How’s your baby sleeping?

One of the most common concerns of parents is that their babies are “turned around” or have “their nights and days mixed up”. This is very common in newborns which, along with the frequent need to feed, makes caring for a newborn such a challenging (but wonderful) experience.    We expect some exhaustion and schedule disruption at first, but how long is too long and what can we do if the sleep problems/ night waking persist?  There are things that can be done to help your baby sleep during the night. Babies are expected to wake to feed till 3-6 months of age.  We usually do not recommend sleep training measures until after that period of time.  Some babies will start to sleep for longer periods of time on their own prior to six months which is fine, as long as infant is healthy. (Note- These methods and sleep patterns may not apply to infants with illness, growth problems or underlying medical concerns.) Many parents associate sleep training with abandoning their child to cry for hours.  This need not be the case. There are several methods that can help ease babies into a better nighttime routine.

One of the common themes in all of these methods involves routine bedtime and getting ready for bed activities. Trying to keep a set bedtime will help your child to regulate their sleep schedule and make the going to sleep process ultimately easier.  Many parents (and infants) enjoy routine activities such as nighttime bath, reading, rocking, etc.  This can be a wonderful bonding time with infant as well as helping your baby to wind down.  If baby has a difficult time falling asleep initially, move the bedtime up a little. Often, babies that are overly tired have a difficult time falling asleep.  Make time changes gradually, perhaps 30 minutes earlier to start nighttime routine each night until desired bedtime is reached.  Most methods also advise putting child to sleep drowsy but awake.  If baby falls asleep in your arms, it can be jarring to awaken alone, which can lead to increased full awakening during the night.

Most of the methods involve allowing baby to comfort and fall asleep on his own at bedtime and during the night. The Ferber method advises putting the baby down while drowsy, but then waiting a prescripted amount of time until calming baby.  This method advises parents to check on infant, soothe with words and pat infant, but not to pick up.  This method starts with short intervals of time between calming times and gradually increasing to longer periods of time.  As the intervals lengthen, the methods used to comfort also change as well, starting with contact, but going to just verbal reassurance.  This method does not advise that you just leave the room and let your infant cry all night.  Many times this method can be effective in a fairly short period of time, 1-2 weeks, but obviously these times will differ with each child.

Another popular method is the Sleep Lady Solution. Like the Ferber method, this method utilizes putting baby to bed drowsy, but not fully asleep.  It then starts with parents sitting directly by the crib, patting, gently calming baby as needed.  Then several nights after this, it recommends moving further away from the crib and trying to pat and calm less frequently.  Every few days, parents will move further away from crib and ideally infant will need less frequent calming.  With this technique, parents may pick up child and comfort, but once baby is calm she should be put back in bed to rest.  This technique also advises waking to feed at a set time each night as a way to deal with nighttime feedings.  If awakened slightly before her normal feeding time at night, many babies will then sleep through set waking times, and this can help to change sleeping patterns.  (For example if normal feeding time is 1 AM, but you wake to feed at midnight, if baby wakes again at 1 AM out of habit, parent can be reassured that true hunger is not driving this wake up and hopefully will feel more comfortable with using sleep training methods. ) This method advises not letting baby fall asleep at breast or bottle but putting in crib while still drowsy if possible. A planned daily wake up time with increase in light in the room also can help little ones to get on a better sleep schedule.

Some parents prefer the No-Cry sleep method. It allows parents to actively respond to child’s needs without a prescribed time of crying. Crying babies are picked up and held, rocked, fed until calm or asleep, then are put back into crib to sleep. If the baby awakens again, parent picks up and calms again as needed.  This method also emphasizes nighttime routine and consistent bedtime. This method has many similarities to Sleep Lady method, bedtime routine, introduce a lovey object (older babies), using verbal sleep cues (Shh, time to sleep), and a darkened room at bedtime.

These methods also discuss need for routines with daytime napping like same location, darkened room, quiet or soft music and placing in bed awake but drowsy. Also, learning your child’s sleep cues (rubbing eyes, yawning) can be helpful. Often putting a child to bed when these cues are happening will make bedtime easier.

This is just a very brief description of these methods.  There are more tips and specific examples in the books. I know that with an infant or child at home there is not much time for reading, but these books can be read in pieces. There are brief chapters on the main points of the method and age appropriate chapters as well.  I do recommend reading the pertinent chapters as there are many more points made in the books that can help implement these changes.  Another suggestion is for both parents to discuss changes. Make sure that both parents are ready to try sleep training.   Sometimes it helps to set date to start and plan your schedule for the method you are using.  Many of the books will have worksheets to help this transition. Making a simple cheat sheet for anyone watching the baby during the day can be helpful also.

In my personal experience, I have used a variety of these techniques. As always, certain methods may fit one baby (or family) better than others.  I would advise that you go with your instincts regarding sleep training.  This should be a challenge but not a soul wrenching process. Often parents will find that though it can be difficult, making these changes does end with a happier more well rested baby and better rested parents.  The baby stages are so short, if exhaustion is clouding your time with your baby, it may be best to make a change.

Books that we recommend on sleep:

Solve Your Child’s Sleep Problems by Richard Ferber

The Sleep Lady’s Good Night Sleep Tight by Kim West

The No-Cry Sleep solution by Elizabeth Pantley

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