Early wakings and nighttime wakings are the number one reason families reach out to me for help. And the culprit is one that always surprises them.

You are putting your child to bed too late. 

I know that seems crazy. You put your child to bed at what feels like a very reasonable hour, based on your family's schedule. It feels impossible to put her to bed any earlier. Your days are so hectic. 

Plus your very reasonable fear: you are afraid your child will wake up too early. I know. I get it. I am having exactly the same struggle with my five-year-old who just gave up her nap and needs an earlier bedtime. Even though I know better.

Here's the deal: overtired children don't sleep well. They wake up more at night and they wake up too early in the morning.

I suggest roughly twelve hours in bed each night for children under 6. (Maybe slightly less for preschoolers who still nap). 

The sleep before midnight is the most restful. So sleeping 8 pm to 8 am is not as good as sleeping 7 to 7 and will generally result in less overall sleep. 

My ideal bedtime for most children under six years old is actually 6:30 pm. Especially knowing that if you aim for 6:30, you might actually achieve 7 pm. 

If this sounds too hard... think about your disrupted nights and way-too-early mornings. How much would you like those to go away? Are you willing to push your schedule to make it happen? Even if it means you have to work in the evenings to finish work earlier? Remember that when your child sleeps through the night, you will be more rested and thus, more productive. So you may find you are able to finish your work in less time and not need to continue to work in the evening! 

This tip, moving bedtime earlier, has worked with every child I have worked with. Even my own. I put her overtired five-year-old self to bed at 6:20 last night -- the earliest in weeks -- and she woke up at 7:20. 

A warning: this doesn't always work the first night you try it, though it often does. I tried it for the first time a few days ago and my little one was up at 4:30 AM. Sob.

But two days later, my efforts paid off and she started to sleep later.

Most of my families see results in two to three nights, and often even faster. So give yourself a few days, at least, to try this radically simple suggestion: an earlier bedtime.  

​If you want to put your child to go to bed earlier and sleep all night long but aren't sure how to make it happen -- maybe you struggle emotionally even if you have the book knowledge of what needs to happen -- set up a free consult and get your family the sleep you deserve. 

When I started my job as a pediatric nurse practitioner at a progressive public elementary-through-high school in Brooklyn, NY, I thought I might never leave. At the very least, I thought I would stay until my then-theoretical children graduated from elementary school.

It seemed like the perfect job for me. It was two blocks from my apartment. The politics of the school were amazing, with a focus on prioritizing racial and economic diversity as well as social justice. The teachers were warm and devoted, some of them spending decades at the school. Admissions to the school were through lottery, but as long as I worked there, the odds were high that my future children would be able to attend this gem of a school. I was providing primary care to children ages 4-19, including reproductive health services to adolescents, and seeing a dramatically reduced rate of teen pregnancies in our community as a result. I was treating many asthamtic children, addressing their symptoms as well as starting them on preventative medicines to improve their long-term outcomes. I was making a difference. And it felt amazing. I was happy to work long hours to achieve these results. 

Thirteen years later, it was feeling far less ideal. My commute was now 45 minutes or more, by subway and on foot, dragging a tired child behind me. The demands of the job had increased radically. My popularity meant there was an ever-increasing demand for my clinical services, while at the same time, the advent of electronic medical records and other new documentation requirements meant my administrative work had increased exponentially. 

I was exhausted. My child was exhausted. I was missing my baby at home with the nanny. I was almost never fully emotionally present with them, because I was racing the clock throughout the day. It was a battle to get out of the apartment in the mornings -- especially with the nanny often being late herself -- and to get home in time to relieve the nanny at the end of the day. 

Then I rushed them through dinner and into bed at night so I could cook dinner, eat, clean up and fall into bed exhausted at night, only to get up at 5:15 the next morning to start the cycle all over again. 

I was also rushing through my patients during the day, anxious to keep up with the ever-growing pile of paperwork. Our funding was always in question, and we got laid off several times, only to have funding reinstated when our devoted patient families fought on our behalf. I was humbled by their efforts, but exhausted by the stress of job insecurity.

One day my beloved medical director made a comment that I mistakenly interpreted to mean that our program's medical assistants would be laid off. One day of working solo without my assistant was miserable -- swabbing a sore throat for strep before dashing back to the waiting room to check on the latest patient to arrive. An eternity of working alone was intolerable. 

