A blog by Dr Lin Day



Baby Sleep

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.

 

Stages of sleep

 

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.

 

Sleep routine

 

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 bedtime.
  • 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.

 

Signs of tiredness

 

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.

 

Tips for promoting sleep

 

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 before bedtime.
  • 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 day.
  • 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 fall asleep.

 

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.

 

Newborn

 

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.

 

6 months

 

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, visit http://www.babysensory.com/en/parentclasses for details of parent workshops.

 

Loading