Dear Annie,

My son is 2 1/2 years old. He has yet to sleep through the night. He wakes up crying for milk. I’m past exhaustion, I can’t be up every hour with him anymore. What should I do? He also is not eating very much during the day. Do you think these are problems are related? How do I get him to eat more? Thanks!

~Emily

Dear Emily,

I’m sure you know that you are hardly alone in your nighttime misery; in fact, I must receive a letter a week from a parent desperately seeking sleep. Your toddler’s frustrating pattern should not be hard to correct provided you are willing to a) wean him off nighttime feedings; b) commit the time to reconditioning him to sleep longer at night; and c) let him cry a little.

Let’s start with the first challenge: At his age, your son should not need milk at night. If you are still breastfeeding him, it’s likely he is using you to soothe himself rather than for nourishment. The same goes for bottle feeding; he should be able to last from dinner or a bedtime snack until morning without supplemental milk. You also mention that he’s not eating a lot during the day. Two year olds do not eat a lot, which can drive their parents nuts – or lead them to imagine that they’re starving to death. Rest assured that even if your son grazes his way through the day, provided he isn’t consuming a lot of empty calories, he doesn’t need as much as he may have a year ago when his body was growing much more rapidly. If you are really concerned about his eating habits, by all means talk to your pediatrician.

You can eliminate nighttime feedings in one of two ways: Gradually or by going cold turkey. Either way, he’s going to resist and you are going to have to be calm and consistent. If you decide to reduce gradually the number and duration of the nighttime feedings, start by resolving to feed him just at, say, 3 a.m., but when he wakes up again, put a chair by his bed or crib and use your voice or a pat on the back to reassure him. Do not pick him up and nurse or bottle feed or you’ll be back to square one. Obviously, your goal is to then eliminate one of the nighttime feedings and then go to none – again, with alternative soothing techniques just to get him out of the habit.

Depending on his language skills, you may be able to tell him, “Tonight, you’re going to have some milk before bed, but then no more bottle until breakfast.” When he wakes up, you can sit by his bed or stand at the door of his room, telling him that it’s time to go back to sleep, but resist the urge to nurse him.

The absolute toughest part of this will be the first couple of nights, but if you (and your husband/partner) are on the same page and if you are committed to making the change, your chances of success are much greater. All of the experts I have ever consulted about kids’ sleeping habits say the same thing: consistency is key. If you go two or three days without caving and then you are too exhausted one night to follow through or your partner sneaks in and gives him some milk, you will sent the message, “If you cry long and hard enough, we’ll give you what you want.” So try to find a time (maybe a weekend), when you can be home and determined to establish a different — wonderfully different — approach to getting some much-needed sleep. Believe me, you’ll be doing your son a favor, too!

For more on sleep, check out the interview I did with Kim West, “The Sleep Lady.”

I also highly recommend Mary Sheedy Kurcinka’s book Sleepless in America: Is Your Child Misbehaving or Missing Sleep? and Jodi A. Mindell’s Sleeping Through The Night: How Infants, Toddlers, and Their Parents Can Get a Good Night’s Sleep.

Dear Annie,

When my three-year-old daughter wakes up in the middle of the night, she always crawls into bed with my husband and me. We want to break this habit, but I don’t look forward to the nightly drama that I’m sure will ensue if we make her stick out the night in her own room. Any suggestions?

Beverly

Dear Beverly, 

You are not alone. According to the National Sleep Foundation, more than 10 percent of parents let their kids crawl into Mom and Dad’s bed if they wake up in the middle of the night. When my daughter Madeleine was little, I would spend hours getting her to  sleep before crawling out of the room on my hands and knees to keep the floor from creaking.

Ever since I’ve been collecting tips from parents and sleep experts -and here are a few of my favorites

• Try setting up a mattress for your daughter to sleep on at the foot of your bed, then move it each day a little closer to the door and eventually into her room. Alternatively, you can set up a pallet on her floor and gradually move down the hall.
• Don’t reward negative behavior by running every time she cries; instead, tell her that you’ll come check on her every 10 minutes as long as she’s quiet (but be sure to keep your promise).
• Do reward her positive behavior by setting up a sleep chart. For nights when she manages to stay in her bed, she earns a star on the calendar.  A week’s worth of stars earns her a special treat - a small gift or date with Mom or Dad alone.
• Remember, change doesn’t happen over night. In fact changing sleep patterns may take up to four weeks. So be patient, but consistent.
• Think empowerment, not punishment. Although your daughter is not going to thank you for forcing her to stay in her room, you are doing her a favor by teaching her to soothe herself. When we give our children opportunities to tolerate frustration or even a little sadness, we are empowering, not punishing, them.