Once you've figured out what works to get your little ones to sleep, you'll then need to figure out how to adjust the sleep routines and progress towards your ideal sleep situation.
Progressing - aka. consistency & patience. I would assume that most parents have the same goals for their children's sleep habits. My guess would be that parents would love to help their children get pjs on (or even send them to get pjs on), then kiss them goodnight and walk out of the room... and not see or hear them again until morning.
To achieve this goal, parents will need to gradually help infants & children learn to finish falling asleep on their own. This usually means cutting out the very last part of the routine. If you're breastfeeding, the biggest trick is to unlatch the baby while they're drowsy, but still awake, and let them fall asleep the rest of the way.
Also, when I say "gradually", I mean it... C's preferred method of falling asleep still involves the breast... but it's not the only way she can fall asleep. A few days ago, I was nursing her down for a nap and one of the twins started fussing. I just told C that her brother needed me and she unlatched, rolled over and fell asleep. But, at this point, those drowsy nursing sessions are still enjoyable for both C and I, so I see no reason to stop them yet. (Plus, it's still the easiest way to get her to sleep.) Since K and D no longer nurse, their preferred method of falling asleep usually involves cuddling... but who doesn't love to fall asleep while snuggled up to someone? Even though K and D *prefer* this method, it only happens on rare occasions now. Now K asks to "cuddle", but after 5 minutes or so she tells me I can go to my own bed. :) More often the girls fall asleep in their beds, while I'm nursing C or the boys.
Adjusting - aka. flexibility. We need to be constantly aware of what is working and what is not working. If something doesn't work... that means it's time to change. For a long time I did NOT. EVER. get out of bed in the middle of the night. When my babies needed me, I rolled over and got them. When my toddlers needed me, they crawled over to me or climbed into our bed (depending on where they were sleeping), and when my preschoolers needed me, I simply told them to come find me. Recently, however, this has led to too many extra kids in our bed and Dave and I are not getting the sleep we need. We recognized that this was no longer working and tried to find a way to fix it. We discovered that most of the time our preschoolers woke up, they simply needed to go potty. If we just told them to go potty themselves, they would climb into our bed. But if someone got up to take them to the bathroom, then they would happily climb back into their own bed.
Troubleshooting - getting little ones to fall asleep on their own is not the main issue most parents complain about... instead, it is the frequent wakings throughout the night. Night wakings are common even for adults, so the trick isn't to prevent night wakings, but to help children fall asleep again with minimal parental involvement. Sometimes this involves teaching a child to take care of the reason for the waking, sometimes it involves simply waiting for a child to outgrow the reason for the waking. Either way, there are things parents can do to ease the waking and minimize the time awake.
Again,
read The No-Cry Sleep Solution by Elizabeth Pantley for more tips on troubleshooting, but here are a few things we've dealt with and a few things that worked for us.
Hunger/Thirst - Obviously tiny babies need to eat in the middle of the night. Their tiny digestive systems are simply not mature enough to handle going so many hours without food. Growth spurts can also cause more frequent night wakings than normal. The best way to handle these types of night wakings is to simply feed the baby. The sooner they have a full belly, the sooner you can all go back to sleep. This is another reason I prefer co-sleeping with tiny ones... I don't have to get up to handle the night feedings.
For older babies and toddlers who can go all night without eating, they still may wake up thirsty. If you are nursing, you can just offer the breast. If you are no longer nursing, or if you have night-weaned or want to night-wean, you can offer a water bottle for those middle of the night wakings. Our children have each been given a water bottle around their first birthday, which stays right next to their beds all night for middle of the night sips. Again, the idea here is not to stop the night waking... but to help them deal with the cause on their own. Personally, I still wake up thirsty in the middle of the night, so I also have a water bottle by my bed.
Teething - Long term, teething affects sleeping until all 20 baby teeth are completely in. My children are early teethers and usually finish this portion of teething by around 2 1/2. Short term, there are a few things you can do to make teething more comfortable. I prefer not to use Tylenol or other medicines for my children, and usually choose more natural topical options first. We LOVE clove oil for teething. 2-3 drops of clove oil, diluted in a tablespoon or so of extra virgin olive oil, is usually sitting by my bed. A drop or two rubbed on sore gums numbs them enough to help them sleep longer. I've also heard excellent things about Hyland's Teething Tablets, but I've never tried them because clove oil works so well for us.
