Sleep-onset association disorder.  Your child closely connects falling asleep with something else (being nursed, rocked or held while going to sleep, car rides, etc.).  When the action, person, or object is missing, the child is unable to sleep and may awaken in the night to have help with falling asleep.

Teach your child to fall asleep in ways which do not require a response from you.

For children six months to three years old

Place your drowsy child in the bed after a quiet bedtime or nap routine.  Say goodnight and leave the room, making sure to allow a little light into the room.  Only return to the room keeping to the following schedule.  Do not stay longer than two minutes.  The schedule may be modified with more or less time spent at each time point depending on how the child is doing.

For older children (over three years old) 
When you believe that it is time for your older child to learn to fall asleep on his own, explain that you will sit in a chair near the bed (rather than on or in the bed) until he falls asleep.  After a few nights, move the chair farther away from the bed and closer to the door, until it is out of the room.  Leave the door open for a child who does not get out of bed but close it for a child who does.  Relearning may take one to three weeks.

To end the habit of nighttime feedings, start by slowly cutting back the number of feedings.  For an infant feeding every hour-and-a-half at night, the parent should wait two hours between feedings the first night, then two-and-a-half hours the second night.  Increase the time in between feedings until all feedings are gone.  The process may take one to two weeks.  If bottle feeding, you can also try giving one ounce less per night at each feeding.

Parents should understand the importance of limit-setting during the day or night.  For an older child who is getting out of the bed, a gate can be placed in the doorway or the door can be closed until you are sure she is staying in her room.  A gate is preferred.  For safety, two gates can be used if the child has learned to crawl over a single gate.  If using the door method, you can tell her you will gladly open the door again when she stops trying to leave her bedroom.  You will want to follow through with your warning, although early on, close it for just a few seconds moving slowly to a closed door for up to three minutes.  The purpose is to teach her a new way to fall asleep, not to scare her.  Use a calm, kind but firm voice when teaching how it will work.

Other suggestions include using a checking method where the parent promises to come back to the room after several minutes and check that the child is still in bed.  This could be repeated several times at bedtime until the child falls asleep with the parent waiting longer and longer time periods between times of checking.  The final suggestion is a “bedtime pass” in which a child is given 1 to 3 “passes” that they can use for their requests such as a drink of water, hug, and so forth.  If the child does not use all of the passes on a given night, then a small reward is provided in the morning.  Positive reinforcement with a sticker chart or a small reward in the morning can be very helpful with any of the above methods