlier the next time. You may have to do this for a few nights in a row but this interruption in her sleep cycle may be enough to change her nap duration.

If possible keep her nap location free from distractions. Don’t leave toys in her cot and if you can, keep the room dark or at least dimly lit. You don’t mention what time she wakes up or goes to sleep but I recommend a bedtime of around 7.

You asked if you should let her lie there if she wakes up but is content? I would say yes. She will let you know when she wants some attention and you do not want her to get used to you getting her up prematurely.

You also asked if you should let her nap beyond an allotted time. Absolutely. As you correctly pointed out, an overtired child will sleep more poorly and will have trouble getting to sleep. If you get lucky and she has a long nap, then let her. In fact you may wish to try and recreate the conditions that led to this. Once you have established the habit, you can easily move the naptime.

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If you have any experiences to add or comments to make, please feel free to comment using the form below.

First let me point out that a well rested toddler will be alert and will be receptive to, and interactive with, his or her environment. In this state your child is much more likely to be calm, attentive, pleasant and socially at ease. On the flip side, children with sleep problems will be less alert, less attentive and will have much
poorer concentration.

Surprisingly, they may also show signs of hyperactivity. This is because children often try to fight their fatigue, and in doing so produce adrenaline. This in turn leads to an exhausted child that is wide-awake, fussy and irritable. Interestingly, children that go to bed when they are over exhausted are more likely to wake up during the night.

The solution is to watch for signs that your child is getting tired and to then implement your bedtime routine to match this natural tiredness. After about a week, your child will start to form a strong association between sleep and the bedtime routine. You can then start to move the bedtime routine 15 minutes at a time until you have arrived at a more suitable hour.

Studies have shown this method to be equally as effective as “Cry It Out” when it comes to reducing tantrums.

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As a rough guide, a full-term infant (not premature) will sleep on average, for about 14-16 hours per day. At first, your newborn baby will have quite a chaotic sleep cycle and each sleep period can last between 30 minutes and 3 hours, with a complete sleep cycle about every 50-60 minutes.

This means that your newborn is invariably in light sleep and can wake up many times a night. Don’t worry though, this stage does not last forever and after about 6 weeks a more predictable pattern will start to establish itself. By age three to four months, your baby will start to sleep for shorter durations during the day and for longer durations at night. At this point about 75% of babies will be sleeping 14-15 hours in a 24 hour period with a 6-8 hour chunk at night.

If you feel your baby won’t sleep to the point where something is wrong, you may wish to consider some of the following points:

• Are you baby’s physical needs being met? Before laying your baby down to sleep make sure that your baby is well fed and dry and is a comfortable temperature. Newborn babies are not very good at regulating their own temperature, so you should be careful not to overheat them. Use your common sense and if the room is a comfortable temperature, do not wrap your baby in multiple layers of bedding.
• In the first three months, it will help your baby establish his or her biological clock if you can expose your baby to as much natural light during the day and as little artificial light in the evening or night.
• There is a window of opportunity when it is an ideal time to lay your baby down to sleep. If your baby gets overtired then your baby will be more likely to sleep poorly and will usually not sleep as long. Try and get used to observing the signals that your baby gives when getting tired. This may include, yawning, eye rubbing, ear pulling and arching.
• Make sure that you don’t overstimulate your baby just before bed.
• Try to develop a consistent bedtime routine. Studies have shown that a properly developed bedtime routine increases the quality and duration of sleep. The routine need not be long but it should provide consistent cues for sleep. These should take into consideration, location, sound, smell and lighting.
• It may be that your baby has come to rely on external help to get to sleep. This may be a pacifier (dummy), driving around the block, being nursed to sleep or other similar sleep prop. Unless you can consistently provide this external help, you should remove it.
• If your baby falls asleep fine but can not go to sleep without assistance if he or she wakes at night, then you will need to teach your baby to self soothe. This does NOT mean that you should use “Cry It Out” style techniques.
• Finally, if you hear her during the night, don’t rush in to her straight away. I’m not suggesting that you ignore the cries of your distressed baby though. Just try and wait for a couple of minutes if you can.

I can remember vividly how these first few months can feel. You can’t ever seem to shake off your tiredness and every time you start drifting off, your baby starts crying and requires your attention. You are probably wondering if you will ever get a decent night’s sleep and when (if ever) your baby will “sleep through the night”.

With this in mind I have put together some tips that will help you through these early days. I can’t promise that you won’t feel tired any more, but if you follow these tips, you will be better equipped to make the most of your situation.

Sleep Tips

* If you can breastfeed, do. There is evidence to show that breastfed babies sleep about 45 minutes longer on average than babies that are raised on formula.

* If you can, sleep near to or co-sleep with your baby in the early weeks. It is important to make sure that you follow sensible safety precautions, but again there is evidence to show that babies sleep longer when in proximity to their mothers.

* Sleep when your baby sleeps. This one may sound obvious but you would be surprised how many mothers ignore it. I know that there are many household chores that you have been neglecting but it is more important for you to get some sleep when you can. Even resting with your eyes closed can have strong recuperative effects.

* During the daylight hours, try and expose your baby to as much natural sunlight as possible. Conversely, you should try to keep artificial lighting low at night. This will help your baby to set her body clock more quickly.

* Once your milk supply (if you are breastfeeding) is established and you are confident in your breastfeeding, you may wish to express some milk so that your partner or other family member can feed your baby while you sleep. If you are already bottle feeding then the same applies.

* Don’t worry about waking up your baby if you suspect that he or she has a wet nappy. Modern nappies can easily cope with a few hours of urine and your little one will soon let you know if he or she is uncomfortable.

There is one other point that I would like to mention. If you don’t get enough sleep, you are putting yourself at greater risk of illness and postpartum depression. This isn’t good for you or for your baby. On a brighter note, I know it may seem like you haven’t slept since forever, but things WILL get better soon.