Ask the Expert

Q: My toddler has frequent nightmares. Could that be the sign of something serious?

A: Since a toddler's sense of reality and fantasy are still a bit unclear, it's not uncommon for them to have nightmares (maybe even more often than the rest of us). Perhaps they saw scary shadows or caught a frightening image on TV before bedtime that stuck with them.

To try and avoid having frightened children, make sure they are extra comfortable when you tuck them in at night. When preparing for lights out, read a story that is soothing or sing a calming song.

If your child is old enough to tell you about the nightmares he experiences, listen carefully and discuss them. Each family has its own version of dealing with "monsters." Come up with your own and stick with it. For example, inventing a superhero to get rid of them may put your child's mind at ease.

Usually, toddlers who awake from a nightmare will go back to sleep on their own, and parents needn't go in and intervene. If children are crying and panicked, parents should calm them, but be wary of getting too involved. It is best that children don't depend on their parents to go back to sleep.

Of course, when nightmares occur frequently (4-5 times a week), it is a sign to look at what is going on in your toddler's life. Nightmares can occur if the child is outside of a familiar home environment (e.g. if you have just moved or are on vacation). Other times, nightmares can be caused by fevers or recent trauma. It might be necessary to consult with your doctor.

Carmen Alonso, MD, is Director of Residency Training for the Division of Child and Adolescent Psychiatry at the New York University School of Medicine. In addition, Dr. Alonso is a board certified pediatrician and is certified by the American Board of Psychiatry and Neurology, Inc. in child psychiatry.