By Laurie Albertini, M.D., Brenner Children’s Hospital
If you ask a new parent what they would wish for the most, they will often say “a full night of sleep,” followed by a day with no crying or dirty diapers. In the first two years of life, sleep problems are the most frequent complaints of parents during pediatric office visits, so you are not alone. About 30-50% of infants have enough of a sleep problem to cause parents to seek help, and they can persist into childhood if left untreated.
Sleep is a highly organized process that is influenced by the child’s environment. The parent’s role is to facilitate their child’s ability to develop the internal controls to stay asleep. We, as parents, are often the creators of our children’s sleep problems. Simple things such as light, noise, food, and rocking can turn our babies into trained night wakers.
Let’s look at what is considered normal sleeping for our babies. Sleep patterns vary a lot in the first few months of life. A normal newborn can sleep from 11 to 23hours per day, with the average newborn sleeping 16.5 hours in a 24 hour period. Sleep patterns become more regular as the child approaches three months of age, and by 6 months most infants are sleeping through the night and taking regular naps. The average baby will sleep through the night at approximately 4 months of age and a weight of 14 pounds, unless they have learned to do otherwise.
Infants often have their days and nights mixed up. Caregivers need to assist their babies in differentiating the difference between day and night. Remember, not too long ago this baby’s life was all in darkness. Parents need to hold babies frequently during the day, make noise in the house, keep the lights on, and live life. In the evening, and especially in the middle of the night, all should be kept quiet, calm, and dark. For nighttime feeds, the encounter should be as brief and non-stimulating as possible, despite the fact that this is the time when your child is cutest and most interactive. If you do this, your baby will start to have their cute, interactive times during the day, when you are actually awake.
As babies head towards 3-4 months of age, when many start to sleep for a long period at night, we need to help them to learn to settle themselves. Babies have a memory of how they fell asleep, so if we allow a baby to settle him- or herself to sleep at the beginning of the night, i.e. put down sleepy but awake, they will know how to settle themselves back to sleep in the middle of the night, without waking you up. If we allow them to fall asleep while feeding, they will expect to be feeding when they wake up in the middle of the night. The same goes for being held or rocked. This is how we create trained night wakers and trained night feeders.
There are several ways that you can teach your babies how to self soothe. Every pediatrician has a slightly different approach, but all involve establishing a consistent routine as you approach bedtime, and making sure that you put your baby in the crib drowsy, but not asleep. There is usually some crying involved the first few nights, but this improves each night. One tip: All caregivers have to be ready to assist the baby in this process. If one person resumes rocking or feeding, it can set you back to the beginning. Once you establish a routine you will once again sleep for a full night.
For more information about children’s health, visit www.brennerchildrens.org.
Please share some of your experiences with getting your baby down to sleep – for the night!