Ask The Doctor

Dear Concerned,
Today, mothers are often separated from their own parents and siblings, and have fewer people to turn to when they feel tired, ill, or simply in need of a break from child tending. Probably nowhere do cultural expectations and the reality of children’s needs conflict more than in the area of sleeping behavior. Because of these factors, a baby’s needs can feel emotionally and physically overwhelming.

All babies normally wale up several times during the night. It seems that your baby has never learned how to fall back to sleep on his own. Children learn to associate a certain sequence of events with falling asleep, such as being held, sung to, rocked, or nursed. Babies can become dependent on these learned routines and they can't fall asleep until they experience the accustomed sequence. This is what is called "sleep onset association" If you have always held, nursed or rocked the baby until he is completely asleep, this has become a habit and he relies on that. You find yourself having to do that same thing several times at night.

In the case of a 22 month old, there is an element of separation anxiety. When he wakes up in the night, he knows that you must be nearby, so he wants to be comforted by you, to feel safe and secure. If you are anxious and exhausted, I suspect that these feelings are transmitted to the baby who then becomes anxious and upset.

You are obviously a concerned and loving mother. As you approach this situation with confidence, you will be less anxious yourself, and able to take control. Particularly if you keep the baby in bed with you, in a firm but soothing voice you can let you baby know that you love him but that this is sleep time, that mommy is tired and that there will be no rocking but that you are together.

In general, when evaluating a particular method, ask yourself if this advice sounds sensible. Does it fit your baby’s temperament? Does it feel right to you? I suggest that you follow your instincts rather than some stranger’s sleep training advice. You and your baby will eventually work out the right nighttime parenting style for your family.

If your current routine is not working for you, think about what changes you can make in yourself and your lifestyle that will make it easier for you to meet your baby’s needs. This is a better approach than immediately trying to change your baby. Advice that promises a sleep-through-the night convenient baby involves the risk of creating a distance between you and your baby and undermining your mutual trust. Babies are adaptable and most will eventually adjust to whatever method seems to fit your lifestyle. The most important thing is that the baby not lose the sense that his needs will be consistently met by a loving and nurturing caregiver.