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How to discourage nighttime water breaks
Q: I’ve allowed my 2-year-old twins to take sippy cups of water to bed. They wake up several times and scream until I fill them back up. They drink so much at night—as much as 20 ounces—that their diapers overflow and I change their bedding two or more times each night!

How do I rid them of this habit? I tried taking the cups away and they cried all night for three days. They are the second and third of four children.
A: Patricia, it sounds like your twins have gotten into a nighttime routine that is exhausting for you. Since 2-year-olds love routines, it would be great to get them into a nighttime routine that is more manageable for you.

To start with, check with your children’s doctor to make sure they don’t have any health problem that might be causing excessive thirst at night, which is very unlikely. Also, since most 2-year-olds can speak in two-word sentences, check with the doctor to make sure their development is on track.

Why are your twins drinking 20 ounces of water every night? They may be thirsty because they haven’t been drinking enough during the daytime. So the first step would be to encourage them to drink more from the sippy cup or a regular cup during the day. But the most likely reason is simply because it’s become a habit or routine.

Many 2-year-olds are attached to sleeping with a bottle of milk, which can lead to tooth decay and ear infections, so it’s good that you’ve already graduated them from the bottle to the sippy cup with water. Now you could graduate them from sleeping with a sippy cup to sleeping with a healthier comfort object, such as a stuffed animal. Since 2-year-olds are often motivated by being “big girls,” you could buy them each a special big-girl stuffed animal and explain that now that they’re big girls, they get to sleep with the stuffed animal instead of the sippy cup, which is for babies.

You can even get your older child to help pick out the stuffed animals, give them to the twins and explain that now they’ll be big kids like him or her. Consider starting up a new, more manageable bedtime routine: a sip of water for each girl and each stuffed animal, then explain to the stuffed animals that there’s no more water for the night, then a story for the girls and the stuffed animals, then going to sleep. They may fuss and cry for a few nights, but be persistent. Over time they will learn to enjoy the new routine, and you will get a lot more rest at night.
Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician