I’m a nationally published sleep expert, journalist, and the mom of three young kids. I’ve been helping tired families sleep since 2007 (more about me here). Subscribe to The Well Rested Family for fresh news and tips on keeping your bunch happy and healthy. Thanks for stopping by!


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Entries in pacifier (3)


Ask Malia: Bye-Bye Binky

Dear Malia,

Our son has used a pacifier almost since birth, but we’re ready to get rid of them for good. Any tips for breaking a pretty strong paci habit?


Your son isn’t alone: nearly 70 percent of parents give their baby a pacifier before six weeks of age. For tips on giving the binky the old heave-ho without losing your sanity, take a peek at my widely-published article “Parting with the Pacifier.” And good luck!


Parting with the Pacifier: How to Break the Habit

Ready to help your child give up a pacifier? Here are some tips for navigating the tricky transition.

Whether they’re crystal clear, neon-bright, or covered in rhinestones, pacifiers are the modern baby’s accessory of choice. Thanks to studies showing that they reduce the incidence of Sudden Infant Death Syndrome (SIDS), most pediatricians have given pacifiers the green light. A study in Pediatrics found that a whopping 68 percent of parents give them to their babies before six weeks of age.

Babies aren’t the only ones who love them; parents quickly become addicted to the pacifier’s soothing effects on their offspring. Unfortunately, it often becomes a habit that overstays its welcome.

Why Wean?

While some children give up non-nutritive or comfort sucking on their own, others cling to the habit well into the preschool years. According to Lotus Su, D.D.S., of Pediatric Dental Associates, using a pacific too much or for too long can contribute to dental problems, including deformation the palate and shifting of the teeth, as well as mouth breathing and dry mouth, which may increase susceptibility to tooth decay.

Many doctors and dentists recommend ending the habit before permanent front teeth begin to emerge, which can happen before kindergarten. “I recommend stopping pacifier use by age three,” says Dr. Su.

“The earlier a pacifier habit is stopped, the less likely that there will be any dental problems.”

Potential problems extend beyond the teeth. Pacifier use is associated with otitis media, or middle ear infections. Minor health upsets like gastrointestinal infections and oral thrush are also more commonly seen in pacifier users.

Parents may be swayed by medical data and dentists’ recommendations, but kids often need some coaxing to give up the long-held habit. Guilt-inducing lectures about dental problems or germs may be counterproductive, causing them to dig in their heels.

Click here for the complete article (complete with six great tactics for ditching the paci!) at the website of Chesapeake Family magazine, where this article appeared.


Ask Malia: Big-Kid Milestones are Wrecking Sleep

Hi Malia,

We moved my 3-year-old to a big-girl-bed a couple months ago, around the time her baby sister was born. It went great. Then, last week when she turned 3, we took away pacifier. Though she knew this was coming and we talked about it for months, it hasn't gone well. She comes into our room 3-6 times per night wanting to be tucked in and get one more song. She willingly goes back to bed, but comes out again and again. Is this likely just a transition issue? When she adjusts to not having the pacifier, will it go away? How long do we keep forcing her to go back to her room?



Dear Theresa,

Congratulations on the new addition to your family—and congrats on your older daughter’s milestones! It sounds like there’s a lot to celebrate at your house. Now for the bad news: Too much change, all at once, can throw off a child’s sleep. As you probably know, your daughter’s world is kind of topsy-turvy right now. She’s only a few months into the big-kid-kid bed transition, recently paci-free, and just celebrated a birthday, all on top of becoming a big sister.

It's normal to deal with regression in these circumstances. And it’s normal for a child with a new sibling to want more attention from mom and dad. Unfortunately, sometimes this manifests in the middle of the night. So you are going to need to be patient with her. I always advise parents to deal with one issue at a time, but you have multiple things going on here. You can't go back and give her the pacifier or put her back into a crib (nor would you want to) so you're just going to have to deal with it all at once.

Here is my advice:

  1. With such broken nighttime sleep, she’s at risk for becoming severely overtired. To prevent this, maintain a consistent nap schedule (but don’t let her nap longer than 1.5 hours) and an age-appropriate bedtime.  Try to have her in bed by 8 pm.
  2. Remain very consistent in taking her back to her room each time she wakes up during the night.

