It is the combo of sounds feared by every parent and caregiver in the land: The middle of the night THUD-pause-SCREAM.
Your kid just flew the coop, A.K.A., the dreaded crib jailbreak.
There is a lot of conflicting information out there so to get an expert opinion, I reached out to Pediatrician Dr. June Liu who practices with the UCLA West LA Pediatrics Office in Los Angeles, California. She’s also a Fellow of the American Academy of Pediatrics (AAP) so she’s not only an amazing pediatrician, but she supports the latest and greatest advice from the AAP.
Check out my interview with Dr. Liu below and don’t miss the FREE Crib to Bed Tips download available at the bottom of this post.
P: At what age do you see children trying and succeeding in climbing out of their cribs?
Dr. Liu: On average, I tend to see toddlers around the age of 2 years climbing out of their cribs, however, I do see it as early as 18 months. It is usually during my 2-year visits that I address this issue and provide the appropriate anticipatory guidance.
P: What are some of the crib safety concerns you see when a child is able to climb out of their crib?
Dr. Liu: Safety issues are injuries associated with falls from the crib. Minor injuries include abrasions, bruises, and cuts. Probably the most concerning safety issue is head injury. Severity of head injury is directly correlated with the height of the fall. I have seen head concussions with toddlers falling from 2-3 feet. The type of floor, (carpet, wood, or marble) also makes a difference. Concussions are the most common head injury. More serious head injuries include skull fractures and intracranial bleeds.
P: Are there any tips to encourage a child to stay in their crib until an older age?
Dr. Liu: I recommend two tactics:
- Keep the mattress at the lowest setting
- It is okay to have a transitional object (a lovey) which provides security in the crib. It should be limited to 12 x12 inches to avoid SIDs risks.
P: Are there any crib safety products that encourage a child to stay in their crib until an older age?
Dr. Liu: No, no products have shown to prevent toddlers from climbing out. Moreover, bumper pads which are not recommended for other reasons can actually help toddlers climb and fall out.
P: If a child doesn't seem to show interest in climbing out of their crib, how long do you recommend keeping them in the crib before moving them to a big bed?
Dr. Liu: According the American Academy of Pediatrics (AAP), you should move your child to a bed when he is 35 inches or when the height of the side rail is less that ¾ of his height (typically nipple level). (In real practice, if there is no interest, I recommend keeping them in their crib for as long as possible or when the timing works for the family to transition) Typically, most toddlers outgrow their crib by 3 years. As the child grows, make sure the crib is away from all windows, drapery, electrical, and other cords. Also, take down mobiles or other hanging toys.
P: Once the first climb-out happens, what do you recommend parents or caregivers do? I've seen conflicting information if a parent should wait until a second climbing incidence happens vs. immediately moving the child to a big-kid bed. What's the best approach?
Dr. Liu: Realistically, after the 1st attempt, it's best to start the planning process of transitioning to a toddler bed. In the interim while waiting for a new bed to arrive or to install a new bed, you can simply transition to a small mattress (like the one in the crib) on the floor. Over time, the crib mattress can be replaced by a larger mattress (twin), still on the floor, and then later raised to up into a frame.
P: Any tips on making the transition to a big-kid bed as smooth as possible?
Dr. Liu: Toddlers can get very excited at the prospect of a new bed. Get them involved the process. Picking the bed out, choosing the patterns of the sheets, pillows, blankets. And offer words of encouragement/progression that they are now a “big boy/girl” and they get to sleep in a big girl/boy bed.
Try to maintain the same bedtime routine established from the very beginning. Toddlers do well when they feel a sense of autonomy and control. So offer them as many possible choices around bedtime to ease them during this transitional process (what pajamas to wear, what book to read, etc).
P: If a child is climbing out of their crib during a hectic period like during potty training or the arrival of a new sibling, do you recommend waiting for a more stable period to make the move to a big bed?
Dr. Liu: Yes, I always recommend parents to find the right time to make any transition to optimize success. If the parent is already in the midst of the transition, try to identify and address the stressors. For example, if it is potty training, then ease up on it during the time of transition.
P: What safety concerns and baby proofing tips do you have for parents and caregivers after the big bed move?
Dr. Liu: After the move has been made, the entire room can be viewed as the crib. So you may have to put a baby gate at the door and a hardware mounted gate at the top of the stairs. There is also the option of closing the bedroom door, but that would have to be done in progressively longer periods of time. Start off with ½ min, 1, 2, 3, 4. There are even special door knobs that inhibit the toddler from opening from the inside. Personally, I prefer the 1st option because there can be more fear and anxiety over door closure.
You can also consider using a guardrail on the bed to keep them safe while sleeping.
Remove all large toys and furniture like rocking horses, rocking chairs. Make sure bookcases are secured or remove tall bookcases altogether. Install childproof latches on drawers so they cannot be pulled out and used as steps.
Another concern is that the child could access other rooms in the home without being supervised by an adult. Make sure all medicines, cosmetics, chemicals or other hazards are in a locked location or removed from the home.
P: What tactics or tips do you have to keep a child in their bed during sleeping periods?
Dr. Liu: Similarly to the time of transition, you want to maintain a scheduled bedtime routine. At the end of the routine, tell the toddler to stay in bed until you come for them in the morning. Reassure them you will check on them during the night. Reinforce that big kids stay in bed until morning unless they have to go the bathroom. Make sure you do one last bathroom break before bed.
Leave a night light on and let them sleep with their security/transitional object.
Praise them in the morning if they have stayed in bed all night. You can institute a star/sticker/stamp chart (similar to potty training) for earned rewards for staying in bed.
P: If a child is repeatedly climbing out of bed during sleeping periods, what should a parent or caregiver do?
Dr. Liu: This is tricky. To optimize success in all transitions and adjustments in toddlerhood, limit setting and consistency is key. That being said, it can be challenging, on both parents and child. The routine chosen should be tailored to the family and situation. Every time a child climbs out of bed, the parent should calmly walk them back and put them back into their bed. If they cry after you leave, give them several minutes to stop on their own before going in to settle them. This can happen multiple times a night (15-20!). Many times parents get so tired and eventually allow them to fall asleep in an alternative setting (couch, parents bed) which will only delay the transition. It is important to be calm and boring during this time. No extra stimulation or attention should be given.
If the toddler shows signs of fear and separation anxiety, the parent can be more lenient. Definitely address if there are underlying stressors first. Otherwise, a the parent can sit in the room until they fall asleep, then sit outside the room, then later in their own room.
For very anxious toddlers that have always co -shared a room, I recommend starting with the crib/small mattress on the floor of the parents’ bedroom. Explain to the toddler that they cannot leave their designated “space” until morning. And if they do, repeat the steps above. Slowly as the child gains more confidence, you can transition the mattress to their own room.
I can’t thank Dr. Liu enough for her awesome insight and practical tips to making this move as painless as possible for the whole family. If you want to see how these tips work in the real world, please read my recap of our own crib to big-bed move here, spoiler alert, we had my son sleeping from 7pm - 7am and staying in bed until we went in his room by night #2!
Here is to fewer bonks in the night! I’ve put together this FREE tips sheet for you to download - it's a must-read for toddler parents and caregivers.
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