Two-and-a-half year old Liam’s sleep was finally improving. After months of bedtime protests, he was going to sleep independently and easily.
But there was a catch.
Liam still had one more tool in his toolbox. The potty.
You see, Liam had successfully potty trained during the day, and was dry most nights, despite wearing a Pull-Up. Both Liam and his parents were excited by his progress… and that made them reluctant to ignore Liam’s requests to go to the bathroom…. Even when it was only 15 minutes since the bedtime bathroom trip.
Liam was also requesting lots of water at night. He actually slept with his water bottle in his bed! He also drank water somewhat compulsively during the night, but not during the day. (So we knew there wasn’t a medical issue going on.) And the frequent refills were, of course, making Liam need to go to the bathroom more often. Disturbing his sleep and his parents’ sleep.
But Liam's parents were loathe to tell him that he couldn’t have water at all. Both because they didn’t want him to be genuinely thirsty, and also because Liam would throw a massive tantrum if they took his beloved water bottle away. It seemed to be like a security blanket for him.
So here’s what we did. We set new, very clear boundaries.
Liam got two “pop-up cards” each night. He decorated them with marker and stickers so they felt very special to him. He actually loved them so much he carried them around the house with him!
After lights out – which was dictated by a timer set ahead of time – Liam could trade in his pop-up cards to have his parents come back. Just twice. His parents warned him – ahead of time, so there was no middle of the night conversation – that when the pop-up cards were gone, they wouldn’t come back, no matter what.
Because the presence of the water bottle was so soothing to Liam, his parents decided to keep the water bottle but gradually decreased the volume of water in it, so that it was less likely to create another bathroom visit. And then instead of refilling the water bottle, which took more time and thus created more engagement, they kept extra water bottles at the ready, outside his room.
So when Liam invariably used a pop-up card to request a trip to the bathroom, they also handed him a new water bottle, with only about an ounce of water. No negotiating for more.
Liam’s mom asked why he was still waking up twice a night near the end of the two weeks, and we realized that they were probably inadvertently reinforcing the night wakings with too much attention, even though it was so much less attention than he had received prior to sleep training.
Handing him a new water bottle instead of refilling the old one helped. I also instructed them to reduce the nighttime conversation to zero. They would silently take him by the hand to the bathroom, help him use the potty and wash his hands, silently escort him back to his bedroom, and silently point him in the direction of his bed. No more tucking him into bed in the middle of the night. Even the time and attention of tucking him into bed was reinforcing his night wakings. I asked his mom to act like a robot. Zero interaction, beyond escorting him and providing physical attention in the bathroom.
In case this sounds cruel, remember that this is only in the middle of the night. I encouraged his parents to actually give him extra attention during the day, in the form of roughhousing before dinner, so that he felt extra supported and loved. The idea is to give attention at appropriate times. When a child’s night wakings are rewarded with attention, though, it creates more night wakings, and everyone suffers, most of all the child, who becomes overtired.
Love and attention are critically important… but they should only happen during the day. Give extra attention during the day to make up for the lack of attention during the night.
If you are ready to set more clear boundaries around sleep but aren't sure where to start, set up a free discovery call and discover that your entire family really can feel well-rested.
Abby Wolfson is a pediatric nurse practitioner, certified child sleep consultant and former NICU nurse. She divides her time between Brooklyn, NY and San Miguel de Allende, Mexico.