When you take her back to her room, STAY WITH HER UNTIL SHE IS DEEP ASLEEP. I recognize that this is the last thing you want to do. But unless you do this, two things will happen. 1) She will pop out of her room again and again, becoming more awake and less likely to go back to sleep each time, and 2) You and your spouse will get zero sleep because she’ll be up and down for hours.

Stay in her room until she is deep asleep. If she protests and wants to get out of her room, tell her “It’s time for sleep.” Deal with any requests (glass of water, etc.) with minimal interaction and only in her room.

To answer your question of "how long do we keep forcing her to go back to her room"—as many times as you need to. Your willpower has got to be stronger than hers. Don’t allow her to get up and stay up. Being up at 4:30 am is not appropriate for a child. If she does wake up that early, stay in a darkened room to protect her circadian rhythms from disruption (too much light or stimulation early in the morning will program her brain to continue the early wakings—the last thing you want).

If you need to lie in her bed with her, rock her, or rub her back to get her to sleep, so be it. It is much easier to wean her off these behaviors later, than it is to deal with a circadian cycle that’s completely out of whack from being up all night.

I’m sure you’re ready for some good news now, so here it is: As the transitions in your home smooth out, her sleep will smooth out too. Keep being a fabulous mom to your two lucky kids, and good luck!


Image courtesy of zazzle.com


Ask Malia: Sleep Sleuthing and The Case of the Three-Hour Nap

Sometimes, figuring out a sleep problem feels a bit like detective work. Recently, the mom of a toddler contacted me for help getting rid of her son's pacifier, which she believed was causing him to wake during the night. But when we looked into the issue, we discovered that the pacifier wasn't the real problem. Read on...

Hi Malia,

My son is 17 months old, and he started sleeping through the night around 13 months. Within the last month, he’s been waking up about 2 am (6 hours after his bedtime.) Sometimes it seems as if he's in the middle of a dream; he will stand up in his crib and cry an unusual cry. Depending on how tired I am, I'll bring him in bed with me, which sometimes works and other times he just plays with my face. We have not taken away his pacifier yet, which is our New Years resolution, as it seems to be giving him more grief than pleasure lately. He needs it to fall asleep, but he'll take it out sometime during his sleep and when he wakes up in the night to put it back in, he can't find it. He never uses it during his waking hours. What is your recommendation on weaning him off the pacifier?

He naps between 1-3 hours during the day and sleeps about 11 hours at night. We kept the pacifier around this long because it helped him sleep before, but now with another baby due in May, I would like him away from this habit before it comes really hard!


Hi Beth,

Most kids are overtired, so when I'm looking for a reason for nighttime wakings I consider overtiredness first. However, the patterns he's displaying with his night wakings don't suggest that he's overtired, they suggests that he's undertired.

And I don’t think the pacifier is the problem. You can get rid of it if you choose, but I doubt that doing so will stop his nighttime wakings right now.

The thing that I'm honing in on is his naptime: you said he sleeps between 1 and 3 hours. That's a big variation in nap length. At this age, length and quality of nap can be a big factor in nighttime sleep, and it's important for naps to be consistent. That sometimes means waking your child from his nap to make sure he doesn't sleep too long.

Have you noticed a difference in the quality of his nighttime sleep when he takes a 3 hour nap? It's rare for a child to regularly take a 3 hour nap without it affecting their nighttime sleep. 3 hours is a very long nap, and in many cases, it's just too much daytime sleep.

If he's doing well on 11 hours of sleep at night, I would keep his bedtime and wake-up time the same. What I recommend is trying to keep his naptime consistent and waking him after 2 hours maximum.

After a few days of that, if he's still waking at night, I would reduce the nap to 1.5 hours.

The key is to encourage a nap that's restorative but not overly long, and to keep it very consistent.

It sounds like you're on the right track in many areas, so once you get the timing figured out, I think things will smooth out with his nighttime sleep.

Lo and behold, Beth did notice a connection between her son's 3 hour naps and his night wakings, and they're on the way to better sleep. Another sleep sleuthing case, solved.