Hello Baby, Goodbye Sleep

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babysleep1

Babies sleep a lot.

We sleep more as babies than in any other time of our lives. Infants under two months sleep for 12-18 hours every day. So why are parents of infants so sleep deprived? Even though infants sleep for a long time overall, individual stretches of sleep are pretty short – typically just a few hours at a time, or less.

Parents know the joys of midnight feedings, as well as 3 am crying bouts, 5 am lullabies, and changes every hour in between. In fact, new parents can expect to lose about 600 hours of sleep in the first year. But this kind of sacrifice has a serious effect on the health and well-being of parents.

Sleep deprivation brings many short term and long term risks. With the stress of a new baby, sleep-deprived parents can face:

  • Stress
  • Irritability
  • Resentment
  • Depression
  • Extreme fatigue

In order to get parents well rested, we need to get at the source – babies that don’t know how to sleep yet.

Building Brains, One Nap at a Time

Sleep may be more important for infants than any other period in human development. Babies don’t just rest during sleep, they actually develop their brains.

While a baby sleeps, her brain processes and sorts all the new experiences she has experienced. This is the process of creating memory. Not necessarily long term event memories, but remembering the faces of parents and basic stimulus of waking life. Since babies are born with no information about the world, they need to remember a lot. Sleeping a lot helps them do it.

Aside from memory and learning about their world, babies are also learning about their own bodies. This doesn’t just happen when they are awake. You may have seen an infant twitch his limbs, shift, or grimace while sleeping. This isn’t a side effect of dreams – this is the baby building new neural pathways. Each twitch helps the infant understand the impulses that lead to, say, a kick of a leg or how a jaw works.

With sleep being so important for the development of newborns, it would make sense if babies would have no problem sleeping through the night. But this is not the case.

Learning Sleep

babysleep4Just as babies don’t know how to walk, talk, or feed themselves, babies also don’t know how to control their sleep, or their emotions.

Until about six weeks of age, all bets are off. Babies will wake at all hours, have bouts of colic, and there’s not too much that any parent can do about it.

Babies have also not yet developed their circadian rhythm – the natural sleep cycle that follows day and night.

After six weeks, most babies will begin to develop more regular sleep schedules. By three months, most infants can stay in bed through the night.

Although many people think that infants are “sleeping through” the night, recent studies show that infants at three months actually continue to wake during the night. But, they have developed the ability to resettle themselves and fall back asleep on their own, unlike their younger counterparts.

By six months, babies start to have more regular, predicable sleep schedules. They may wake occasionally during the night, but go back to sleep in a few minutes.

Smooth sailing, right? Unfortunately, we’re not all blessed with babies that follow these stages of sleep. Upwards of a quarter of babies at six months will still be unable to fall back asleep on their own if they wake during the night.  Read on to see our tips to put babies to bed.

Basic Baby Sleep Tips

Just like grown ups, healthy baby sleep doesn’t just start at bedtime, it needs to be worked at during the day, at bedtime, and during the night.

During the day:

  • Interact with your baby as much as you can. Talking and playing with your baby will keep him awake longer during daylight hours, and help associate daytime with activity. This will also tucker him out, and help him sleep during the night.
  • To help your baby develop a day-night cycle, try to see that she gets light during the day and darkness at night.

At Bed Time:

  • Put your infant to bed when drowsy, but not yet asleep. If you put your baby to bed when she is not yet asleep, but falling asleep, this will help her actually fall asleep on her own. Helping her sleep by rocking or cradling may make her unable to sleep without those aids. Putting her to bed when drowsy can help her become a “self soother,” a baby can put herself to sleep, and also calm herself if she wakes at night.
  • Wrap up your baby like a burrito! Aside from the gentle twitches a baby can make during sleep, they can also jerk and flail around during sleep, something known as the moro reflex. This can startle them and wake them. Swaddling your baby safely and securely with a small blanket will help contain these spasms and prevent them from waking themselves up. To do this, snugly bundle up the arms and legs (or just the legs), ensuring that the blanket will not come undone during the night. Also, be sure the hips aren’t too tight, so the baby can lie naturally.
  • There is some evidence that the composition of breast milk changes throughout the day. Bedtime feedings may contain properties that will help your baby develop his circadian rhythm.

babysleep2During the Night:

  • Keep the crib in your room, in arm’s reach of your bed. Also keep everything you might need during the night nearby (diapers, bottles, soothers, etc.)
  • Use a nightlight. When you wake during the night to care for your infant, turning on a bright bedroom light will only wake up the baby more – and you. A dim light will keep stimulation to a minimum,
  • Keep all other stimulation as minimal as possible. Besides the light, try keep your voice low, no strong smells, and so on.
  • If your infant cries during the night, give him a minute or two. He might be able to put himself back to sleep without any help from you. (This isn’t to be confused with “Ferberizing” in the section below.)

Sleep Training Methods

Aside from the general sleep tips above, sleep specialists and pediatricians have also developed a few more regimented ways to encourage your baby to sleep during the night. This is also where things get a little sticky. One of these methods involves a little more crying than the others, and everyone, not just parents, gets upset at things that cause crying babies.

The Ferber Method

Also known as “Ferberizing” or “cry it out” by some, the Ferber method is the most controversial. Dating from Richard Ferber’s 1985 Book Solve Your Child’s Sleep Problems, the Ferber method states that it’s OK to let your baby cry for a set time before rushing to help them.