A switch flipped. I was done. 

I started looking for other jobs and even had an interview for a similar job with another, more well-funded and stable organization. I realized I couldn't start over, doing the same job again, just in a new and more geographically distant community, no matter how stable the organization. 

A couple of weeks later, I had an evening off and went to get a pedicure, blissfully alone. My pedicurist was Mexican and we cheerfully chatted together in Spanish. A lightbulb went off. I loved speaking Spanish.

I remembered a conversation I had recently with my older friend, Scott, who was beginning his retirement and talking excitedly about the places he would travel. I remembered thinking wistfully that I didn't want to wait until my own retirement to travel. I wanted to travel now, with my children, while they were still young enough to want to travel with me.

I remembered my years' long "conversation" over Facebook Messenger with my friend and fellow single-mother-by-choice, Jackie, about our desire for immersion travel with our children. We had traveled together the previous summer to San Miguel de Allende. I had always thought "immersion travel" meant trips during my glorious summers off from work. 

But now I started to have a different dream. What if I gave up everything -- my newly remodeled apartment, my beloved community of friends, my devoted patient population -- and moved to Mexico? 

It seemed like a crazy idea. And yet. I knew I had to do it. I had to make the leap. 

I got in touch with Jackie and shortly therafter, to my amazement, she decided to make the same leap. She already worked remotely so she didn't have to give up her employment but just like me, she packed up her home, sold or gave away most of her possessions, and flew her family to Mexico. 

Saying goodbye to the only life my children knew wasn't easy. It was particularly hard to say goodbye to Amy's family -- we had shared a nanny and raised our children together every day for seven years -- and to Emily's family -- we lived in the same building, were both single mothers, rode the subway together every morning and often shared meals. I couldn't speak as I silently, tearfully said goodbye to each. They weren't just my friends, they were our family. 

But I knew that the time we spent together, as precious as it was, didn't make up for the hours and hours of stress and exhaustion every week. As much as I loved being in their lives, it wasn't enough.

So on August 6, 2018, we boarded a plane with 7 overstuffed suitcases and flew to our new lives in Mexico. 

​to be continued....

Hi Abby!

Well, the world is collapsing and so am I!!

Julie and I have been home for 3 weeks (due to COVID-19) and somehow her sleep is even worse and I desperately need a schedule.

She gets tired after only an hour and a half of wake time which is crazy because she’s about to turn 9 months. I try to stretch her awake time and I think she’s so overtired that she does gymnastics in her crib and then only naps for 20 minutes. It's like getting in the crib invigorates her! She will lay on her back for a bit kicking, then stands and mouths the crib, then lays down and pushes her arm through the slats, then puts her head on the mattress and waves her booty around. Sometimes she just sits up waving her paci around and holding a press conference. It's adorable but very odd! I’m just grateful she’s not crying so I don’t go in unless I think she needs me.

I’m supposed to be working from home and while I obviously can’t work while she’s awake, it’s impossible to get anything done in the day when she never sleeps! Lately she's been skipping her third nap of the day -- should I keep trying to put her down for it?

I’m also trying to feed her solids twice a day and struggling to get her to actually eat and I think it’s because she’s always so tired! She's also started waking up between 4 and 5 each morning so I am very tired too!

Please help!

Erin, mom to Julie, 9 months

As soon as you get used to a routine with a baby, the routine changes.

Babies typically give up the third nap by about 9 months; some a bit sooner. I encourage parents to maintain that third nap as long as possible but at some point, it stops working. 

This nap transition is often complicated by the fact that it is occurring at an exciting time, developmentally. This baby is sitting and pulling to stand and babbling, all things that she is excited to practice in her crib, even when she's exhausted. Her lack of interest in solid food right now likely reflects her total exhaustion. It's not a health concern at this age, when it's fine for her to get most of her calories from breastmilk or formula anyway, but it is naturally worrying to her mother. 

In the case of this overtired baby, we decided to have her mother put her in the crib for 30-45 minutes each day at 3 or 3:30 so that this single mother has a brief opportunity to work and so that baby can have some quiet time. She hasn't been falling asleep but it's not a problem or a punishment to put a baby in her crib for some time to decompress. It's actually a great opportunity for the baby to practice all her exciting new skills in a safe environment. Luckily she doesn't protest this time out. 

