Toddler not sleeping after being sick: how to reset

Ask Sally · the column

Whenever I get an SOS message like this I always think of Mrs Doubtfire saying, “Help is on the way, dear!”

I actually have a very similar story.

When my daughter was about 15 months old she had a really horrific bout of hand, foot and mouth. She had sores all through her mouth, high fevers, she was off her food and understandably we were doing all the things overnight. Lots of cuddles, lots of comforting and lots of helping her back to sleep. And keep in mind, this was my unicorn sleeper. She slept 12 hours from 12 weeks and had always been the queen of sleep.

Then she recovered.

Except I started noticing bedtime was still dragging out and at 1am she was awake and saying, “Mummy sit.” “Mummy chair.” “Mummy read book.”

I remember lying there thinking, hang on a minute. If you’re well enough to tell me exactly what you’d like me to do at one o’clock in the morning, I think you’re well enough to go back to sleeping through the night.

The next evening I texted my husband and said, “Don’t come home, I’m sleep training P.” I just knew he’d walk through the door riiiiiight as I was putting her to bed and get her all jazzed haha.

I went back to exactly what we’d always done before she got sick. After our normal bedtime routine I put her into her cot completely awake, said my sleepy phrase, “Shhh, shhh, shhh… Mummy loves you,” gave her a cuddle and a kiss and walked out.

Naturally she stood up and cried. Not because she’d forgotten how to sleep, but because I wasn’t doing all the extra things I’d been doing while she was unwell.

I used a simple 5, 10, 15 minute timed check approach. When the five-minute timer went off she was still upset, so I went back in, repeated my sleepy phrase, gave the mattress three reassuring pats and calmly left again.

We never even made it to the ten-minute check. She lay back down, put her thumb in her mouth, went off to sleep and slept through until morning.

Now, I appreciate that most two-year-olds are going to put up a much bigger fight than that, and honestly, that’s their job. Re-sleep training a toddler is very different from sleep training a six-month-old. They’ve got opinions, determination and the communication skills to let you know exactly how they feel about your new plan.

The good news is you’re not asking them to learn something they’ve never done before. These are toddlers who already know how to self-settle. They already have the skill. They’ve simply had a period where, for very good reasons, the routine changed. They’re not learning to sleep, they’re just not in on the new plan… yet.

First, do the audit

Before we even get to techniques, I always want families to do what I call the audit.

Is their room still set up for great sleep? Are they still in a cot and sleeping bag? (I hope so!) Is the sleeping bag the right TOG rating with the right layers underneath for the room temperature, particularly at 3am when the house is at its coldest?

Then I’d be looking closely at the schedule. Are they a fresh two-year-old or are they edging towards three? Is bedtime still appropriate? Are they getting enough awake time during the day?

I’d also have a look at the bedtime routine itself. Toddlers are wired for independence, so I like giving them lots of little opportunities to have some control well before they get to bed. Things like, “Would you like the pink pyjamas or the striped ones?” or “Are you taking Bunny or Bear to bed tonight?” These tiny moments of choice help fill their independence cup, and I genuinely think they make it easier for us to confidently hold boundaries when bedtime rolls around.

I also wouldn’t be afraid to tell them what’s happening. Toddlers understand so much more than we often give them credit for.

“Tonight you’re going to stay in your cot alllll night long because you’re such an amazing sleeper. Mummy and Daddy will always come and check on you if you need us.”

Then hit reset

Once you know your foundations are solid, it’s time to hit reset.

Which sleep training technique you use is completely up to you. With toddlers though I often find less is more. The more we do, the more opportunities there are for them to negotiate, delay or keep us in the room. The biggest predictor of success isn’t usually the technique itself. It’s whether you can apply it consistently, particularly at that predictable 10:30pm wake-up when they’re expecting to hop into bed with you.

And I won’t sugarcoat it. The first night might be hard. You could spend an hour+ resettling them. They might protest loudly because they’re frustrated that the rules have changed. That’s okay.

This is where doing the audit first becomes so important. When you know they’re well, warm, comfortable, safe and on an appropriate schedule, you can remind yourself that the tears aren’t because they can’t sleep. They’re because you’re making a change, and they had absolutely no notes on how things were going.

The beautiful thing about toddlers is they learn quickly. You might not feel like you’re making progress while you’re standing outside the bedroom door on night one, but when you back it up with exactly the same approach on night two, you’ll often be amazed at how much easier it already feels.

Consistency, repetition and opportunity really are the name of the game.

Post-sickness is one of the most common reasons families come to me needing a little reset. We absolutely throw the rule book out the window when our babies or toddlers are genuinely unwell. That’s responsive parenting. But once everyone is healthy again, if what you’re doing is no longer sustainable, it’s okay to change it.

A few nights of consistency now can save you months of broken sleep later. And if your little one used to be a “see you in the morning” sleeper, I promise that child is still in there. Sometimes they just need a little reminder.

Sally x

Ask Sally is my weekly column, where I answer the questions that land in my inbox and DMs. If there is something you are navigating with your baby’s sleep, send me your question. Yours might be the next one I answer.

Written by Sally Woods, internationally certified sleep consultant and former paediatric nurse.