Sleep problems are common in babies, but understanding and
knowing how to deal with them enables parents to get a better night’s sleep for
themselves, which in turn enables them to provide loving, patient and
consistent care for their baby.
There are all sorts of reasons why babies experience sleep
difficulties, but knowing something about the different stages of sleep, what
to do if your baby wakes up in the night, how to establish a regular bedtime,
and what to expect from your baby can be helpful.
Newborn sleep begins with REM sleep (dream sleep or active sleep),
followed by non-rapid eye movement (NREM) sleep (deep sleep or quiet sleep). By 3 months-old, babies enter NREM first,
and then REM. The changed pattern reflects maturation
of the central nervous system and its timing mechanisms, and increased
production of melatonin, the ‘sleep’ hormone.
By 6 months-old, your baby may experience 5 cycles of
sleep during the night. Each cycle consists of light (NREM), deep and active
sleep (REM) and lasts about one hour.
During light sleep, your baby’s muscles relax, her eyelids
flutter and she may twitch, grimace and suck intermittently. If you put your
baby in her cot at this stage, she may wake up. Try waiting until her fists unfold
and her breathing becomes shallow and regular. It is less likely that your baby
will wake up once she has entered deep sleep.
After deep sleep, your baby will enter the frenzied period
of active sleep. She may grimace and fuss, jerk involuntarily and breathe
irregularly and wake up. If your baby is comfortable and the room is dark and
quiet, she may drift back into the next cycle of sleep.
However, if your baby should need a feed or nappy change
(most babies will tolerate a wet nappy), keep this as low-key as possible and
put her in her cot as soon as her needs have been met.
If your baby is not hungry or uncomfortable, do not pick
her up, speak to her, make eye contact, put on music or lights or interact with
her in any way or she will expect the same treatment every time she wakes up.
Simply place your hand on your baby to comfort her until she settles back to
sleep again. If your baby is rewarded with too much attention, waking and play
at odd hours may be prolonged into late childhood. Your baby may also cry more
due to tiredness.
The one thing that the sleep experts all agree on is the
need for a consistent, regular bedtime routine. It doesn’t matter what the
routine consists of providing the same things happen every night.
Although it may be difficult to ensure that bedtime
events happen in a regular sequence in the first 6 weeks, as your baby grows
older, she will associate certain
situations with bedtime. By 6 months-old, the bedtime routine should be well established. An occasional break is
unlikely to cause too much disruption to the routine, but regular changes may
unsettle your baby.
Here are a
few tips that may help:
- Allow a quiet wind-down
period of about 20 minutes before bedtime.
- Turn off the television
and dim the lights.
- Make the bedtime routine
as calm and as relaxed as possible to reduce stress levels.
- Help your baby relax and
unwind in a warm bath. When she gets out, the surrounding cooler air will
lower her temperature, which will help trigger the sleep mechanism.
- Put baby in special
clothes that are only used at night.
- Snuggle up quietly with your
baby and massage her feet (stimulates melatonin production) or read a
story, but avoid over-stimulating her or she will still be fizzing at
- Use key words such as
‘Bedtime’ or ‘Night-night’ which are associated with sleep.
A reduction in parent-infant interactions before bedtime can
dramatically improve your baby’s sleep. If your baby is over-tired or over-stimulated, she may
find it difficult to settle.
Look out for signs of tiredness. For example, an
intermittent ‘Owh’ sound means that baby is sleepy. Other signs include
fussing, gaze aversion, unfocused glazed eyes and yawning.
Research shows that going outside in the fresh air and sunshine for 15 minutes a day can
improve sleep patterns. Exposure to sunlight also regulates
the secretion of melatonin. Being held
close or carried for 3 or more hours during the day can also help your baby
settle more readily at night.
- Let your baby have a
daytime nap when she needs it or she may become over-tired and difficult
to settle at bedtime.
- Avoid putting your baby
down on a very full tummy, as this will increase core body temperature and
keep her awake.
- Wind your baby fully
- If breastfeeding, avoid
alcohol, artificial sweeteners and excess caffeine, which can have a
negative effect on your baby’s ability to sleep.
- Ensure that the
room temperature is not too hot. The optimal room temperature for sleep is
between 16 and 18 °C.
- Avoid warming baby’s bed
with cot bumpers or too many soft toys. They can raise core body
temperature and keep your baby awake.
- Make sure that the room
is dark and quiet to help your baby learn the difference between night and
- Provide a dummy or
comforter to help your baby to fall asleep (if breastfeeding, ensure that
milk supply is established first).
- Put your baby on her
back on a firm surface to keep her spine as flat as possible and to allow
her lungs to expand fully.
Everyone has a period of latency before going to sleep, so
don’t expect your baby to fall asleep the moment she is in her cot. Some babies take twice as long as adults to
Your baby will also sleep
better if the room is completely dark. Keeping the house bright during the day, dimming
the lights in the evening, and putting your baby to bed in complete darkness at
night will help regulate
wakefulness and sleep over a 24-hour period. Although a night light with a dimmer can aid night time feeds and nappy changes, it can increase wakefulness.
Although some newborns sleep
longer than others at night, most wake up every 2 to 3 hours at the end of a sleep cycle at night for a feed, regardless of whether they are breast or bottle fed. As
your baby’s stomach increases its capacity to take in greater quantities of
milk at each feed, she may sleep longer periods between feeds.
Research suggests waking up every
2 to 3 hours to be a survival mechanism. If
the sleep state was so deep, that hunger needs, extremes of temperature, and
breathing difficulties could not be communicated to the parent, the baby’s
well-being could be threatened. This is why parents
should not expect too much from a young baby in the early days or feel
pressured to get their new baby to sleep too long, too deeply, too soon.
3 – 6 months
Three to 6 month-old babies may sleep 5 or more hours once a sleep
pattern has been established. However, if your baby is teething, unwell, going through a growth spurt
or has been recently immunized, she may experience a temporary disturbance in
her sleep pattern.
By 6 months-old, your baby will become more active during the day and
may sleep 5 to 6 hours
or longer without a feed at night. Sometimes, older babies who have learned to
sleep through the night will begin waking up again for no obvious reason. If
waking up continues for more than a few days, putting your baby to bed half an
hour earlier than normal may solve the problem.
If sleep problems persist, then you may need help to keep
going. Health visitors are a good source of advice and support.
By Dr Lin Day www.babysensory.com
For more information on sleep behaviours and patterns in young babies,
for details of parent workshops.