We also moved her naps earlier, to 8:30 am and 11:30 am, to try to get her to sleep before she is overtired. And we are striving for a 5 pm bedtime. Occasionally, when her short naps lead to early morning wakings, I have counseled her mother to attempt a third nap in the car. 

Normally, I never recommend car naps because naps in motion are never of high quality for older babies and toddlers. But sometimes, when a child is overtired, a nap in motion can help prevent the sleep debt from becoming too great. A mid to late afternoon nap in motion, when she wouldn't be napping in the crib anyway, serves as a bridge to keep her from getting too overtired before her very early bedtime. 

We are still working together and finetuning the plan each day, but Julie is gradually -- usually -- lengthening out her two naps a day. Her early morning wakings are improving. 

The good news is that this transition, like all transitions with babies, is generally short-lived... even if it feels like it lasts forever. Julie will master the latest set of developmental skills and be more willing to sleep at bedtime again... so the early morning wakings should end. Her body will become more accustomed to only two naps a day and the naps should lengthen out, especially when she doesn't wake up so early in the morning. 

It all sounds simple here but when you and your baby are both exhausted, it's hard to troubleshoot successfully. Let me help.

"Ask Me Anything" sessions are just $45 for a fifteen-minute call. During this season of COVID-19, I am offering a special one-week package of sleep support for only $279 (normally it's $379 for two weeks) and additional discounts are available for returning clients. Schedule a free consult today and get your tired family back on track.

Dear Abby,

How long do you normally give a schedule adjustment before deciding whether you think it's working? We had a rough night with the baby last night and I feel like I did everything "right" yesterday — all three naps were on time and I put her to bed early last night. She woke up and got herself back to sleep in a few minutes at about midnight; but then woke up at 2 and cried off and on until I went in at 3a. 


The confounding factor: She started flipping onto her belly on Sunday. When I went in at 3a she was on her belly and crying, and I'm wondering if she was upset because she didn't know how to flip onto her back. I will say, when I went in at 7a this morning, she was sleeping happily on her belly, so maybe she came to terms with it quickly?? She also rolled belly-to-back for the first time while playing this morning, so who knows??

Thanks, 

Anna, mom to 5 month old baby S

Welcome to developmental leaps. They are exciting but they can really mess with sleep! The good news is that the disturbance will be temporary if you are consistent in your response. In other words, refrain from rewarding the unwanted behavior.  

In the case of this particular developmental leap, rolling, this mom did perfectly. She left her baby alone to sort it out. She could have gone in sooner to flip her baby over onto her back again... but the baby might well have rolled back onto her stomach again and cried all over again. You can certainly try rolling her back and if it works, great, but if she keeps rolling back, there's nothing to do but let her figure it out.

The best way to help takes time but it is to give her lots and lots of floor time to practice her rolling skills. Limit your baby's time in containment devices such as swings, bouncers, exersaucers, Bumbos, Jumparoos as much as possible. This baby learned to roll back to her belly just three days after rolling to her stomach but it can sometimes take a month or longer. A clean blanket on the floor is always the ideal place for a baby to play unless there is a toddler or pet around who poses a risk to her safety. In that case, I recommend a Pack n Play for safety if there is not an adult closely supervising her. Toddlers can hurt an infant very, very quickly and it's not fair to expect them to know better. Same with animals. If you can create physical boundaries to keep them apart, I highly recommend doing so.  

In terms of safe sleeping, the American Academy of Pediatrics says that once a baby can roll onto his back indepdently, it is safe to leave him there. This typically happens between 4 and 6 months of age. The important thing is that you make sure that the crib has nothing in it but a tight-fitting bottom sheet and perhaps a pacifier, if desired. Bumpers, soft toys, and blankets are dangerous for babies. A sleep sack is safe but a swaddle -- once a baby can roll -- is not.  

The good news is that once babies grow accustomed to rolling, they often sleep more soundly on their stomachs. Assuming you have not been rewarding her new wakings, you may well experience better sleep for the whole family once baby learns to sleep on her belly. 

If you want your family to receive all the benefits of being well-rested but need a little help getting there, schedule a free consult and to get the sleep you deserve.