Night Nursing

Remember that this is unedited text -- like "letters to the editor." Identifying information, such as names, has been removed; but otherwise it is posted here pretty much as it came in. So read it as personal opinion shared with warm intentions but without authority of any kind.

If you want your child to go to sleep earlier, you might try getting her up earlier in the morning. But if what you really want is for your child to sleep more, your only solution may be to wait a few years. Toddlers often do not need as much sleep as parents wish. By school-age, however. most children's sleep needs increase, and they usually go to bed more readily. NJB

Scroll down on this page for notes on research into toddler sleep and bed-sharing.

For some of the best research information on infant and toddler sleep, follow the work of Dr. James McKenna at Notre Dame and his research on safe cosleeping.

I have a just-turned toddler who is at the extreme of nursing behavior (up to 10 times a night!) and it was really only through meeting other women that I discovered other babies and toddlers sometimes do that. I thought I was going to lose my mind until I found out that other young toddlers can nurse every hour or so. Perhaps some research information about why family bed babies do not learn to sleep without nursing until long after their crib baby contemporaries? You suggest it is easier to have the child in bed vs. the crib, saying one will need to get up many times with babies/toddlers in a crib. However, my experience with friends who put their children in cribs is that most of the time those parents get a restful night of sleep, and every so often (teething, developmental times, nightmares) the parents have a difficult night. (These are friends who put their babies in a crib from the start, so the baby gradually learned to sleep through the night on their own -- not through any "let-them-cry" program.) Anyway, sleep is the one issue that seems to come up over and again for discussion, even among toddler circles, so the more information on night time issues, the better.

Sleeping through the night continues to be a subject of concern at toddler meetings and more information on normal and appropriate sleeping patterns would be helpful. (Is nursing every two hours at night normal?) We often quote the Mothering Magazine survey done many years ago that broke down the percentage of children sleeping "through the night" at many different ages. Many mothers are amazed to hear that the survey of their readership found that not until between the ages of 3 and 4 years were over half of these children sleeping through. Without repeating Bill Sears too much from Nighttime Parenting it would be great to see information on various methods of coping with nighttime waking specifically in toddlers.

[The doctor at our son's] one year checkup, made me feel like a terrible, lazy mother for allowing our child to sleep in our bed. She advised putting him in his crib, in his own room, and (yes, you've heard it before) allowing him to cry it out. Our son did not start sleeping with until he was about 9 months old, and at time we had intially tried that method. It only resulted in our son screaming nonstop for hours and left him with acough for over a week and a horse voice. I tried to explain to the doctor that at this time in our son's life he is most comfortable being with the ones he loves, awake and asleep. Very huffily she told me I could raise him however I wanted, but she wanted me to know that I would be raising a very demanding child because we allowed him to share our bed. Guess what? I do believe it's time to find a new pediatrician! How on earth does anyone think that allowing a very small child who is still extremely attached to both nursing and his mother to sleep in a common bed produce anything other than a happier, healthier child?

My 14 month old was nursing every couple of hours throughout the night. I wasn't getting enough sleep. I decided to stop nursing him at night. We had a about a week of difficult nights. He sleeps with us, so when he woke up I would hold him and stroke him and tell him I loved him but wouldn't nurse him. He would eventually cry himself back to sleep. I felt awful doing this, but felt he had to learn how to fall back asleep by himself. Now if he wakes up at night, which isn't often I just stroke his back and tell him to go back asleep and he does! He doesn't cry any more. I am finally getting enough sleep.

The problem is he is very clingy during the day and is nursing a lot more than he used to. I know he is making up for not getting nursed at night. I worry I have broken his spirit. He doesn't seem as happy as he used to be. Will he eventually be the smiley boy he once was? I know I just have to be patient and reassure him during the day. Will he eventually relax and adjust to this new routine? I could not find much to read on the subject of night weaning. I love nursing and plan on continuing.

I have just gotten my son to give up the night nursing, and I would have appreciated more in your book about reasons and ways to go about it. I am a student in college and my sex drive is lacking and I desperately needed my sleep so I weaned my son from the night nursing. But I scoured your book [1982 edition] for info and didn't find as much as I had hoped. I ended up combining Dr. Sears suggestions with my own bargaining to get it to work. Wanted more support that it WAS the right thing to do tho!

