Renee A Alli, MD
Many a parent has made excuses for a cranky child because the little one missed a precious nap. Or perhaps the parent has dropped everything, barely obeying the speed limit, so the tired tot makes it home in time for some afternoon ZZZs.
There is no doubt about it: Napping is an important part of your toddler's day -- and yours. You count on nap time to get things done, and your child needs to recharge and reboot or everyone will suffer the consequences. But why are naps so critical to youngsters, when will they outgrow them, and how can you make sure naps don't interfere with a good night's sleep?
By following WebMD's no-nonsense, expert-approved napping guide, that's how.
"Napping conserves energy," explains Charles Shubin, MD, medical director of the Children's Health Center of Mercy Family Care in Baltimore and an associate professor of pediatrics at the University of Maryland, also in Baltimore. "When going through a growth spurt, an infant or toddler will sleep more and eat more because the energy demand that growth creates is tremendous," says Shubin, also an assistant professor of pediatrics at Johns Hopkins University in Baltimore.
"To grow, we need adequate calories and ample sleep, and that is why babies sleep more than we do," he tells WebMD. As toddlers get older, they will eat and sleep less, says Shubin.
Some of this sleeping is done as naps, while some of it takes the form of nighttime sleep. Exactly how it is divided depends largely on the child's age and developmental stage, he says.
For example, newborns sleep between feedings all day and all night long, he says. "At around 3 months, they will start developing a day/night variation and their longer sleep will hopefully be at night." This typically doesn't happen much earlier because newborns need to eat every few hours and just can't get the stretch they need at night.
"Infants sleep 16 to 20 hours per day, and as time goes on, they outgrow sleeping all day long and only take two naps -- one in the morning and one in the afternoon," says Susan Zafarlotfi, PhD, the clinical director of the Institute for Sleep and Wake Disorders at the Hackensack University Medical Center in New Jersey.
Naps tend to work themselves out, agrees Greg Yapalater, MD, a New York City pediatrician in private practice. This pattern usually is established when the child is an infant and often revolves around feeding schedules. This helps shape the schedule going forward. "You are probably feeding every three hours, which is four bottles a day, so things start falling into place and then what you are going to do about naps becomes very straightforward," he says. For example, some parents may choose an hour after the first bottle for the morning nap and then an hour after the midday bottle for the afternoon nap.
"If your child goes to day care, shoot for the same schedule that the facility imposes regarding naps," suggests Rafael Pelayo, MD, an associate professor of sleep medicine at Stanford University School of Medicine and a sleep specialist at Lucile Packard Children's Hospital, both in Palo Alto, Calif.
"Tune in to your kids' signs that they are ready to nap," Shubin says. "Some kids sit there and stare. Some get fussy and some kids cry when they are ready to nap."
"They may start blinking their eyes, yawning, getting cranky, rubbing their eyes, or start zoning out when they need a nap," Yapalater says, warning that "this can happen quite quickly."
"Try to put your child in the same environment for each nap," Yapalater suggests. "Don't let your child nap in the crib one day, a day bed the next, and in your bed the day after that," he says. Why? "You really want the napping environment to be as consistent as possible so your child will associate it with going to sleep," he tells WebMD.
"You can't force anyone to take a nap, but you can create the environment for sleep," Yapalater says. "Tell your child 'you can sleep, be awake, or sing, but you have to stay put,'" he says. "Don't make an appearance as you would at night because there are more distractions during the day, so it doesn't take much for them to say 'there is too much going on here for me to nap.'"
This may be convenient, especially if your sleepy tot doesn't transfer well, but it can be dangerous, Yapalater warns. "Do not let your children nap in strollers, bouncy seats, or car seats that are parked on the floor because these places are not made for sleeping unless they are constantly monitored." Accidental strangulation, suffocation, and/or entanglement can occur due to all the buckles and straps.
In most children, the morning nap drops out by 12 to 18 months because they need less sleep. "Let this happen on its own," Shubin says. "Your child will stick to an afternoon nap until they are anywhere from 2 1/2 to 4 years old. Some 3- or 4-year-olds still take an afternoon nap, but 6-year-olds don't nap."
"There is not a hard-and-fast rule about outgrowing naps," says Mary Michaeleen Cradock, PhD, a clinical psychologist with St. Louis Children's Hospital in Missouri. "You may start to see signs that the child wakes up earlier from a nap, or they may not show any signs that they need one."
Nap refusal in an 18-month-old is not a sign that he or she is outgrowing their nap (however, it may be in a three-year-old). "If a child doesn't want to take a nap, this can be mistaken for having outgrown their nap, but he or she may just be overtired," Craddock says.
"If it's a day or two of protesting, don't subtract the nap too fast, but if nap protesting goes on for a couple of weeks, then it may be time to give it up," Yapalater says.
Some parents are really uptight about their toddlers napping schedule. "They get carried away and the whole day is centered around the napping schedule," says Stanford's Pelayo, author of the forthcoming Sleeping Makes Me Tired. "If getting your toddler down for a nap is interfering with your life, it's a problem. You have to be flexible. You can always slip in a shorter nap or a later nap."
Shubin agrees: "Nap schedules are more about parents. There aren't rigid guidelines about when and how long a child should nap. Most tables are pure approximations."
"If nap is more than one hour and 45 minutes, your kids may wake up cranky," says Pelayo. "Ninety minutes is just right."
This may sound like a good plan, but it doesn't work and may even backfire, says Cradock. "If you keep them up to make them more tired, they will be too restless and unsettled to use the normal self-soothing routines that put them to sleep at night," she says. A better plan is to tweak the nap or nap schedule by shaving off 15 minutes or starting the nap earlier in the day. Later naps are not always the best call because your child needs to get a certain amount of daylight, and napping until its dark may prevent this from occurring, Cradock says.
"If you have a good nighttime sleep routine such as doing something calming or reading a book to your child before bed, you can repeat this ritual for nap time to increase the likelihood of a successful napper," Cradock says. "If at night, you hold and rock your child until they fall asleep and at nap time, you put them in their room and suggest a nap, it's probably not going to happen."
SOURCES:Charles Shubin, MD, medical director of the Children's Health Center at Mercy Family Care, Baltimore; associate professor of pediatrics, University of Maryland, Baltimore; assistant professor, Johns Hopkins University, Baltimore.Susan Zafarlotfi, PhD, clinical director, Institute for Sleep and Wake Disorders, Hackensack University Medical Center, N.J.Mary Michaeleen Cradock, PhD, clinical psychologist, St. Louis Children's Hospital, Missouri.Rafael Pelayo, MD, associate professor of sleep medicine, Stanford University School of Medicine; sleep specialist, Lucile Packard Children's Hospital, Palo Alto, Calif.Greg Yapalater, MD, pediatrician, New York City.
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