Jul 15, 2009 Table of Contents

Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education Web site.

Information from Your Family Doctor

Early Childhood Issues: Nighttime Waking, Thumb Sucking, Picky Eating, and School Readiness

Am Fam Physician. 2009 Jul 15;80(2):online.

See related article on early childhood concerns.

How do I get my baby to sleep through the night?

Newborns usually wake up every two to three hours. Each baby will have different sleep habits. Babies will sleep longer as they get older. Most babies sleep through the night by one year of age, but some babies start sleeping through the night by four to six months of age.

If your baby is not sleeping through the night by the end of the first year, you can try some things to help him or her sleep longer. Responding less often to your baby's cries may help. For example, at first go to your baby within five minutes of crying, then wait for 10 minutes the next time, and then a little longer each time. After awhile, your baby will learn to calm down and go back to sleep.

Having your baby wake up at the same time each morning and go to sleep at the same time each night can help. Waking up your baby before expected middle-of-the-night awakening times also might help. For example, if your baby usually wakes up at 1:00 a.m., 4:00 a.m., and 7:00 a.m., wake him or her 15 minutes earlier each time. Your baby may eventually sleep through his or her predicted times.

How do I get my child to stop thumb sucking?

Thumb sucking is a normal behavior. Most children stop sucking their thumb between two and four years of age. Children who have not stopped by the time they start school should be checked for tooth problems. If your child does not stop sucking his or her thumb, here are some things to try:

  • Praise your child when he or she doesn't suck his or her thumb.

  • Find another way to comfort your child (example: a stuffed toy or special blanket).

  • Remind your child to stop thumb sucking (example: put a bandage on the thumb, or apply an over-the-counter bitter liquid, such as Mavala Stop or Thum).

  • Reward your child for not sucking his or her thumb (example: for every day children do not suck their thumb, they get to mark an “X” on a calendar. After a certain number of “X's,” they can receive a reward).

What can I do if my child is a picky eater?

One way children start to show their independence is by choosing what they want to eat. You should make meal times as pleasant as possible. Forcing your child to eat or arguing about food may make the problem worse. The amount of calories and nutrition a child needs is less than many parents realize. You can find out how much your child needs by going to http://www.mypyramid.gov. Some ways to reduce picky eating include:

  • Don't let your child drink too much milk or juice. The calories in liquids can take away appetite. A child should have no more than 16 to 24 oz of milk and 4 to 6 oz of juice per day.

  • Follow the rule of 10s: children should try a food at least 10 times before deciding they don't like it.

  • Offer foods that are similar to ones your child likes. (For example, if your child likes canned peas, offer cooked carrots instead of raw carrots. The softness of the food may make a difference.)

  • Use an older sibling as a role model to help children try things they think they don't like.

  • Mix foods, even if the mixture doesn't make sense to you. (For example, a child may eat “ants on a log” because it is a fun way to present celery, peanut butter, and raisins.)

How do I know if my child is ready to go to school?

Children learn many social and academic skills in kindergarten, and they learn at a higher rate than those who are held back. Although school-readiness tests exist, they should not be used to delay a child's entry into school. Children do well in school if they have strong support at home. If you worry that your child is not ready for kindergarten, you should talk with your doctor about it.


This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.

Copyright © 2009 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests.

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