The constant refrain of every exhausted sleep-deprived parent at my clinic is, “How can I get my baby to sleep through the night?”

More often than not, a baby that was a good sleeper as an infant reverses the trend once they are toddlers, and, suddenly, sleep is the last thing on their mind.

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The primary thing to set good sleeping patterns is creating a bedtime routine for your toddler. It should be a predictable routine lasting 30 to 45 minutes and could include:

* Having a nice warm bath, brushing their teeth and wearing pajamas etc.

* Having quiet time after the bath — don’t let them run around/watch screens, but instead do a puzzle or read a book. Running around/Screens and being active can stimulate them making it harder to fall asleep. You can dim the lights and draw the curtains to reduce the light.

* You can sing or read a story or some other soothing activity.

Be consistent about the bedtime routine. Aim for a series of predictable activities that help your baby wind down and signal that it’s time to sleep. A bath and snuggles plus a story or a song all work. The most important thing is to not overstimulate them. Put your baby to bed early enough so your baby can get 10 to 12 hours of sleep at night. If your baby’s zonked during the day, try to offer a little more nap time or an even earlier bedtime.

Between the Internet and the advice pouring in from all directions, there are a slew of sleep-training methods for beleaguered parents to choose from, which more often than not can be overwhelming rather than helpful.

Imagine how easy it would be if there was one 100 per cent foolproof method that all parents could use. Unfortunately, we don’t live in a perfect world and just like other aspects of parenting, no one method works for all children. There is no one solution that fits all; there are several methods to help your toddler sleep that you can choose from. Ultimately, parents will have to use trial and error to see what your child responds to best. It, however, goes without saying that babies under nine months ought not to be put through sleep training. Here are some of the preferred methods –

While understandably this method is not a great favourite among parents — seriously who wants to hear a baby cry in the middle of the night for over an hour? Before you know it, your neighbours will be at your door — it has proven to be the most effective method.

Most children know that when they cry, their parents will promptly appear to soothe them through the night. They are smart enough to know that you will keep coming in to check on them. This method requires you to hold back on your instinct to rush to your child no matter how much they fuss and cry. You have to steel yourself not to re-enter the room, no matter how much they cry. At the most you may pop your head in the doorway to reassure them, tell them, “Everything is ok, I love you, go back to sleep.”

There are variations of this method, which include returning at set intervals or gradually increasing the length of time between leaving and returning to reassure your child.

Though it can be very difficult and heartbreaking to hear your child cry, this method definitely works faster than most other methods. To make it work, you cannot give in halfway as they will soon learn that crying longer and harder is how to get what they want. You should begin to see reduced crying as the days pass and within one week you should be able to assess whether your child is responding to this method.

If you have a toddler who only falls asleep while being rocked or held then you should try this method. Going from a lap sleeper to a bed sleeper is a big transition, so taking away the comfort of being held cold turkey is almost too much for them to bear. So, in this method, you give your child the hugs and cuddles they need periodically while allowing them to slowly adjust to falling asleep on their own.

After completing your bedtime routine, put your child in the crib or bed while they are awake and exit the room, closing the door behind you. If you toddler fusses, don’t go in immediately, rather you can wait a little and see if the crying settles. If not, go in to soothe him and pat or rub his back to calm him and again leave the room. If your toddler starts crying, go back and repeat the process till he falls asleep.

If you find your baby out of the bed, pick him up and take him back to the bed and tuck him in. A quick hug will soothe him and again make a graceful exit. This may take time but don’t give up. This method helps your toddler self-soothe and eventually he will fall asleep with little fuss.

The Ferber Method is a more strict version of this. Also known as “graduated extinction”, it calls for parents to leave their child alone for strictly timed intervals, even in the face of escalating tears and tantrums. This method may tend to be too regimented for some, one huge drawback is that Ferberizing can be very stressful for both the parents and the baby.

The Chair method is a gradual sleep-training method, usually taking up to two weeks before results are seen, and requires a lot of discipline on the part of the parents. Here, you prep your baby for bed, but instead of leaving the room, sit in a chair next to the crib. When they fall asleep, leave the room, but every time they wake up, sit back down in the chair until they fall asleep. With each passing night, move the chair further away until you’re out of the room.

Another frequent issue faced by parents is transitioning from your child from your bed to their own. Here the camping-out method usually helps. One way is to place the baby in his own bed which you sleep on the floor on a mattress for a few nights. Once he is comfortable in the bed, you can sit in a chair till he falls asleep. Then, you can place him in his bed and leave the room after a couple of minutes. You may need to pop your head in a couple of times if they cry for reassurance but don’t stay for too long.

It is often even hard for toddlers to transition from sleeping in a crib to a bed. Truthfully, there is no magic number to make this transition. It really depends on the child and can be anywhere from 1 ½ to 3 ½ years. Signs that you need to make the transition is when your toddler is fully potty-trained and wants to use the bathroom at night or once he starts climbing over the crib sides. Chances are that your toddler may find his way to your bed in the middle of the night.

Make the transition easier by keeping things as they are so the room is familiar. Don’t make too many changes at once, like if she has just started a play school or there is going to be a new addition to the family, then that is not the time to move him into a cot or separate room. Use positive reinforcement and not bribery. Reward them with a new toy or an extra bedtime story.

Now that your toddler may be beginning to walk around the room or even the rest of the house unsupervised, you should be baby proofing the home.

How to proceed with nap times

Toddlers who are overtired are cranky and have tantrums and everything else in between. The methods detailed above work for nap times also. But for short naps you can get them to do an energetic activity just before so that they are ready for a nap. Your toddler will be so tired that afternoon naps will be a breeze. Schedule naps at the same time every day. If he naps at a particular time at school or daycare, keep to that time on the weekend also. Make sure the afternoon nap is done by 4 pm otherwise getting them to bed at night will be difficult – once your child is sleeping 12 hours at night they may not need an afternoon nap.

Sometimes sleep issues are too big for parents to cope. At such times, you may want to talk to your paediatrician or even speak to a sleep consultant.

Sleep training is not easy. Many children will resist and throw a fit or two, but others may settle easily. There is no way to know where your child falls until you try. The trick is consistency and choosing a method and sticking with it. Results take time, so be patient with your child.

(Dr Saroja Balan is consultant neonatologist and paediatrician at Indraprastha Apollo Hospital. Her column appears every fortnight)

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Dr Saroja BalanDr Saroja Balan is consultant neonatologist and paediatrician at Indra... read more