The Two Sides of Sleep: Part 2

Eat. Poop. Play. Sleep. Repeat.
That may be your baby’s routine for their first year of life, but as they age, that schedule (and their sleep) become much more complex. The internet is filled with suggestions to ease your kiddo to sleep, but today we’re investigating two things that can affect toddler sleep: melatonin and co-sleeping.

Sleepy Little Pill

Melatonin (also known as the sleep hormone) is responsible for regulating our body’s sleep/wake cycle. Triggered by darkness, it’s released into the bloodstream and stops at the first signs of light. Research has found that melatonin is effective in helping people doze off into dreamland, resulting in its recommended use to treat jet lag, adapt to new time zones, or to assist in shifting natural bedtime schedules. Although the brain naturally produces this hormone, its synthetic version can be found over the counter as a sleep supplement and usually takes effect within 30 minutes.

When it comes to kids, the research on this topic is limited. While there’s been studies conducted on certain populations (specifically those with autism or ADHD) showing improvements with falling asleep, recent studies have found that the outcomes vary between children due to different sleep disorders and circadian rhythms.

Is Melatonin Safe for Kids?

Use with caution. Even though melatonin is fairly safe for children at low doses as a short-term strategy, the long-term effects of its usage at any amount remains unknown. Because it is a hormone, some experts question if it will affect other hormonal development as kids enter adolescence. Other concerns include:

Inappropriate dosage and timing – can drastically affect their sleep schedule
No standardized dosage chart or when to take it – recommendation varies between experts depending on the child
Melatonin concentration vary between supplement brands – some may also contain other hormones like serotonin
Side effects – kids may experience headaches, nausea, sweating, dizziness, bed wetting, or drowsiness in the morning
NOT FDA approved for children – meaning that melatonin manufacturers are not subject to their quality control of safety measures and approval process.

If you feel that melatonin may be beneficial for your child, discuss this option with your pediatrician as they can help determine the appropriate dosage and timing for them. Also be sure to follow directions on the bottle. Serving sizes do vary based on age and weight.

Is Melatonin Safe for Babies?

No. Babies don’t begin producing melatonin until 3 months of age and when they do, it’s a small amount as their sleep/wake cycle is still developing. Currently, there are no-long term studies on melatonin use in infants. Over-the-counter children’s melatonin gummies are usually recommended for kids at least 3 years of age and older.

Remember that melatonin serves as a short-term solution for your child’s sleep. Although it can help your child fall asleep faster, it does not mean that they will stay asleep (it’s not a tranquilizer, jeez…). Instead, pair it with proper sleep hygiene to ensure a good night’s rest in the long run.

We also do not recommend melatonin while night potty training. Although your kid may find themselves stressed out without a nighttime pull-up, a sleep aid will not help them with the body awareness needed to wake up and use the toilet at night.

Three in the Bed and the Little One Said…

Co-sleeping is when your child sleeps close to you, either in arm’s reach of each other or sharing the same room. The three main accepted forms of co-sleeping are:

Sidecar arrangement – baby’s bed is adjacent to and touching the parent’s bed at the same height, allowing for physical access to one another
Room sharing – baby’s bed is in the same bedroom and is considered the safest choice by the American Academy of Pediatrics (AAP) as it reduces the risk of SIDS by 50%
Retractive co-sleeping – the child has their own bedroom, but can sleep with their parents as needed

Co-sleeping not only reduces the risk of SIDS, but also:

Can reduce nighttime separation anxiety
Can result in more sleep for mother and baby
Can help a baby self-soothe if they wake at night
Can help a fussy baby have better quality of sleep
Lessen stress and struggle at bedtime and throughout the night
Makes night feeds easier
Helps tending to a sick child simpler
Helps mother and baby sync their sleeping patterns, making feedings easier
Allows for working mothers to spend more time with their child

Wait, what about bed-sharing?

Not recommended for babies 12 months and under.
(Please note this says “not recommended”, which is different from “never” or “forbidden”)
Bed-sharing, as the name implies, involves your little one sleeping in the same bed as you. While it may be a typical method of co-sleeping in many non-Western countries, it is frowned upon by many pediatric health experts due to the significant risks it has for your child. These dangers include increased chances of suffocation, strangulation, and SIDS as well as safety hazards present with an adult bed (like loose pillows and bedding, opportunities to fall off an adult bed, etc). However, as the child gets older, the safer this type of co-sleeping becomes.

Although it is generally accepted to do in the first 6 months of your baby’s life, there is some debate on whether co-sleeping affects children’s growth and development as they age. There currently are no sleep guidelines for toddlers, despite night awakenings and difficulties falling back to sleep which are common with this age group. Because of this, critics of co-sleeping are concerned that children are not able to establish healthy sleep habits early on to self-soothe and sleep independently.

As children get older, opponents say that its practice can lead to:

Limited intimacy between parents
Co-dependency between parent and child
Using co-sleep to address anxiety
Lower sleep quality for both parent and child, resulting in more night waking and daytime grogginess

Can co-sleeping with your toddler negatively impact your quality of sleep?

Not necessarily. A 2018 study found that mothers who co-slept with their toddlers lost about 51 minutes of sleep on average with reports of stress, depression, and anxiety. However, these were with toddlers who had a perceived sleep problem. In fact, the same study showed that mothers whose toddlers did not have a sleep issue lost little to no sleep or reported having any depressive symptoms regardless of sleeping arrangement. This suggests that your child’s ability to sleep has more of an impact on your quality of sleep regardless of where they get shut-eye.

Can co-sleeping affect your child developmentally?

It depends. It can, especially if they are frequently anxious. Parents have reported that they allow their older kids to sleep with them when they’re nervous or frightened. Although an occasional slumber party with your kiddo isn’t detrimental, it can become an issue if it turns into a habit and parental boundaries are not put in the place. This can affect a child’s social development as they may not appropriately participate in peer activities, like sleepovers, over-night school trips, or sleep-away camps.

On the flip side, co-sleeping develops strong emotional bonds between parent and baby that promote safety and security later. For example, a 2012 study assessed how different forms of co-sleeping affected testosterone levels in male parents. They found that fathers who slept on the same surface as their child showed lower testosterone levels, implying that less testosterone equates to more responsive parenting. Moreover, although it has been reported that children who co-slept were able to transition to independent sleep a year later compared to those that didn’t, they were more self-sufficient and confident in their daily lives.

When is my child too old to co-sleep?

There is no correct answer as it depends on entirely you and your spouse. However, the sooner you can transition your child from co-sleeping to on their own, the better. Some experts recommend co-sleeping until your baby reaches 6 months to a year, when they begin to sleep for longer periods and the risk of SIDS drops.

Research has shown that children who are able to sleep by themselves are:

Less likely to have difficulties falling asleep
More likely to sleep longer and wake less at night
Able to wake up in the morning with fewer problems
Less likely to have behavioral sleep issues in the future

Even though independent sleep for your child is the goal, we know that it may take a minute to get there. We may try to rush it for our own benefit (because who doesn’t want a good night’s sleep?), but it is a process. The answer is simply “whatever works best for your family”.

Practice good sleep hygiene and remember that your child will become a teen and should no longer need your assistance to ease them to sleep…and that’s a good thing.