My 22-month-old daughter doesn’t sleep. She was never a great sleeper even as a baby but she’s not getting any better. We have brought her to my doctor several times and he referred us to a specialist who recommended we take her off bottle formula, but she will not go to bed without a milk bottle. When she goes to sleep, she is uneasy constantly, cannot sleep in the same position and often lies crouched over. She looks quite uncomfortable, but she seems to like sleeping in that position. I have asked for a scan to be done on her tummy, but the pediatrician told me her tummy was fine, ‘nice and soft.’ I’m exhausted – why isn’t she? Some days she will have a nap during the day for an hour or two but that’s a rare occasion.
Please let me know what you think I should do? Should I demand a scan be done on her?
– A Very Exhausted Mum
Dear Very Exhausted Mum,
We can’t tell you whether this might be a bowel problem, a digestion issue or any other medical problem for a number of reasons, high among them the fact that we’re not doctors. We also don’t know enough of the circumstances to even begin to speculate (with the zero authority we have) on the subject. We can tell you with the authority of personal and professional experience that a fair number of 22-month-olds do not sleep soundly through the night. This is especially true if waking up has been a regular part of the sleep pattern since birth.
Sleep behavior is usually a combination of inborn nature and learned habits. Human sleep happens in cycles, which range from around 45 to 90 minutes, depending on age and other factors. Everyone wakes up between cycles, but mostly we put ourselves back to sleep so quickly we don’t register the interruption. Babies often can’t put themselves back to sleep easily, and some argue they need to be trained to do so. Children may develop an ability to put themselves back to sleep as they get older and their sleep cycles become longer. Still, healthy toddlers and even older children can wake up several times a night and be unable to get back to sleep without help. If this is the case with your child, you can think about ways to cultivate positive sleep habits. There are many books and websites out there with tips on getting toddlers to sleep through the night. Depending on where you live, there may be sleep training specialists who will look at your specific situation and advise you.
But you may in fact be dealing with a health issue. We are big champions of the mother’s instinct. Mothers know their babies and can see subtleties of behavior that a doctor sometimes can’t pick up in a quick visit. This is new territory for you so it’s hard to know what’s normal and what’s not.
Our best advice to you now would be to pursue your line of questioning with your doctor, the specialist or another doctor until you feel satisfied with the response. We’re not getting the impression that you do not fully understand why further investigation into digestive issues is not warranted. We want you to feel good and secure in the logic behind your doctor’s assessments.
There’s no reason to cross-examine your pediatrician – putting someone on the spot or making him or her feel defensive is not productive. But it is important to have clear communication with your care-provider. One way to encourage this is to come in prepared, knowledgeable and eager to learn about all your options. If you’re worried about your daughter’s digestion, you may want to research common digestive issues for toddlers online and write up a list of questions to ask. Sometimes in the heat of the moment of a perhaps rushed, doctor’s appointment, it can be hard to gather and retain the crucial information. We’ve found that it can be very helpful to bring someone along with you to the appointment. The other person can hold or comfort your toddler while you really focus on the questions with the doctor. When your doctor suggests something you can always ask: What are the risks and benefits of doing or not doing a particular thing? Are there alternatives? What are they?
If you keep hitting a brick wall with your doctor or specialist and continue to worry about your daughter’s health, try for another opinion. Some doctors are better at explaining what is going on than others. Communication is a big part of the doctor’s job, it’s not always as finely tuned as other skills.
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This article was written by Rebecca Odes and Ceridwen Morris for Babble.com, the magazine and community for a new generation of parents.