My Two Year Won't Sleep

Hi Dr. Cason,

You took care of my twins in SD almost 2.5 yrs ago. You offered some guidance when we were having sleep issues with them before. Guess what? My daughter is having sleep issues again. She's in her own room in a big girl bed. She just finished getting her 2yr molars. I've taken her to the pedi 2-3 times to rule out any obvious physical problem. Nothing. This child is a beast at night! She wakes up 3-4 times a night and it's always at the same times, like clockwork. She won't fall asleep on her own. If I don't stay with her at her initial bedtime she'll get up out of bed countless times. We are dealing with a speech delay so she's unable to tell me what's wrong. She doesn't want daddy. Just me. I haven't had a full night's sleep in months. I refuse to take her to bed with us. Instead I go to her bed, but it's the same darn problem! I don't want to sleep in the Dora bed. I'd like to sleep with my husband! I've read a bunch of books and done some research, but nothing seems to be working. I guess I'm just looking for some insight. Nothing's different as far as bedtime routines. She was having this behavior even before we put her into her own room and big bed. I'd appreciate any thoughts of yours! Thank you.

- Lisa

Hi Lisa,

Good to hear from you!

I think you have hit the nail on the head. It's teaching her to sleep at the initial bedtime that will solve your problems. Remember that when children go to sleep they need to to learn to put themselves down. When she is arousing out of her sleep in the middle of the night, she just wants to replicate what happens when she originally goes to sleep.

Solve the bedtime problem and your on your way to solving the latter problem. Sounds easy right?

Remember the key to any behavior issues with children is consistency. Develop a good bedtime routine- bath, book and bedtime.

When mine were littler we used stickers to reward them in the AM if they went to bed nicely. Also now if they talk then I close the door. They really want it open so that usually works.
When we are busy with company and ignore their yelps and cries and playtime then usually they rile themselves up even worse. When we are consistent and won't tolerate any playing they go to sleep. For a long while we had to take out the offending person - remember I have three kids - and put them to sleep on their own in the guest room. We warned once and then took them out. When we forgot and yelled, warning them incessantly but not backing it up- not too surprisingly they pushed it further and further.

Some people will use a gate at the door. This isn't being a mean parent this is ensuring their safety. They can't be allowed to roam the house at will.

So the upshot is- Tuck her in her bed at night and walk away. Expect that she will stay there. When she comes out, take her back. No talking, no cajoling, no yelling. If she keeps coming back out then stand by her door. The key is not to ignore her when she comes out and let her play or run around. She comes out, take her back. If she's crying in her room but staying there then I would leave her be.

It's a matter of wills. You're older and wiser and have more tenacity. You can do it!

Let me know how it works!

Sheila Cason MD

Eleven Years Old and Underweight

Dear Dr. Cason,

My grand child is 11 and weighs 55 lbs, short (familial) , he eats little but has large normal bowel movements. He had symptoms of ADD and has difficulties learning. Because of his weight he has never been on meds for very long. He has kept some babyish habits(sucking fingers and playing with clothing labels).He has been extremely healthy and has done well in sports. His parents have found that he seems to be doing better since he does triathlons and eats better after swimming. His mother is obsessed with keeping her weight down and is also very thin, she maintained herself on a fat free diet while pregnant. The father was also low weight, ADD as a child . We feel that his poor intake maybe related to his lower functioning . He gets easily frustrated and cries.
Any input would be appreciated.
Thank You !

- BR


Dear BR,

At 11 years of age 55 lbs is certainly low, but it is difficult to tell exactly what is going on. It is good that he is active and eats well at times. I am assuming with the mention of the extreme health issues at homes that there may be some restriction in what foods are available to him. By no means should a child be on a fat free diet or carbohydrate restricted. But even if he has a variety of food available to him, given his home environment, he may be picking up some unhealthy habits. It is not completely uncommon to see eating disorders in young children- boys included.

Also with your mention of some young child like behaviors- sucking fingers and playing with clothes tag,there may be a developmental issue such as pervasive developmental disorder. Remember that very frequently children can fit a certain diagnosis such as ADD when really there may be an other diagnosis to be considered. Often children who are very sensitive in general can have oral aversions. Textures, taste and temperature can play a large role in what they prefer to eat.

I suggest taking him to a developmental pediatrician. If there isn't one available then take him to his pediatrician and ask for a consult. They should be able to tease out what issues are at play here and give you a better idea how to help your grandchild.

Good luck and let me know if you have any other questions.

Sheila Cason MD

The Cold and Flu in Pediatrics

Dr. Cason,

Danger has had a cold for just over a month now. It was REALLY BAD for about a week and a half but now is just kinda there. She has a couple of coughing fits a day, usually while sleeping and always has a runny nose and last week a very mild rash formed on her chest and back of her neck. I took her to the public health nurse and she said it was fine. When do I need to be concerned about it? Do I need to be concerned about it?- Nikki

Hi Nikki!

You did the right thing by taking Danger in to be evaluated. You should expect her to be feeling better in a few days, most upper respiratory tract infections should resolve by one to two weeks. If she persists with her symptoms or suddenly develops focal signs such as a fever, ear pain or worsening cough, then return sooner.

I'm not sure what's going on with the rash. It could be a mild form of eczema- which can flare when kids are sick. If it is spreading or your child has a fever and looks very ill then seek medical attention immediately.

At this time of year we see a lot of cold and flu symptoms in children. Most kids just need a little monitoring and plenty of fluids. Two previous posts that I have written on the subject are:

1. Cold and Flu Season- When to Take Your Child to the Doctor

2.The Flu in Children

I hope she feels better!

Sheila Cason MD