Friday, April 19, 2013

Crib [or family bed] to Bed Transition


Toddlers are capable of climbing out of cribs as early as 13 months! I caught a little boy this age as he dove head first over the side of a crib. I haven't had cribs in my child care since then, only pack-n-plays, which are deeper and have soft sides they have more trouble getting a firm foothold upon. 


I also currently have a toddler who was easily climbing out of a pack-n-play prior to 18 months. She is a limber and STRONG little bitty child who could hook her foot up over the top and pull herself over with no issue WAY too early. She still can, this is for demonstration purposes of her technique. She couldn't even get her arm over the top when she first climbed out. She's been out on a bed for a good while now.



Little Monkey Miss N at 21 months
Some state regulations require children in child care settings to be removed from cribs and pack-n-plays at EXACTLY 18 months. There are reasons for this mandate. 

I have had parents tell me that they want to keep their child in the crib as long as possible so that the child is basically caged, i.e. SAFE while alone in the nursery. However, this is definitely NOT the case. A toddler tumbling from a crib can be deadly, and a monitor can't tell you something's wrong if the child can't cry to get your attention. 
THURSDAY, Feb. 17 (HealthDay News) -- Each year in the United States, nearly 10,000 children under the age of 2 arrive in emergency rooms with injuries suffered while in cribs, playpens and bassinets, a new report shows.
Most of these injuries involve cribs and are usually caused by kids climbing out and falling on the floor, said the researchers from Nationwide Children's Hospital in Columbus, Ohio.
"The most surprising thing to me was the number of crib-related injuries we found being treated in hospital emergency departments," said lead researcher Dr. Gary A Smith, a professor of pediatrics and director of the hospital's Center for Injury Research and Policy.
"This is an underestimate," he said. "We know that children are taken to their private physician and urgent care centers."
Smith noted that only about 1 percent of the injuries involved a parent or sibling: "It appears that most of these falls are children climbing out of the crib and falling."
In most cases, the children landed head first, Smith noted, which "really makes this an issue that we should pay attention to." Children at that age are top-heavy, so when they fall they fall head first and don't have the ability to break their fall these injuries can be serious, he explained.
Smith added that as the children became more mobile, the number of injuries increased. "So, parents need to be cautious when a child is in a crib and can start to pull himself up," Smith said. READ MORE


What I have suggested to my clients that has worked well: 

  • Remove the crib, place the crib mattress on the floor. The crib mattress is comfortable and familiar and will sleep/feel/smell the same once it's on the floor. Transitioning to a different mattress, bedding, bed position in the room, etc. is just asking to stimulate your child and cause issues. If the bed is the same, just lower with no bars, then your child has only one change to handle. Children do best with consistency and routine, and too many changes thrown at once can be disturbing to them.
  • Place a gate over the bedroom doorway so your child can be heard but not roam the house. 
  • Keep only a few toys down and accessible to your child in the bedroom. When your child goes to sleep, the toys are locked in the closet or placed into a bin and removed to another room or the hallway so if s/he wakes up, there's no reason to not go back to sleep, no stimulation. The room basically becomes a large pack-n-play. It also removes any boosters for getting over the gate.
Miss H 18 months

Falling out of bed 3-4 inches onto the floor isn't going to hurt a child. As they gain spatial awareness of their non-restricted environment, falling out of bed is normal. Eventually their body will accustom and adjust naturally to ensure that doesn't happen. A child jumping on a crib mattress on the floor is also not likely to break a bone, or cause them to fall improperly and hurt themselves badly. Again, letting them gain the spatial awareness with the mattress on the floor will help prevent them falling from their eventual big-kid bed when they jump on it, possibly preventing a concussion. They probably will jump on the bed at some point, no matter how much you admonish them not to do so.

A toddler bed, a frame to hold the crib mattress, is really a waste of money and time and only necessary for someone wanting to keep the "look" of the child's room. Even with transition cribs, if the side is off and the mattress is as low as possible, it is still likely that the child will fall out or off a few times, from a greater height than just the mattress on the floor.

