Teens Don’t Sleep Enough. It’s YOUR FAULT

We all know that teens don’t sleep enough. Why don’t they?

Parents, you aren’t going to like the reason: it’s your fault.


Why Teens Don’t Sleep Enough


The National Sleep Foundation (NSF) performs an annual poll to learn more about the way Americans sleep. In 2014, the poll focused on parental attitudes toward their children’s sleep. In particular NSF asked parents how much they valued sleep and how much sleep they believe their children actually got.

Then NSF asked a series of questions about household rules regarding sleep, including questions about limits setting on caffeine and use of technology in the bedroom.

Parents were asked to fill out a survey on the internet. Questions were asked about demographics (age, socioeconomic status, etc), followed by questions about sleep.

The Results

Most parents (>90%) reported that sleep was either “very important” or “extremely important” for good mood, health, and performance in both themselves and their children.

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Teens don’t sleep enough and neither do their younger sibs

However, almost 90% children did not in fact sleep the recommended number of hours, whether they were younger children or adolescents. The children in the study reportedly sleep fewer hours than children in other comparable developed countries.

Children 6-11 years of age ideally should get about 10 hours sleep. Teenagers should get 9 1/2 hours. In the NSF study, both groups got about one full hour less sleep than recommended.

Adolescents (12-17 years old) slept fewer hours than their younger siblings during the week. However, on weekends, both groups slept the same number of hours.

The survey was concerned not only with quantity of sleep, but also with quality. Slightly less than half of parents thought the quality of their children’s sleep was “excellent” or “good”.

Limits Setting and Enforcement

The survey was particularly interested in rules setting and enforcement, and the effect of rules on sleep. The results were significant.

Long hours of sleep were significantly associated with parents being married, always enforcing rules about how late the child can consume caffeine, and never leaving any technology on in the bedroom. Excellent sleep quality was significantly associated with always enforcing a bedtime for the child and with never leaving any technology on in the bedroom.

Not surprisingly, if parents slept with electronic devices, so did their children. Many parents admitted on the survey that they would read and respond to text messages after they had planned to go to sleep!

“Technology” was defined as virtually any electronic device with a screen, including television. In the age of the cell phone, the television continues to be the biggest contributor to loss of sleep.

TV is a Bad Actor

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Teens don’t sleep enough if they watch the big flat screen before bed

The study did try to explain why television appears to be worse than cell phones for inhibiting sleep. We can make some guesses, however.

It is well known that the blue light emitted from screens is bad for sleep. Exposure to this light tends to delay the sleep cycle and to increase the amount of time it takes to fall asleep (“sleep latency”). Television screens are larger than cell phones or tablets. In fact, on average television screens are larger than they have ever been! It’s possible that the larger the screen, the larger the amount of blue light. As a result, sleep is even more inhibited.


Like it or not, parents are role models for their children. It’s not reasonable to hold your kids to a standard that you yourself cannot keep up. If you have a television in your bedroom, how can you deny one to your child? If you sleep with your cell phone or tablet on your end table, your child is going to find out.

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Teens don’t sleep enough after an espresso

The parents who sleep the best, and who have children who sleep the best, make rules about technology use, enforce those rules, and observe the rules themselves!


Removing technology from the bedroom is easy, or should be. More difficult is modeling behavior for your children around healthy bed times. The NSF study showed that parents who get enough sleep quantity and quality have children who also sleep long and well.

Caffeine use is an important contributor to sleep hygiene, but it’s not often discussed. This study does us a favor by raising the issue of caffeine consumption in both parents and children.

As an admitted caffeine addict, I appreciate that the issue is being raised and I’m grateful to the NSF for bringing it up. I’m also grateful that my children have not inherited my addiction. But perhaps we’re not merely lucky. We make a conscious effort to model healthy eating and drinking behavior for our children. The same goes for exercise.

My own parents were heroic coffee drinkers and neither lifted a finger of exercise. How my sisters and I ever became health nuts will remain a mystery. Perhaps our parents modeled better behavior than I give them credit for.

Most children today are not so lucky. Parental modeling of behavior matters.

When I counsel a family about a sleep problem, I’m really counseling the entire family. To me the expression “sleep hygiene” refers to the sleep habits of the entire family, not just a child’s.

