"I have a 20 month old that have not slept through the night since she was 2 days old. She still wakes up a minimum of 3 times a night and once we hit the 3:00am mark it is every hour upon the hour until 6:30am. She is an exclusively breast fed baby and still very attached to it. Will your book work for us? I honestly don't know what to do other than letting her cry herself to sleep. An approach that I strongly disagree with but seems to be my only option at this point. Please help.

p.s. Since my husband is not a reader, is there a 90minute video tape/DVD out there?"

- Nada, San Diego

What you describe sounds like a baby that does not get enough sleep, and by that I mean, she sounds extremely sleep deprived. My guess is she's so reliant on or attached to breast feeding because she is so sleep deprived, and thus she's unable to soothe herself, and she "knows" she needs external sources of soothing to get the sleep she "knows" she needs. (I put the word "know" in quotes because I mean on some level, she knows it, or her body knows it, even if she doesn't know it consciously, if you know what I mean.)

You don't mention daytime naps but I'm willing to bet they are irregular or don't occur at all.

Honestly I don't know whether or not the book will work for you, but I also know that crying it out is not likely to work, and very likely to backfire in your daughter's case. She is clearly unable to soothe herself at this time. This is why she seems so attached to breastfeeding.

But I believe you should still try to focus your efforts on getting her to nap during the day, and I believe that doing so will bring you other successes with her sleep. At your daughter's age, she should be having at least one afternoon nap of two hours or more, and possibly also a morning nap. Look for signs of sleepiness about 3 hours after she awakens, or at about 4.5 hours after awakening. Getting a nap or two will help her sleep a little better at night, and she should start to have fewer awakenings then. After that point, you can address the remaining night wakings with other strategies, possibly to including crying it out, though this is certainly not the only option.

I don't have a DVD yet, I'm sorry to say. There is one out there, though it is not "authorized" by me, and I don't recommend it. Since you are San Diego based, I can refer you to my colleague Dr Brad Schnierow, who has an excellent track record with toddlers' sleep problems. I believe his office number is 858 623 3266.

Good luck and I'd like to know how things go if you have the opportunity to do so---