      I am nursing both E. (23 months) and M.(4 months). Though the tandem nursing was initially stressful, it has become much more enjoyable and I can already see the wonderful relationship developing between the girls. My question is in regards to E., the 23 month old. We have been family bedding since the first day we brought her home from the hospital. A couple months before I had M. we moved her onto a futon mattress next to our bed. By that time her nursing during the day had really decreased, although she still woke up several times a night to nurse.

     With the birth of M. her nursing greatly increased. My husband also became the one responsible for E. during the night so that I could focus on the newborn. We were able to eliminate most of her nighttime nursings. We have several concerns at this point in time.

     1)E. has lately been initially sleeping for about 4 hours when she first goes to bed and then often wakes up every 1 to 1-1/2 hours after that. Falling back to sleep often means my husband has to walk around the house with her for 30 minutes before she can be put back down, but then she wakes up 30 to 45 minutes later. E.'s bedtime is between 8 and 8:30 and then she wakes up at about 5:30 or 6. Needless to say my husband is exhausted and I feel guilty because the little one wakes up only once maybe twice a night, so I'm well rested. Any suggestions on how we might be able to guide her to sleep more soundly so she's not waking up as often.

     2)My second concern involves how E. falls asleep - the only way I can get her to sleep is if I nurse her, my husband can get her to sleep by walking and singing to her (it takes an extra 1 to 1-1/2 hours after her usual bedtime) , and baby-sitting grandparents have to wait for complete exhaustion (about 3 hours after her usual bedtime). This creates a problem at nap time when I'm alone. Unless the stars are perfectly aligned and the little one is sleeping when E. is tired, I have a hard time getting her down for a nap. How can I get E. to fall asleep without nursing, because I usually have to worry about M.?

     3)My final concern is in regards to when E. actually does take a nap. As of late she is not taking a nap at all or it ends up being about 5:30. which of course means she doesn't want to go to bed at 8. When she does nap at a more normal nap time she often only sleeps for 30 to 45 minutes and wakes up screaming. Then if I would let her she would nurse for another 1-1/2 hours in my lap, not letting me remove my nipple from her grasp. Any suggestions?

  Response to the above from NJB:  I can just see the circles under your eyes (or your husband's) as I read about your sleepless nights. Most parents have been there one time or another. You may not like what I'm going to say, considering our traditions about bedtimes. (Before I say it, I'll remind you that I am trained as a journalist, not as an expert in child development, so there is absolutely no reason you have to believe me.) I would suggest that your daughter doesn't need nearly as much sleep as you need her to need. That's certainly the way it was with mine. Early to bed and some quiet adult time without children underfoot just doesn't happen with many toddlers. I found some comfort back then in reading that the more intelligent the children, the less sleep they seem to need. [Anybody remember reading this, and where?] My life changed for the better when I forgot about the time and just put them to bed when they dropped. Fortunately for all concerned, sleep patterns seemed to change as they get into school. Then their sleep needs increase, and life gets a bit closer to what we expect. I hope you find something helpful here.

I would like to see updated info on family beds -- how to make room for new baby with a 4 year old firmly planted in the middle!

See La Leche League International’s Toddler Tips on nursing at night

Notes from some research on cosleeping and bed-sharing. Some of the older studies reflect cultural bias against parents' sleeping with babies and toddlers, reflected in, for example, a definition of "problems" that includes night waking that doesn't worry the parents.

(Notes by NJB from McKenna, JJ. Cultural influences on infant and childhood sleep biology, and the science that studies it: toward a more inclusive paradigm, in Loughlin, J; Carroll, J; Marcus, C (Eds.), Sleep and Breathing In Children: A Developmental Approach Marcell Dakker 2000, 199-230)      Children's needs change much more slowly than the culture. Sleep management strategies suitable for some are unsuitable for others. Yet when established sleep norms don't work, parents can end up blaming themselves or their children.
     In the US, Great Britain, and Australia, possibly as many as 1/3 of healthy children who have been conditioned to fall asleep alone have difficulty falling asleep or staying asleep. This high percentage probably reflects a problem, not with the parents or children, but with our expectations.
     Dr. McKenna, Professor of Anthropology and Director of the Mother-Baby Behavioral Sleep Laboratory at the University of Notre Dame, writes: "Only in the last hundred years or so, in a relatively small number of world cultures, have parents and health professionals become concerned with how infants should be conditioned to sleep. And only in western cultures are infants thought to need to "learn" to sleep, in this case, alone and without parental contact. Most cultures simply take infant sleep for granted."

