By six months of age, most babies are able to sleep through the night. Problems develop when children wake up and have difficulty falling back to sleep. The reasons for night wakings vary from child to child. Many young children who are still nursing and/or bottle feeding wake up during the night because they're hungry. However, by four months of age, children no longer need to be fed at bedtime and then again during the night.

If parents suspect that nighttime feedings and the wet diapers that follow are the cause of their children's sleep problem, the first thing to do is to gradually eliminate nighttime feedings. This can be done by following the program described below.

*Consult health care provider. Parents should consult their children's health care provider to rule out any other explanation for the problem before beginning this program.

*When children have lots of liquid at night, sleep can be disturbed for a number of reasons. First of all, many children who drink liquids late at night soak their diapers, and this discomfort may awaken them. Secondly, feeding close to bedtime stimulates the digestive system, which can interfere with sleeping. Also, children naturally begin to feel hungry at the times they're used to feeding. If children regularly feed during the night, they will naturally become hungry during the night, even though they have no nutritional need for food during the night. Lastly, children's sleep patterns are disrupted when they wake frequently to feed.

*Children probably have a problem with nighttime feedings if they are at least four months old and take in eight or more ounces of fluid during the night. Breast feeding mothers who have to feed their children more than two times during the night should be suspicious, too, that their children may have a problem. Another clue is if children's diapers are usually soaked when they wake during the night.

*Correct the problem. This is one of the easiest problems to correct. Two things must be done. One is to gradually eliminate feedings during the night. The other is for parents to teach their children to fall asleep on their own without help from a bottle or a parent or caretaker. Please refer to the handout entitled "Getting Young Children to Sleep Through the Night" for more information on teaching children to fall asleep on their own.

*Minimize nighttime feedings. Begin minimizing feedings by putting one ounce less of formula in each bottle at nap time and nighttime feedings. Breast feeding mothers can start by shortening the time spent nursing by a few minutes each night.

*Return children to their cribs once the feeding is over, whether they are asleep or not. If their children cry when the feeding is over, parents should not feed them again until at least two hours have passed. This waiting period will be gradually increased.