Q. What can I do about my daughter climbing out of bed at night?

We have co-slept with our 12-month old daughter since she was born. At first it worked well because she was waking frequently so it was easy to feed or pat her to get her back to sleep quickly. The problem is that she is still waking and sometimes she tries to get off the bed during the night. I am concerned she may do this while we are sleeping. What do you recommend?

Dr. Cohen:

At her age, the safest place for her to be sleeping is definitely a crib! All the soft materials that are on a bed are a risk for suffocation and strangulation and there have been numerous reports of accidental falls off a bed as well as children getting trapped between a mattress and headboard or wall.

Also, as you described, research shows that many parents and children who co-sleep do not sleep through the night. This is because noises and movements from one another can disturb sleep and because it is easier to respond to (and therefore reinforce) night wakings due to being near-by.

For all these reasons, I would suggest transitioning her to a crib in her own room. This can be done gradually, if you think it would be helpful. For example, you can start by sitting next to her crib and patting her until she falls asleep for 5-7 days. I would then move on to just doing very brief ‘checks’ and aiming for her to fall asleep on her own. This same gradual approach can also be done following night wakings and for her naps. At her age, things may get worse before they get better, but with a good plan and a lot of consistency things will improve.

Q. Can I put my baby on her side or tummy to sleep?

When I put my 5 month old to sleep in his crib, I put him on his side or tummy as I find he sleeps much better that way. Is that OK to do? He has started to roll a little bit during the day but is not yet rolling in his crib when he sleeps.

Dr. Cohen:

According to Health Canada and Canadian Paediatric Society guidelines, children should be placed on their back to sleep for all sleep periods until 12 months of age. This position, until a child can roll on his own, is associated with a decreased risk of sudden infant death syndrome. However, according to the guidelines, once a child is able to roll on his own to sleep on his side or stomach, it is not necessary to roll him back during the night or nap, unless his physician has told you of a medical reason to do so.

For more information on safe sleep practices for infants, see the following handouts for parents:

“Safe Sleep for Babies� (Canadian Paediatric Society)

“Safe Sleep for Your Baby� (Health Canada)

Q. How can I keep my son from climbing out of his crib?

My 2 year old son has started to climb out of his crib when I put him to bed at night. I know a lot of kids are in beds at this age but I am worried he will be up all night and all over the house! What should I do?

Dr. Cohen:

If he is close to 3 years and otherwise sleeping well, I would consider transitioning him to a toddler bed with guard-rails. If not, I would suggest keeping him in his crib. If the transition to a bed is made too soon, bedtime problems and night wakings often develop or worsen and then you have a child who is up and about all night. This could be a safety concern as well as difficult to manage because many young children are not yet “mature� enough to understand the rules associated with staying in bed. Barring no safety concerns, I like to keep a child in a crib until 3-3.5 years if possible.

If he only climbs out of his crib when a parent is in the room or if the lights are on, be sure to only put him in his crib in the dark as you are about to leave his room. If he is brave enough to continue climbing out, I would suggest putting up a safety gate at his bedroom door to try to deter the behaviour. Children quickly learn that if they stay in their crib the gate comes down. Some parents use crib tents to keep their little ones safe in their cribs.

©Dr. Nicky Cohen 2011