The truth is, fixing a child’s sleep problem often means fixing the entire family’s sleep problem. If you want to find out more, feel free to contact me. I can help.

When Will My Preemie Sleep Through the Night?

Many parents want to know when, at long last, will their preemie sleep through the night?

It’s a good question.

First Things First

Perspective is an easy thing to lose. So is patience, especially when you are massively sleep-deprived and stressed out. I know. I’ve been there.

My second child was born at 35 weeks. He spent the first 13 days of his life in the NICU. We were lucky. Every day I walked past the ventilators and isolettes of babies who would be living in the NICU for weeks, possibly months. I couldn’t imagine what kind of stress these parents were feeling.

And yet, life was stressful. We already had an energetic pre-schooler at home. Now we were caring for a tiny little guy who ate well, but he was so… small!

I saw a picture of myself taken when the baby was 4 months old. I gasped out loud. I had lost a ton of weight without realizing it. I’m quite sure I did not lift a finger of exercise. And the majority of my diet probably consisted of eating stuff that my 2 1/2 year old dropped on the floor.

I don’t remember a whole lot from that first year, but I do remember asking when will our preemie sleep through the night.

And I remember stopping myself. “What am I saying?”

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Would that it were so simple!

We were lucky we had a healthy, growing boy. We had avoided a much worse fate. Was I asking too much by wondering when would our preemie sleep through the night?

With the passage of time and the acquisition of some perspective, I can answer ‘yes’, I was asking too much. He’s in high school now. The time went by so quickly. In the big picture, the sleep-deprived part of my life was very short!

When WILL My Preemie Sleep Through the Night?

There’s an answer to this question. But when parents ask me, I always begin by telling them my story. I want to help them gain some perspective on their situation. Most of them had endured extreme stress, as I had. I want them to know that there is a light at the end of the tunnel. I want them to know that with the passage of time, they too will see that the sleep-deprived part of their lives was relatively short.

The due date is a big event. I counsel parents to celebrate this day. Take stock of what they’ve gone through, and pretend to start the clock again.

Full term babies start to sleep through the night between 4-6 months of age. By “through the night” I mean 5-6 hours. I give a range of 4-6 months because girls tend to reach the milestone closer to 4 months, boys closer to 6 months.

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For babies born early, you can predict when they will sleep through the night using “corrected gestational age“. When they reach 4-6 months, corrected, you can expect that they should be ready to stretch those hours of blissful sleep together.

Now, I’m hesitant to dangle promises. I hate to write checks that your preemie cannot cash. But I should say that often a preemie will sleep through the night prior 4-6 months corrected. This is because of a phenomenon I call “catch up development”. What I mean is that by being here on earth, a baby learns some things that she might not otherwise know if she were “inside”. Sometimes the experience of being here helps accelerate certain developmental milestones. Sleep is one.

For example, there is the the development of circadian rhythm, the daily cycle of her body’s systems. It goes without saying that there is no day and night inside the uterus! Once she is out here in the world, the relative brightness of day and the relative darkness of night helps train her brain to adopt a day-night sleep cycle. Sometimes, despite premature birth, a baby can be “nudged” into sleep habits that are more mature than her corrected gestational age.


  • Feed the baby! If your pediatrician suggests that the baby needs to eat every 3-4 hours, you may need to wake her up, even if she’s sleeping! If she’s gaining good weight (an ounce per day), waking her may not be necessary.
  • Back to sleep saves lives! She should always sleep on her back, on a firm surface.
  • SHHHHH! Premies can be more sensitive to sensations than full-term babies. Try to keep her environment as calm and quiet as possible. This will help her sleep better.
  • Consistency, consistency, consistency.  Try to keep the baby’s day as regular and as predictable as possible. Falling into a routine will help her eat and sleep!

If you need any help getting your preemie to sleep, I can help!

Sleep Training Twins

If you’ve got twins (or higher multiples!) I don’t need to tell you: it’s a lot of work. It’s not twice the work, it’s four times the work (exponential, not additive, for the math whizzes out there). Sleep training twins is not easy, but it’s not very different from sleep training “singletons”.

The books you may find on the subject will tell you basically the same things you’d learn from any general resource about baby sleep. There are only two basic differences in strategy. I’ll tell you what they are up front: 1) Keep a tight schedule. 2) Occasionally break the “never wake a sleeping baby” rule. Now, to the details!

