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Expert Q&A:
Should I put my 20-month-old in a bed if she is climbing out of her crib?

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Answered by Suzanne Dixon MD, MPH

"I love this job!" says Suzanne Dixon. "I believe I can bring the best of information to families by the thousands every day. I'm not shy about tapping my colleagues and friends all around the country so that we can get the latest, best, and most sensible advice on every issue."

Suzanne Dixon, MD, MPH, was born and raised in Minnesota and graduated from the University of Minnesota, School of Medicine. She did her paediatric training at Massachusetts General Hospital in Boston and then completed a fellowship in Child Development at Boston's Children's Hospital. Dr Dixon joined the faculty at the University of California, San Diego, and did patient care, teaching, and research for 20 years. She ran a large newborn service, performed research in early child development, and was involved in many community outreach activities in maternal child health. Throughout her entire professional life she has maintained an interest in cross-cultural activities, living and working in many parts of the world, including Mexico, India, Kenya, Indonesia, and several countries from the former USSR.

Dr. Dixon is the author of numerous research articles, review articles, and textbook chapters in paediatrics, child and family development, and public health. Her textbook, written with Dr. Martin Stein, Encounters With Children: Pediatric Behavior and Development, has become a classic in child health education andis just coming out in its third edition. She has served as an associate editor for Infant Mental Health and currently reviews for several major paediatric journals.

Dr Dixon is a fellow of the American Academy of Paediatrics and served in national positions in that organization. She is a member of the Society for Paediatric Research, the Society for Research in Child Development, the American Public Health Association, and the Society for Developmental and Behavioral Paediatrics.

Dr. Dixon continues to lecture and consult worldwide on aspects of maternal, child, and family health. She practices behavioral and developmental paediatrics in Montana and works with local advocacy groups on education and women's health. Dr Dixon has been married for 25 years and has three sons. She and her husband travel frequently and enjoy being amateur anthropologists.

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Question


My extremely active 20-month-old daughter is beginning to climb out of her cot. I'm concerned about her safety when she's able to climb out and wander around while we sleep. Should I go ahead and buy her a bed or wait until she really learns to climb out? How can I keep her from climbing over bed rails on a big bed?

Answer


Active children do like to climb out of bed at this age, and it's impossible to stop them. They can get hurt if they fall, get caught up or wander around or even out of the house. If you have already lowered the cot mattress to the lowest rung, you can buy time with a cot cage. These are expensive, however, and have a limited useful lifespan. You can put the side down altogether and use the cot as a big bed. Or you can make the switch to a big bed now; bed guards will keep her from falling out, but climbing out is still a possibility. Put her to bed in a sleeping bag type of sleep suit to slow her down a bit. In any case, you need to teach her to stay in her room until you get her. Make her room completely safe so if she is up, you don't have to worry about injury. Set up an area with some books or quiet toys for her to amuse herself with when she wakes up. You can put a buzzer on the door or an intercom in the room to let you know when she's up. If it's still dark, put her back to bed without comment, a hundred times if necessary until she gets the message. You could make her bedtime later if she consistently gets up too early for the rest of the family. Long naps reduce night-time sleep. A stable door or a gate can also be used as a barrier. Some families have to put a hook on the door to keep children safe; I hate to lock children in their rooms, but for some kids it's the only way. You have to keep a 20-month-old in her room at night as she is just not safe outside without supervision at this age. By the time children are 3, most get into less trouble and can usually understand rules like "Stay in your room until it is light outside." They also do less testing and teasing around this issue. But since you have a way to go before that point, you'll need to make modifications straight away.
 
 
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A stable door or a gate can also be used as a barrier. Some families have to put a hook on the door ..
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