Once your child reaches 2 years, s/he can transition up onto a twin bed with no issue, having most likely gained the spatial awareness necessary to remain on it during sleep. If your child continues to wake up on the floor while down on the crib mattress, however, bed rails, or a pool noodle tucked under the fitted sheet on the sides of the bed, may be necessary to provide a boundary.


Family Bed Transition

This also is a good idea if you are trying to get your toddler out of YOUR bed. It is an easier, gentler, kinder way to do it than just kicking them down the hall. Getting a new bed, that smells, feels, and sleeps VERY differently; in a new environment, which, even if they play in their room regularly, it is TOTALLY different at night, with different sounds, light/shadows, and smells; without the heartbeat and warmth and comfort of the person/people they have ALWAYS been surrounded with at night, is traumatizing to a toddler.

Imagine if your spouse told you that you need to sleep in the guest room from now on because you disturbed their sleep. They helped move you into the guest room, talking about how great this was going to be for YOU. You lay there at night, not comfortable with the bed, listening to how the house sounds different in this room, how it smells different. You miss your spouse's warmth and smell and gentle snores. You feel like you are in a foreign land. You wonder if your spouse will change their mind tomorrow and let you back into YOUR bed. Surely they won't kick you out if you slip back in there, or if you let them know how much it means to you to sleep with them every night, to feel that closeness and connection. You feel lonely, abandoned, rejected, sad, unloved, unappreciated. You are an adult and you feel all these things even though you have some understanding of the reasons behind the request and life experience with which to relate similar experiences in a rational manner. It hurts. 
Now imagine what your toddler feels like when it happens.
Think about how much you LOVE your bed, dislike sleeping on others when you travel, or how long it takes for you to become accustomed to a new mattress. UGH! The same is true for your child, and they don't understand it. You don't like changing beds, they don't either, and your bed is most likely the only one they've ever known.

Once the decision is made to remove your child from your bed, it must be a firm decision, and your child must not be allowed back into your bed. If you do, then it's just mean, because it will be on YOUR terms and just jerking your child around, which s/he doesn't understand. Make a rule and stick with it. Vacillating back and forth on ANY issue...you can be in my bed tonight...you CAN'T be in my bed tonight...you can be in my bed tonight...you can nap on the couch today..., especially something like this that deals with your child's connection and access to YOU, just makes children uncertain, stressed, fearful, and distrustful. Consistency allows them to trust that, "This is the way it is." They won't like it at first, of course, because it's YOU who is making that decision FOR THEM to remove them from THEIR BED to a new one, but they will quickly understand that, "This is the way it is." Period. And they will adjust accordingly. Just not happily. 

The crib mattress can begin to be used at nap time. Once your child seems comfortable napping on it, which may take a while, place the crib mattress next to your bed for their "special spot" at night.  

If you are eventually trying to get them into their own room, once they adjust well to sleeping on the mattress at night, gradually move the mattress a little farther away from your bed and toward their room each night, allowing for extra nights if you hit a transition period where the child balks. Never move it back toward your bed, but just keep it in the same position for a few nights. It will eventually reach the hall, and eventually reach their room, and eventually reach the place in their room that you want it be. Make sure that gates are up and hallway doors are shut and/or childproofed with handle guards so your child only has access to their bed location and your room if they get up at night, which they most likely will during this transition. Just consistently place them back on the crib mattress with calm reassurance. Every. Single. Time.

Breaking from this even one time gives your child hope and expanded possibilities. They will run with it, and the transition will be much harder and longer the second time around, and exponentially thereafter. 

Tags: toddler, infant, bed, transition, family, removing, transitioning, crib, bassinet, playpen, pack-n-play, child, care, daycare, crib to bed transition, toddler bed, own room, son, daughter, boy, girl, parent, parenting, discipline, gentle, easy,

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