The goal of the Ferber method is to teach your baby to sooth themselves – to learn that crying for a parent is not the only way to calm themselves down and get to sleep. If good sleep is a skill, then we can compare it to walking. Rushing to your child’s crib immediately would be like constantly holding them up – not letting them take the tries and tumbles that teach them how to stand and how to walk. With walking and with sleeping, there may be tears involved.

Along with this, constantly being there to rock or cradle your baby to sleep may lead to a dependency. They need your presence to sleep, because that’s all they’ve ever known. Some kids can’t get to sleep without their favorite stuffed animal – but the stuffed animal doesn’t need to get up early in the morning.

The Ferber method begins when your baby is old enough to begin sleep training. Typically, a baby can start at around 4 to 6 months old – but this varies a lot depending on the physical and emotional maturity of your child.

The first night of the Ferber method might look something like this:

  1. Put your baby in the crib when he’s drowsy, but not yet asleep
  2. Tuck him in safely, say your goodnights, and leave the room.
  3. If your baby cries out, let him cry for two or three minutes, then re-enter the room. Keep stimulation to a minimum (dim lights, quiet voices, and leave him lying in his crib). Only stay in the room for a couple of minutes, and then leave again – even if he’s still crying.
  4. If your baby continues to cry, or cries out again during the night, leave him for a little longer – five minutes or so. Then go in again and repeat the low-stimulus care. After that, leave for ten minutes at a time.
  5. Repeat until your baby falls asleep with you out of the room.

For each night that follows, stay out of the room a little longer. If the first night is three minutes, five then ten, the second would be five minutes out, then ten, then twelve. Only you know what is best for you and your child – you might find that longer or shorter waits fit you better.

If the process doesn’t seem to work, your baby may still be too young. Try again in a couple of weeks.

Remember that Ferber’s method does not mean sticking your child in a closet from dusk till dawn and ignoring them. The purpose of the method is not to close up emotionally, or not to deny care for your child, but to impose structure. And this sometimes means tears.

No Tears!

No Tears methods are a reaction to the Ferber style of sleep training. Rather than gradually imposing structure on your baby’s sleep patterns, they call for quick responses to crying. Its proponents include William Sears of The Baby Sleep Book and Elizabeth Pantley of The No-Cry Sleep Solution.

The criticisms of Ferber’s method are that sleep is a time to connect and bond with your child – including responding to any cries. They hold that Ferber methods could impart negative sleep associations to your child, which may last well beyond infancy.

Five S method

If Ferber is all about bringing babies to a self-reliant, self-comforting world, then Harvey Karp is all about bringing babies back to the womb. Outlined in The Happiest Baby on the Block, his five “S” strategy works to recreate the sensations that your baby experiences in the womb. By recreating them, your baby will be relaxed and able to fall asleep.

  1. Swaddle: This technique is mentioned above – wrapping your baby snugly in a blanket. According to Karp, this does more than prevent flailing limbs. It also recreates the familiar confined space of the womb.
  2. Side/Stomach: Babies should always sleep on their back (see bottom section). However, to help calm a crying baby you can rest her on her side or stomach for a time before bed.
  3. Shush: In the womb, babies are surrounded by sound: the mother’s pulse creates a white noise that is with the baby until birth. To mimic this comforting noise with a crying baby, put your lips close to your baby’s ear and make a shhh sound. Match the volume of your shushes to however loud your baby is crying, growing quieter as they do.
  4. Swing: Swing is just what is sounds like – swing your baby to and fro. Short, fast swings will reproduce the sensations of shifting around in the womb.
  5. Suck: A pacifier, thumb, or other nipple-replacement for babies that want it.

So, put it all together and with the Five S method your bedtime baby is swaddled, temporarily on her side, shushed if she’s crying, swung, and then sucks. Then, hopefully, sleeping.

Staying Safe

babysleep3No matter which method works best for you and your baby, the most important thing is keeping your child safe. The American Academy of Pediatrics has recommended guidelines for lowering the risk of Sudden Infant Death Syndrome in babies under 1 year of age. These steps might not help your baby fall asleep faster, but will make sure she stays safe when she does.

  • Put your baby to sleep on a firm surface
  • It’s helpful to keep the crib in your own bedroom, but it’s safest if your baby does not sleep in your bed
  • Make sure your crib is safe and there have been no recalls issued. Check here for crib safety standards: http://www.cpsc.gov/
  • The crib should have no stuffed animals, loose blankets or sheets, toys, or much else that isn’t a baby.
  • Most important of all – your baby should always be put to bed on her back – not her side or tummy.

Additional SIDS guidelines not directly related to sleep are available at HeathyChildren.org.

Before You Go

Take care when researching baby care tips online. One study of information available to parents online attempted to understand how accurate websites were. By comparing them to the American Academy of Pediatrics (AAP) recommendations for infant sleep safety, they found that just 43.5% contained accurate information. 28.1% were inaccurate, and 28% were not relevant.

We’ve made every effort to include accurate and safe information, but only you and your pediatrician know what is best for your child.

Be sure to discuss your baby’s sleep health and habits with a health care professional.

photo credit: bitzcelt, mrtopp, Jennuine Captures, and Telstar Logistics via photopin

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  1. Posted by Camille

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