Diaper/Potty needs - I'm sure that you would not sleep well if you were sleeping in a puddle, so you can understand why a baby/toddler/young child would not sleep well either. I also don't sleep well with a full bladder, and I'm sure you don't either. I don't practice elimination communication or diaper free baby techniques, but those who do explain that even tiny infants will wake because they need to empty their bladders, and often a diaper change is all a baby needs. We have also discovered with our older children, that they will often wake up when they need to use the toilet, but are too sleepy to find the bathroom on their own.
I'm no expert in this area... but I would guess that teaching children to ignore these signals and sleep through them would be contributing to some of the bed wetting issues that are cropping up in our society now. So again, we should not be worried about preventing these night wakings, but we should be helping our children handle them on their own. We can simply change diapers when they are wet/soiled, and take older ones to the bathroom when they need to. Long term, children should be able to figure out how to get to the bathroom and back to bed on their own. Currently, K is handling most of her nighttime potty needs by herself, but D still needs help because she's not completely awake when she gets up.
Temperature - Is the room too hot? too cold? are there enough blankets? too many layers? Finding the right combination of room temperature and coverings is tricky, especially since everyone has different preferences in this area, and because needs & preferences change with the seasons.
When C was a tiny baby, she fell asleep best when she was swaddled nice and tight. However, during her first summer, she started waking about 15 minutes after I put her to bed. When I would go check on her, I realized she was sweating from the thick blanket she had been swaddled in. So, I changed my routine. I still swaddled her to put her to sleep, but about 10 minutes after I put her down (so 5 minutes before she would wake up), I would go carefully unwrap her. She would sprawl out, adjust slightly and sleep another 5 hours until her next feeding.
Developmental Milestones - I hate to say it... but there's not a whole lot you can do about developmental milestones. Learning to roll, crawl, walk, talk, run, read, etc.. all affect sleep. Once the new skill is learned, children usually start sleeping longer stretches again, unless something else is causing the wakings. Long term, you usually just have to wait it out. Short term, if the night waking is causing a little one to wake for an extended period of time, the best thing to do is to just let them be awake.
When K was almost 10 months, she started waking about 2am and staying awake crawling over Dave and I for about 2 hours. She was wide awake, and we tried everything to get her to fall asleep again. I was 6 months pregnant with D at the time and really needed sleep, so we finally put a crib mattress on the floor between our bed and the dresser, and let her play there while she was awake. She would finally either ask to be picked up, or she would fall asleep on the mattress. This went on for about 6 weeks. Finally, just after she turned 11 months, K took her first step, and suddenly started sleeping great!
Night Terrors/Nightmares - Read The No-Cry Sleep Solution for a good explanation of night terrors and nightmares and the differences between them, and for lots of suggestions on handling these situations. The main thing we noticed with night terrors was that the child didn't actually seem to be awake. They did not respond to us, they would cry and ask for mommy or daddy and then not recognize us, and they would push us away. What finally worked for us was to simply talk to them, and put a hand gently on their back and tell them to lie down and go to sleep. When our kids have nightmares, they usually just climb into our bed and go back to sleep, when they get a bit older, we will probably have them make a bed on the floor next to our bed, instead of climbing into our bed with us.
Illness - Of course you should also be on the lookout for any illness. I have learned that D tends to wake up whining and whimpering when she needs to throw up... it's not a fun sound for me to hear, but I'm grateful for the warning. Ear infections, sore throats, nausea and other symptoms of illness can keep kids from sleeping well. Again, I prefer not to give my kids a lot of Tylenol or Benadryl-like medicines, so we use more natural remedies instead when we can... but more often we just let an illness run its course.
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I'm sure this troubleshooting list is not exhaustive, but it should provide the beginnings of the thought process parents should go through when trying to figure out why their child is not sleeping the way they should.
One final thought as I end this Sleep Secrets trilogy - infants, toddlers & children will always try do the best they can. However, the best they can do, may not match up exactly with what a parent hopes or expects. Parents can help children overcome any problems or issues that may be interfering with sleep, but also need to accept that it's okay for a child to have different sleep habits than the parent would choose.
Happy Sleeping!!