Sleep Training Twins

1) Feed Both at the Same Time

Here’s where the rubber hits the road in sleep training twins. The question is not whether you should feed them together (or one right after the other). The question is when. If you want to avoid going crazy, you’re going to have to feed the twins together. If you’re okay with going crazy, who am I to judge? But if you want to maintain your sanity, here’s what you do:

From the time you come home from the hospital, depending on the gestational age of the twins, you’ll be feeding them every 2-3 hours. Hopefully, this interval is every 3 hours, for so many reasons! Not least among these, you’ll have to plan your day around feeding, and the entire process could last one hour. That leaves you 2 hour intervals to do everything else you need to do, like take them to the pediatrician, bathe yourself, eat, exercise, and most important, sleep!


By “entire process”, I mean preparing the bottles (less time if you’re breastfeeding them. And if you are, congratulations!) changing diapers, changing clothes, and putting them back down. This truly can occupy one hour. Meanwhile, the clock has been ticking and twin A will need to start feeding again in three hours. So you have to be efficient and have a system down.

2) Waking the sleeper(s)

To do this, you may have to wake one or both of them up! This is a violation of the “never wake a sleeping baby rule”, but I cannot see a way past it. To do otherwise is to risk getting out of sync. Getting out of sync means chaos. And chaos is never good.sleep training twins 2

The good news is that you probably won’t have to wake one or both of them up for very long. If you do this right, they’ll fall into a pattern and “learn” to wake up around feeding time anyway. Which leads me to the next, and perhaps most important tip:

3) Consistency, Consistency, Consistency

There! I’ve said it three times. Their day should be as regular and as predictable as possible. That is to say, things should occur in the same sequence, at roughly the same time, every day. The fewer disruptions you introduce, the better. The disruptions will introduce themselves, believe me! There are a couple of tricks you can do to help you get a routine going.

  • Let night be dark and day be light. Sounds kinda Biblical, doesn’t it? But the one of the best ways to get your multiples on a schedule is to allow their own circadian rhythms to coordinate with the day-night cycle.
  • Get a white noise machine. All your babies’ senses are working and they can’t filter them out! The best way to help them through this problem is to distract them with soothing noise.
  • Keep a log. I know it sounds dumb. But you’re going to be sleep-deprived. Writing stuff down will help you keep track and avoid confusion.
  • Have them sleep together. As long as they are swaddled, placed on a firm surface, and there is no loose bedding, this will save you on precious time, energy, and laundry detergent!
  • Incorporate time for yourself in the schedule. Just because you are sleep training twins doesn’t mean you don’t have to sleep, eat healthy, and exercise. You still need all three. You can’t take care of multiples if you are a physical and mental basket case! Take care of you, too.

Baby Wise: Parent-led Schedules

Ezzo, Gary, and Bucknam, R. “On Becoming Baby Wise”. Mount Pleasant, SC: Parent-Wise Solutions, 2012

Gary Ezzo is a lucky man.

“On Becoming Baby Wise”, as of this writing, ranks #1 for sleep disorders in Amazon Books. This fact speaks volumes for the message, especially in light of the fact that the messenger, Mr. Ezzo, has been the recipient of some withering criticism for his parenting advice, but especially for his religious beliefs. Some of that criticism, sadly, comes from Ezzo’s own church, or I should say former church. Despite all this, the Ezzo collection has grown to nine volumes. That’s impressive.

baby wise X

When I read “Baby Wise” for the first time, I detected no hint of any religious world-view whatsoever. I did not know of the controversy surrounding Mr. Ezzo and I’m glad I didn’t. I appreciate that the first edition of the book expressed this world-view explicitly. Not so with subsequent versions.

My ignorance allowed me to judge the “Baby Wise” message without regard to the messenger. This is as it should be. Here’s what I took away from it:

Baby Wise

The lesson I took away was the commonsense observation that a baby who has just finished a good feeding is probably not hungry. If one hour later, the baby starts fussing and crying, many experienced parents understand that what is bothering the baby cannot be hunger. Because the baby just ate! “Baby Wise” suggests that parents first seek to find what’s bothering the baby before reflexively feeding her.

