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ESTABLISHING HEALTHY SLEEP HABITS FOR BABY

December 07, 2017

ESTABLISHING HEALTHY SLEEP HABITS FOR BABY

Good sleep is important for babies because it is an essential component of healthy growth and development.  

Babies and toddlers need it, which is why they sleep so often. We tend to focus all of our attention on nutrition and other necessities, but we forget how important good sleep is for everyone in the house to function at their fullest capacity. By helping our children sleep, we're supporting them in their healthy development and giving ourselves the gift of clarity and good health, too.

This is not meant to be a catch-all, sleep training solution. Every baby and every parent is different. 

However, if we are changing a baby’s sleep habits there is always going to be some protest.  Crying is their way of expressing themselves. I do not encourage full on cry-it-out “extinction method” and parents must always do what they feel comfortable with when it comes to crying, I do encourage families to not be thrown — this is baby's way of saying "I am tired, and I just want to go to sleep." Parents who are consistent in their method of getting baby to sleep independently only have to deal with a few nights of protesting before the baby learns to soothe himself to sleep.

Basics

Newborns sleep about 16 to 20 hours and are awake about 1 to 2 hours between periods of sleep. Infants sleep about 13 to 15 hours including nighttime sleep, morning naps, and afternoon naps.

Toddlers sleep about 12 hours including an afternoon nap.

Soothing Techniques

Young babies are not always able to self-soothe. Certain techniques will help baby to soothe/calm and transition from a mother’s womb to the world during the “fourth trimester” after birth. During this transitional period, some babies miss being snug inside mom’s womb along with its motions and sounds. Effective soothing techniques include swaddling, rocking, and pacifier, as well as tools like the Tranquilo Mat.

Worth noting: These soothing techniques and tools have the potential to cause sleep associations (i.e., baby can’t sleep without them/they become a “sleep crutch” or “prop”). But by gently removing the dependency slowly over time, you can avoid this from happening.

Pacifiers

Pacifiers are recommended by the American Academy of Pediatrics (AAP) and can help some babies to calm and relax. Not all babies will take to it.  

Worth noting: Sometimes if baby becomes dependent on a pacifier sleep if or when it falls out it make wake or startle baby. This is why it’s important to practice gently tugging on the pacifier when you’re with baby as they learn to use it. This will strengthen the muscles and “holding” reflex in order to help keep pacifier stable throughout sleep or nap time.

Sleep Regression

Between 3-4 months of age, some babies regress in sleeping through the night. They go from sleeping anywhere between 6-7 hours straight each night to waking every 2-3 hours at night.

A regression can happen when a baby who no longer needs nighttime feedings wakes one night and mom decides that he must be hungry so she feeds him. It happens again the next night and mom attributes it to a growth spurt. She might think: “Baby must be hungry so feeding seems like the right thing to do.” On the contrary, a baby who sleeps through the night for a period of time should not be fed (assuming baby is not sick). It’s normal for babies and adults to wake several times during the night. This does not mean baby is hungry and needs to be fed. When we feed, we are not allowing the baby to fall back asleep on his own. The next time baby wakes he will expect to be fed again. Within a few nights, a baby who had a good sleep routine will start to regress.

Instead, aim to teach baby to fall asleep on his own. You can do this by taking away those sleep associations we talked about earlier. Also, wait to put baby down when he is drowsy but still awake (vs. completely asleep).

Sleep can change so much with every milestone throughout the first year (for example, the development of separation anxiety); yet, these habits are ultimately what help us regain our much-needed rest at night.

Room sharing

The AAP recommends parents keep babies in the same room with them to sleep for the first year to reduce the risk of sudden infant death syndrome (SIDS). But room sharing between babies and mothers beyond the first four months may be associated with less sleep for babies and unsafe sleeping practices that the AAP hopes to prevent.

While room sharing can be justified for the first six months based on the fact that 90 percent of SIDS cases happen in this timeframe, research suggests that evidence was lacking for the 6 to 12-month recommendation made by the AAP.

At 4 months, children who already slept independently in their own room averaged 45 minutes longer stretches of continuous sleep than those who shared a room with a parent. At nine months, the gap widened: Those who learned to sleep independently by 4 months had sleep stretches that averaged 1 hour and 40 minutes longer than babies who were still sleeping in their parent’s room, 542 minutes vs. 442 minutes respectively. Total sleep throughout the night was also greater for the babies who were in their own room.

Room sharing also affected sleep safety. Babies who shared a room at 4 months were more likely to have a blanket, pillow or other unapproved objects that could increase chances of SIDS in their crib than those who slept in their own room. Additionally, babies who shared a room were more likely to be moved into their parent’s bed overnight at both 4 and 9 months old.

At Boston Baby Nurse we recommend parents discuss this study and safe sleep guidance with their pediatrician before making final decisions about room sharing.

Schedules

Scheduling one's baby usually means getting her into an eating/waking/sleeping routine. The idea is to help stabilize her hunger patterns, which helps to organize her sleep cycles (and get her to sleep at night as the rest of us do). During the first eight weeks, the baby is usually fed every two and a half to three hours, around the clock.

During the next eight weeks, parents will keep up the routine but gradually reduce the number of nighttime feedings (by letting the baby cry it out at certain times).

