Daily Dose of DrGreene

How Much Sleep is Needed?

I’m asked almost everyday by some concerned parent whether their child is sleeping enough or too much. That’s not a simple answer and varies from child to child and even from day to day. For instance, if a child has just learned to walk she will often get more sleep because she’s getting a lot more physical activity than she did just before she began walking. When a child first learns to walk, she toddles from place to place trying out her new skills with a new burst of energy. (Note: don’t put your video camera away after she’s taken those monumental first steps! There are some never-to-be-repeated times right around the corner.) Once she’s mastered walking, her sleep needs may decrease again. Of course when a child is ill or even fighting off an infection, he might need more sleep. And if a child (or adult) is looking forward to an exciting day ahead, the excitement and anticipation may naturally result in less sleep the night before.

But back to the question, how much sleep does my baby need? I have general guidelines for the range of normal amount of sleep needed for each age. Keep in mind, this is a general guideline:

 

Average Number of Hours of Sleep Needed

Age	Per Day
Birth	16 to 18 hours
First 6 months	14 to 16 hours
6 to 12 months	13 to 14 hours
12 months to 2 years	12 to 13 hours
2 to 6 years	10 to 13 hours
6 to 12 year	9 to 11 hours
12 to 18 years about	10 hours
Adults about	8 hours

Alan Greene MD FAAP

Ratatouille, Anyone?

It’s not often that I thank film makers for including a great health message for kids (and adults) in their films, but this time I must. Last week we took our 12 year old son to see Ratatouille. We expected it to be a delightful family film and it was. We all thoroughly enjoyed it. The next day my wife decided to serve something for lunch that was not on our son’s normal menu of favorite foods. While our son was helping with lunch preparations he showed unusual interest in learning new cooking skills and even though he didn’t normally eat the dish we were having for lunch, he suggested some additional ingredients that he thought would make it better (and they did). We sat down together, said our family’s traditional thanks for the food, and began our meal. After the first bite, our son closed his eyes and ...(continued)

Alan Greene MD FAAP

The Bedtime Pass Program

For almost ten years now I’ve suggested using a simple, easy “Get Out of Bed Free Card” for those who want to help preschool and school-age children learn to happily stay in their own rooms at night. I’ve heard from thousands of parents around the world who have been thrilled with the results. Now, in the April 2007 Journal of Pediatric Psychology the author of the original study on the technique, and colleagues, report a randomized controlled trial in 19 children whose sleeping habits were carefully monitored and measured. All of the children in the study were bedtime resistant at the start; they regularly cried, called out, and/or left their rooms after bedtime. Half received bedtime passes, which I’ll describe in a moment. The children who received passes quickly began to call and cry out significantly less frequently. The time to quiet dropped significantly. And trips out of the bedroom dropped to near zero. When the children were monitored again 3 months later, the families were still enjoying these benefits, even though none of them were still using the passes. The children who had never received sleep passes, though, were still crying and calling out, taking longer to quiet at bedtime and still leaving their rooms afterwards. The parents who tried the bedtime passes were very satisfied – 92 percent reported that it was easy and stress-free for them and 100 percent believed that their children experienced no discomfort. This is so important. Not responding to a crying child can be very stressful for both parents and children, and cut against our primal instincts.

So how do you use bedtime passes? Simple.

1. Give your child a special card good for one free trip out of their room each night or one visit from a parent – for a brief, acceptable purpose such as a drink and a hug. Many families decorate the cards, often with the child.
2. Require the child to get in bed at bedtime, but be sure the free pass is close at hand.
3. When the child uses the pass, the card is surrendered for the rest of the night.
4. If children leave the room again that night, they are walked back without a word and without eye contact.

This method can work like magic for children age 3 to 10, if your goal is for them to sleep in their own rooms. I’ve also seen it work wonders in some younger and older children. The first couple of nights most children try the pass to be sure it works. They will often try an extra visit or two to be sure you are serious about no attention later in the night. Then, the magic happens: most kids start holding onto their cards throughout the night, in case they might need it later, and fall asleep on their own, remaining in their own rooms all night. If you leave the pass on the nightstand, you might find it in your sleeping child’s hands in the morning. Aren’t they beautiful when they sleep?

Alan Greene MD FAAP