This is what happens in the real world. What mother has not looked into the bassinet at her crying baby (whom she finished nursing 30 minutes ago) and thought, “You can’t be hungry, I just fed you!” Mom then proceeds to see if the baby had gas, or needed a diaper change.

Another Fact of Life

“Baby Wise” recognizes a fact of life about babies: they are not born knowing how to get along in this world. They are equipped with certain biological set-points, but becoming a person requires nurture as well as nature. Most parents understand this implicitly.


Ezzo suggests that babies need to be nudged, gently, in the direction of sleeping when it’s time to sleep and eating when it’s time to eat. This may involve staying with the baby for a few minutes to stroke her back, to sing to her, or to give her a fingertip to suck on. I believe that even parents dedicated to attachment methods recognize this truth. I believe “attachment parents” do a fair bit of nudging themselves, though they might not care to acknowledge it!

Baby Wise Claims the High Middle Ground

It has become fashionable in the Baby Sleep World to claim that one’s own method is “centrist” or a “combination method“, and that all the others are either “baby-led” or “parent-led” extremists. Everyone clamors for the exalted, er, middle ground. Ezzo is no exception.

[Parent-directed feeding] is the center point between hyper-scheduling and the re-attachment theories. It has enough structure to bring security and order to a baby’s world, yet enough flexibility to give Mom the freedom to respond to any need at any time. It is a proactive style of parenting that helps foster healthy growth and optimal development. For example, a baby cannot maximize learning without experiencing optimal alertness, and he can only experience optimal alertness with optimal sleep. Optimal sleep is tied to good naps and established nighttime sleep. These advanced levels of sleep are the end result of consistent feedings. Consistent feedings come from establishing a healthy routine.

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Who’s the director?

Ezzo then goes on to mis-characterize the so-called “baby-led schedule” and “attachment theories” and exhumes the body of Luther Emmett Holt’s clock-feeding schedule.

I wish Ezzo and others were lumpers instead of splitters. We are all “combination schedulers” now. This is where the “debate” has led us.

Off the Rails

Where Ezzo over-promises and under-delivers comes with his discussion of sleeping through the night.

In fact, healthy, full-term babies are born with the capacity to achieve 7-8 hours of continuous nighttime sleep between seven and ten weeks of age and 10 to 12 hours of sleep by twelve weeks of age. But these achievements require parental guidance and a basic understanding of how a baby’s routine impacts healthy outcomes.

I’m not sure where Ezzo gets these optimistic numbers from, but they do not square with observed data, as in this study:

Continuous night-time sleep for at least 6 hours was noted in 35% of the infants under 3 months old and the proportion increased to 72% by the age of 9–12 months. The youngest infants were fed on average 6–7 times per day at 2- to 3-hour intervals in the daytime and at 4- to 6-hour intervals at night.

Ezzo also nods with his misunderstanding of circadian rhythm. “Babies do not have the ability to organize their own days and nights into predictable rhythms, but they have the biological need to do so.” In fact, babies do have the ability to organize day and night, if they are permitted allow synchronize their sleep-wake cycle with the cycle of day and night. This requires no effort on the parents’ part at all. Just allow daytime to be light and nighttime to be dark. You don’t need to train the sun.

I’m not sure what Ezzo means by a “biological need” to organize day and night. There’s a need to sleep, and it’s probably the case that we do better when we sleep long periods at night. Is this what Ezzo means? Perhaps.

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Oops. Ran out of track

Back on Track

The remainder of the book gives solid common-sense advice about the hazards of overstimulation and bad sleep associations (though Ezzo refers to the latter as “props”, confusing cause and effect). The chapters on crying, feeding, baby care and troubleshooting are all pretty standard fare.

In short, the similarities between Baby Wise and other baby sleep books are greater than the differences. The latter are cosmetic, the exceptions having been noted.


  • Ezzo may be a religious man, but “Baby Wise” is not a religious book
  • Apart from some unrealistic expectation management regarding uninterrupted sleep at night, the advice is solid.

Sleep Schedules: Who Makes Them?

New parents who buy baby books and browse the internet may come to believe, reasonably, that there are two basic “philosophies” of sleep schedules for babies: parent-led and baby-led. It’s true that there are different philosophies out there (including combination philosophies), but no philosophy ever made a baby schedule.

