Thursday, January 17, 2008

Helping baby sleep through the night

I talk to every single one of my families about sleep. Sleep is so important, and I have known only one family that wished their baby would sleep less. One of the first things I share is a study I heard about years ago. They took a number of healthy, happy, normal college age folk, who slept regularly. For one month they woke them up only once, to fully awake, and then let them go back to sleep. Those previously healthy, happy, normal kids were all clinically depressed at the end of the month.

Not good news, is it? So why do I tell that story? It's to stress the importance of sleep, and to hopefully help parents to see why teaching their infant to sleep well from the beginning can be a lifelong gift!

A lot of parents think their infants can sleep through the night. Most can't. They biologically are not able to. A few are, and no, we don't know why the few that can, do. Under 8 months, most infants require night time nutrition. They need to eat. After 8 months, unless there is an exacerbating factor medically or with their digestion, they do not need to eat in the night. They should be able to go a good 12 hours sleeping without a meal.

If your baby is under 8 months old and not sleeping through the night, you can help them, but expecting them to be able to do it just isn't reasonable.

The infant's sleep cycle is one of the reasons your baby wakes up. The other is that they may not know how to fall asleep on their own on a regular basis. When our babies are infants, it's the sweetest thing to nurse them to sleep, let them sleep on our chest, or in our arms. We love to rock them, swing them, sing to them. There comes a time, say, at 15 pounds and 3 months or so of age, though, that we start thinking we'd like them to fall asleep on their own. In their beds. And sleep. For a long, long time.

Why is baby's sleep cycle and their ability to fall asleep on their own connected? Every 45 minutes, a baby's sleep cycle goes through one nice big arc on the graph, picture a mountain with a soft peak and two valleys on either side, starting and ending at zero. At the top of the peak, baby is sleeping tight, and can barely be woken. At the valleys, baby is in a very alert state which is built in, for survival. If something is different than how baby fell asleep, then they'll wake up more, maybe all the way up, then if nothing is different, where they'll see nothing is new, and will be more likely to sleep through to another sleep cycle.

For ultimate happiness in babies, naps should last at least 1.5 hours, and sleeps at night should be in 4 hour or more chunks of time.

To get these chunks of sleep, the first thing is to help baby fall asleep on their own. This is most easily done if you start at 4-6 weeks of age. Simply lay baby down sleepy, but not asleep. This means not breastfeeding or letting baby fall asleep on the bottle. I know you might be reeling from me saying "simply", but it is. If baby falls asleep eating, then burping should wake them enough to be slightly awake when they get layed down.

If baby is in bed and starts to wind up instead of down, then calming baby with as little energy as possible (a hand on the chest, some shhh sounds) until baby is calm again will help baby learn they can do it! Only pick baby up if she has actually escalated into a cry. The older the child, use less and less eye contact so you're not "feeding" the energy of wakefulness or agitation.

Baby's sleep cycles, once she is getting herself to sleep by herself, should start to lengthen. Be aware though, that we are constantly training our children. What are you training them? If they wake in the night, are you giving them lots and lots of attention? Or are you giving them a chance to calm down on their own, and then going back to simple calming and having them stay in bed unless necessary? You can teach baby this wonderful skill by supporting them in learning this way!

*Note on the Furber method of letting baby cry in increasingly longer intervals: It doesn't work on infants. Even Dr Furber has said this. It occasionally works on older children who are 1) verbal 2) using not sleeping/crying as a manipulation 3) over 2 years old at least. If those conditions are in place, and you want to try the Furber method, be cautious. Power struggles can often occur with this method, as can the increase in manipulations by child in other areas of their lives. Also, keeping your own calm during the process is difficult, yet imperative.

*Note on food and sleep. Yes, to a point, children need a full tummy to sleep. After that 8 months, we expect baby to have a nice dinner, then maybe a snack, and then sleep. Before, baby needs food, yes. But if under 6 months please don't add cereal to the bottle unless recommended for medical (reflux) purposes by your pediatrician. Adding food to bottles and doing solids close to bed time usually causes causes more problems than it cures.

Sweet dreams...