A baby's ability to last longer between feedings obviously helps in the process of learning to sleep through the night. So scheduled parents tend to work hard at making sure the baby has a full feeding at appointed mealtimes -- and they discourage her from "snacking" on breast or bottle whenever she likes.

Night-time feedings – When babies are twice their birth weight (4-6 months) at about 6 months), they may no longer need a nighttime feeding. Your baby will still wake up for the feeding. Ask your baby’s doctor when you can start to shorten the nighttime feeding a little at a time until it is no longer needed.

Sleep Association - Dos & Don'ts

Don't bring your baby into your bed in hopes of solving a sleep problem. Studies show that both adults and children sleep better alone-your movements and arousals are likely to disturb your baby's sleep, and vice versa. More important, teaching your baby to sleep alone is an important part of her learning to separate from you without anxiety.

Do help ease the transition. A fear of being separated from one's parents often begins to surface around 6 months of age and can trigger new sleep problems. So that your little one doesn't feel abandoned when you put him down for the night, spend 10 or 15 minutes with him in the nursery before bedtime so that he comes to identify your presence with the room. This transition time will also give baby a chance to become comfortable with his surroundings.

Noteworthy: When you do place baby down, don't leave immediately. Instead, spend a few minutes softly talking to baby and perhaps gently stroking her, then quietly leave the room before she falls to sleep.

Sample routine

The routine begins with a consistent 7 a.m. wake-up for baby’s first feeding

0-3 months schedules reflect a timetable of eating about every three hours

For example, at 2 to 4 weeks old, baby gets fed at 7 a.m., 10 a.m., 2 p.m., 5 p.m., 6:15 p.m. (what is known as a cluster feeding), and 10:30 p.m.

Baby's naptimes are 8:30/9 a.m. to 10 a.m., 12 p.m. to 2 p.m., and 4 p.m. to 5 p.m.

As time progresses, the feeding and naptimes are slightly different, based on the baby's age and development at each given week.

Sometimes a baby wakes and cries before his scheduled feeding.

Parents often reason that the baby had not gotten enough food during the previous feeding, and would feed him baby little earlier than the schedule suggested. Not a good idea.

This may be difficult at first. Make sure that each feed is as effective as possible. Wake baby up if needed. It’s OK to stop if baby is not interested despite several attempts.   

Do not feed baby earlier than what is scheduled because you think he did not get enough during his previous feed. This practice is so worth it (as long as baby is healthy and approximately 3 months +). Babies will indeed begin to last longer between feedings.  

Other Tips

  1. Make sure your baby is not hungry when you put him to bed. Feed your baby right before bedtime so he or she is not hungry when put to bed.
  2. Place baby in bed when he is sleepy but not yet asleep. Make sure your child is still awake when he is put down for naps and at bedtime. Placing your baby in bed while he is still awake lets him learn to fall asleep on his own.
  3. Remember to always place baby on his back when putting him to bed, up to one year of age. If baby rolls over in the night do not go into the room to flip him over onto his back.  Risk of SIDS drastically reduced by the time a baby is old enough to roll over.
  4. Of course, always check with your baby’s pediatrician.
  5. Have a nighttime routine and a regular sleep schedule. Set a bedtime for your child. Be sure to stick with the time you select by putting your baby to bed at the same time every night. The routine includes feeding, bath, bedtime story, etc.
  6. Do not let your baby nap for too long or too late in the day. Try to limit naps to no more than 3 hours. If baby is 6 months + make sure he is awake from the afternoon nap by 4 pm. Babies who sleep later than 4 pm may not be ready to go back to sleep when it is their bedtime. Some babies may need a 20-30 min cat nap before they are able to manage this. Try to keep baby awake for three hours before bedtime.
  7. Do not put your child in bed with a bottle or cup. Sleeping with milk or juice in the mouth can lead to cavities and tooth decay.
  8. Sometimes offering a pacifier at nap time and bedtime will help your baby to become sleepy and drowsy.

Check out Carole's Facebook live broadcast wherein she talks about these and other healthy sleep habits for baby:

 

ABOUT THE AUTHOR:

Carole is president and founder of Boston Baby Nurse and Nanny™ providing overnight and daytime newborn care and a wide range of postpartum support services. Her latest book, Newborn 101, includes more valuable information about caring for newborns including multiples and preterm babies.

For over a decade Arsenault has guided parents through pregnancy, labor, birth and the newborn period at Boston’s top birthing hospitals (including Brigham and Women’s Hospital, Beth Israel Deaconess Medical Center, St Elizabeth’s Medical Center, Newton-Wellesley Hospital, Massachusetts General Hospital and Mount Auburn Hospital).

As a parent educator, labor and delivery nurse, and lactation consultant she has shared her expertise on sleep, schedules, soothing, calming and infant development with hundreds of parents as they transition into their new roles. Carole continues to support and educate families through Boston Baby Nurse and Nanny and through professional speaking on
topics such as “newborn care”, “creating a safe “green” home for baby, “transitioning to parenthood”, “establishing healthy sleep habits” and more.

Carole and her team at BBN&N also provide experienced nannies to families who are looking for childcare. Qualified nannies are handpicked by the BBN team of experts.

Arsenault provides weekly pregnancy and baby advice on her blog, contributes monthly maternal and newborn health advice to BOSTONMamas.com is a contributor for The Bump.com and has been featured as an expert on Fox News Boston. To see Carole’s latest media appearances, press, and contributing articles click here.

 

 




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