“Schedule” is a funny word. In English the word schedule implies a scheduler, someone who makes the schedule. I explain to my clients that sleep schedules are a lot less scheduled than parents care to admit.

The philosophy I share with my clients is based on my belief that sleep schedules are a type of spontaneous order: The baby sleeps and eats at (roughly) the same time every day. It looks like a schedule! In fact, it is a schedule. But there was no scheduler.


I’ll get to my account of where I believe the two philosophies came from. But first, a word about the tendency to divide the world into groups.

Lumpers and Splitters

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Thiago Splitter

There world is divided into two parts: People who divide the world into two parts and people who don’t. That’s a joke, of course. But like many jokes, it reveals a truth about human nature. Some people are “splitters” and some are “lumpers”.

Splitters tend to see the world as divided up into categories. The task of the splitter is to find the appropriate category for everything. A splitter asks “how is this thing different from that thing?”

The world is divided into two parts: People who divide the world into two parts, and people who don’t.

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He is a lumper. Look it up

Lumpers tend to see the world as a series of connections among things. The task of the lumper is to find ways to lump everything into as few categories as possible. A lumper asks “how is this thing like that thing?”


I am a lumper by nature. I don’t know how or why I got this way. For me, lumping is the most intellectually-satisfying way to make sense of the world.  It informs the way I look at sleep schedules. Having said that, I don’t “lump together” the various sleep schedule philosophies into one group. Rather, I believe that the various philosophies arrive at the same end-point: the child (and parents) settle into a pattern that appears to be a schedule. Babies contribute to the development of a schedule, and parents play a role as well, but there is an important third party that plays a crucial role as well. I’ll get to that at the end of this post.

Baby Sleep Schedules: Parent-led vs. Baby-led

Prior to the 19th century, nobody thought much about baby sleep schedules, either parent-led, or baby-led. The concepts simply didn’t exist. All a mother had to guide her was the advice and counsel of experienced mothers in her community, first and foremost her own mother. Therefore, if one could say that there were such a thing as child-rearing philosophies, these were traditional philosophies. That is to say they were based on tradition: familial and cultural.

In mid-19th century, coincident with the creation of pediatrics as a medical specialty, there emerged what could be called the “era of scientific parenting”. Pediatrics came into being to solve two problems: infant mortality and malnutrition. By the middle of the 20th century, both problems had been largely solved in the developed world, leaving pediatrics, temporarily, with no reason for being.

The Origins of the Parent-led Schedule

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Luther Emmett Holt, MD

One of the giants of the early days scientific parenting was Luther Emmett Holt, who in 1894 published “The Care and Feeding of Children“. Originally intended as a teaching manual for nurses in New York City, Holt’s book quickly spread in popularity to the reading public. It takes the form of an extended FAQ, with questions and short answers.

The section on sleep in Holt’s book is remarkably brief. Holt’s advice is clearly prescriptive, particularly with respect to feeding and sleeping:

How can a baby be taught to be regular in its habits of feeding and sleeping?

By always feeding at regular intervals and putting to sleep at exactly the same time every day and evening.

When should regular training be begun?

During the first week of life. (p 109)

Holt may not have invented parent-led schedules, but the publication of his book gave the imprimatur of the medical establishment to the method.

The Baby-led Revolution

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Holt’s prescriptions lasted about 60 years, until the publication in 1946 of a book called “The Commonsense Book of Baby and Child Care” by a Connecticut pediatrician named Benjamin Spock.

“Trust Yourself. You know more than you think you do.” With this famous opening line, Spock fired the first shot at medical establishment prescriptions about feeding and sleeping. Spock counseled parents to trust their own instincts and to pay attention to the baby and her signals. It’s difficult to imagine just how controversial this idea was in the mid-20th century. These ideas were so dangerous to his own standing in the medical establishment that Spock couches his recommendations in extremely cautious language. In his chapter called “Schedules”, Spock begins by saying

“Your doctor will prescribe the baby’s schedule on the basis of his needs, and you should consult him about any changes. The following sections are mainly a general discussion of what schedules are all about…”

But Spock then goes on to argue, persuasively in my view, that baby-led feeding and sleeping habits pre-date “scientific pediatrics” and have been in fact the way babies have fed and slept from the beginning of time until Holt. Spock advocates an essentially baby-led feeding and sleeping schedule, and he endured a barrage of criticism because of it. He nevertheless prevailed, and until the modern resurgence of the parent-led schedule movement, Spock reigned.