(Notes by NJB from a 1986 study: Elias MF; Nicolson NA; Bora C; Johnston J. Sleep/wake patterns of breast-fed infants in the first 2 years of life. Pediatrics 1986 Mar; 77 (3): 322-9)
     Published norms predict that babies' sleep increases from four-five to eight-ten hours by four months, with a daily total sleep time of 13-15 hours. A study that followed 32 breast-fed infants for two years showed that those who nursed into the second year continued to wake frequently, especially if they shared a bed with mother. Their total sleep in 24 hours was also less than that of weaned infants. (A quote from the article, p. 327: "It seems ironic that, although night waking is so much less frequent in infants cared for in the western style [i.e., weaned and sleeping alone], it presents so much more of a problem.") The authors' conclusions: "The sleep/wake development accepted as the physiologic norm may be attributable to the early weaning and separated sleeping practiced in western culture. As prolonged breast-feeding becomes more popular in our society, the norms of sleep/wake patterns in infancy will have to be revised."

(Notes by NJB on Lozoff, B; Askew, GL; Wolf, AW. Cosleeping and early childhood sleep problems: Effects of ethnicity and socioeconomic status. Developmental and Behavioral Pediatrics 1996 Feb; 7717 (1): 9-15)
     This study examines the effects of socioeconomic differences within ethnic groups on sleep patterns and problems reported by parents.
     Cosleeping children woke twice as often as those sleeping alone -- or perhaps parents were just twice as aware of their awakening. Many cosleeping black families, regardless of socioeconomic status, did not regard bedtime protests or night waking as a problem or source of conflict, while the majority of co-sleeping white families did.
     Night waking may seem less of a problem to parents when cosleeping is a regular option and when cosleeping began in infancy rather than in toddlerhood.
     A quote: "Cosleeping may cause sleep problems or occur in response to them. The authors do not see cosleeping as a solution to already existing sleep problems. They recommend, however, "that pediatric health professionals examine the cultural context in which cosleeping behavior occurs and tailor the advice they give about cosleeping and sleep problems."

(Notes by NJB from the abstract: Latz S; Wolf AW ; Lozoff B, Cosleeping in context: sleep practices and problems in young children in Japan and the United States. Archchives of Pediatrics and Adolescent Medicine 1999 Apr; 153 (4): 339-46)
A study of 56 Japanese and 61 white US middle class parents of 6- 48-month-old children who had been breastfed:
      More Japanese than US children coslept 3 or more times a week. The Japanese children were much more likely to spend all night with their parents. Most Japanese children had adult company and body contact while falling asleep.
     More US than Japanese children had regular bedtime struggles. For the US parents cosleeping was associated with bedtime struggles, night waking, and stressful sleep problems. Japanese parents connected cosleeping with night waking, but at the same level reported by US parents of children who slept alone.
     The authors' conclusions: "Cultural differences seem to influence the relationship between sleep practices and sleep problems. The experience of the Japanese families indicates that cosleeping per se is not associated with increased sleep problems in early childhood."

(Notes by NJB from the abstract: Wolf AW ; Lozoff B, Object attachment, thumbsucking, and the passage to sleep. Journal of the American Academy of Child and Adolescent Psychiatry, 1989 Mar; 28 (2): 287-92.)
      This study of 126 healthy U.S. infants attempted to determine the most important factor determining whether or not children comforted themselves with thumbsucking or an attachment object at bedtime. The factors compared were presence or absence of a caregiver when the child fell asleep; mode of feeding; location in which the child was supposed to sleep; and whether or not the child slept with the parents. The authors' conclusions: "In contrast to cross-cultural research, the results of the present study suggest that where a child sleeps during the night or how the child is fed is not as important an influence on the bedtime use of an attachment object or thumbsucking as whether an adult is present as the child actually falls asleep.