My toddler refuses to sleep but she clearly needs a nap.

My 2 ½-year-old’s nap routine was to fall asleep while breastfeeding. Our doctor recommended we cut the breastfeeding, and since then she refuses to take a nap. She looks tired and sometimes is fussy. I’ve tried implementing a new routine, but she doesn’t adapt — she just jumps out of bed and opens the curtains (seems like in a fraction of second she can go from sleepy to energized). Lately we’ve been taking car rides so she gets some afternoon sleep, but this is only a band-aid, not a solution.

Thanks for this excellent question. Coordinating feeding, napping and nighttime sleep schedules and routines is often a challenge for children between 6 and 48 months.

The routines and cues that help children fall asleep at the beginning of the night typically help them fall asleep at the beginning of a nap and in the middle of the night. However, sometimes the nap routine can be different. Here are a few strategies that you can try. Start with the first #1 for a few days and if it does not work, move on to #2 and #3.

  1. Recreate the last 10 minutes of your nighttime routine for naps.
  2. Rather than driving her around, try staying in her bedroom at the beginning of the nap and then leaving quietly about 10 minutes after she falls asleep.
  3. You can feed her before her nap in a different room and right after the feeding, put her down for her nap.

It is also possible that the timing of her nighttime sleep, morning wake time and nap might need some adjustments. Some children wake early — 5:00 to 6:00am — and then fall back to sleep. This return to sleep is essentially a nap and may replace her mid-day nap. If she wakes after 5:00am you can start your day and then put her down for an earlier mid-day nap. After a few days, the early morning awakenings may go away and you can just give her a mid-day nap.

The best way to determine an optimal sleep schedule is to keep a sleep log/diary for 1-2 weeks and look for patterns. The goal is regular sleep routines and schedules both day and night. Sleep logs are an important tool that we use in our sleep clinics to give parents the cues that they need to establish a healthy sleep pattern.

ABOUT THE AUTHOR

Daniel Lewin Daniel S. Lewin, PhD, DABSM is a pediatric psychologist, sleep specialist, and licensed clinical psychologist. He is Board Certified in Sleep Medicine and Behavioral Sleep Medicine and is the Associate Director of the Pediatric Sleep Medicine and Director of the Pulmonary Behavioral Medicine Program at Children’s National and Assistant Professor of Pediatrics at George Washington University School of Medicine.

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