The Sun

It’s human nature to see a pattern and to conclude that someone created the pattern. Such is the case with sleep schedules. By a few months of age, most babies tend to sleep and eat at about the same times every day. Some people believe that parents were essential to creation of the schedule. Not coincidentally, these tend to be people who favor parent-led methods of child rearing. Others, who favor baby-led methods, believe that the baby made the schedule.

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The rhythm

Both camps ignore the crucial role played by light. From a very early age, babies start to sleep longer at night, and to stay awake longer throughout the day. How do they do this? The light that strikes their eyes causes them to synchronize their sleep-wake cycles to night and day. We get sleepy at night and alert during the day.  All the baby needs to do to synchronize this “circadian rhythm” to day and night is to see light during the day, and to see darkness at night.

So parents and babies rely on the crucial participation of a third partner: the sun. Little babies wake up when they are hungry and then fall back asleep, but with time, they develop a circadian rhythm that is tuned to the day-night cycle. They sleep longer during the night and less during the day. The sun helps push them into a schedule, as much or more than they schedule themselves, and more than parents schedule them.

The system isn’t perfect. No system is. The schedule gets thrown off. Babies have busy days, they get overstimulated. They get sick and need more comfort. But the basic schedule remains unchanged and so do the influences that created the schedule.

How do you create a good sleep/feed schedule? The best advice I can give is to stop trying to make a schedule and allow the schedule to make itself.

Baby Jet Lag: How to Beat It

Several of my clients boldly take their babies on truly long trips – I mean several time zones! I’ve known families to fly with their little children to India, the Far East, and Africa. From these families I’ve learned the best tips I can find to overcome baby jet lag.

What’s baby jet lag?

It’s just like adult jet lag, only your little one sleeps more than you do, so it probably won’t be as tough on them as it is on you. The local clock says it’s 9 in the morning, but you feel like it’s time to go to bed! Same with the little one. There is simply no way to avoid it. Baby jet lag will probably last a minimum of 3 days, up to 14 days depending on how many time zones you cross. But there are ways you can reduce the shock to the system.

Flashpackerfamily.com has some great tips on managing jet lag for the little ones. One of the best ones is choosing a night flight. It turns out that if you choose a flight time when everyone will be sleeping (make that should be sleeping!)



Night and Day

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Tel Aviv – Jaffa

Most experts agree that the best way to adjust to a new time zone is to allow our own eyes to train our brains to adjust our circadian rhythm. Simply put: let daytime be light and let night time be dark. Our eyes train our brains to secrete melatonin at night so we’ll tend to get sleepy when it gets dark.

This is one of those occasions when I recommend breaking my rule about letting a sleepy child sleep. For the sake of making most of the trip/vacation more pleasant, it may be necessary to wake her up in the local time morning. Then it’s a good idea to take the child out during day time and encourage her to stay awake.

The opposite goes for night time.  Though she may be wide awake and wanting to play, I recommend keeping her room dark, quiet, and relatively free of activity. This is that poor sleep-substitute that I call “downtime”.  It’s better than nothing.

As for naps, to the greatest extent possible, try to time these according to local time.  And good luck.


Most seasoned travelers including deliciousbaby.com recommend meal times at local times. That means, if it’s time to eat breakfast in Tokyo, eat breakfast. In a perfect world, you would start doing this on the plane, but the reality is that you eat when they feed you. Of course, you’ve brought plenty of healthy snacks with you, right?

baby jet lag

Speaking of healthy snacks, when you and your child are up in the wee hours of the morning because you haven’t adjusted your circadian rhythms yet, someone’s liable to get hungry.  I’d keep it healthy and proteinaceous. Sugar not so much. It’ll help. I promise.


Nothing wears the crew out more effectively than lots of physical exertion.  This is not always the easiest thing to do depending on your location. It may come down to going outside and walking (temperature and weather permitting). Along with meals at the usual times and sleep at local time, this is the best way to restore some normalcy.

Finally, remember you’re going to have to do all of this in reverse when you return!