Tuesday, September 1, 2009

Nighttime Waking and the Older Infant

After the long nights of the first 6 to 8 weeks, many new parents start to believe that they will never sleep more than 4 hours again. Fortunately, babies do slowly and steadily lengthen the time they sleep at night. By 6 months, many infants are sleeping 6 hours at a stretch. While 6 hours would never have been considered a full nights’ sleep before the baby was born, the long stretch seems heavenly to the long suffering parents of newborns. As the weeks go by, parents settle in to their new, somewhat more rested, lives.

And then something strange happens.

Just as you thought you might be able to make it through the day without aching for a nap, your little darling starts waking again around 8 or 9 months of age. Sometimes the baby wakes screaming in distress, uninterested in feeding, only calmed by the warmth of your arms. Sometimes you find your baby sitting up or standing in her crib calling out for you and you find her wide awake and ready to play. You may turn to friends, family, books, or magazines for reasons and solutions. In this post, we’ll go over some of the most common reasons why older infants wake during the night.

1. Changes in routine
For children, routines are essential to help them organize their lives and feel safe. Bedtime routines can help infants move easily through alert states to sleep. Starting day care, taking vacations, and visiting grandma’s house may result in big differences in the bedtime routine. For many babies, these changes result in waking. While some changes in routine are to be expected, try to keep the patterns as similar as you can. For example, while at grandma’s house, read the same book, sing the same song, and play whatever night time games you played at home. But be prepared that your baby may wake, at least until you are back home or the new routine is established.

2. Illness and discomfort such as with teething or sinus congestion
Just like adults, children will wake when they are sick and uncomfortable. Sudden waking may be followed by a fever or other signs of illness. Teething is also likely to disturb your baby’s sleep. Check with your doctor to figure out the cause of your baby’s discomfort and ask about safe ways to make your child feel more comfortable. Fortunately, teething doesn’t last forever.

3. Learning new physical skills
As children get older, they are driven to move and practice new found skills like sitting up, standing, and walking, over and over again. Unfortunately, these drives can be so powerful that they’ll want to practice during the night as well as the day. Pulling up to a stand during the day often is met by smiling and clapping from adults. Babies think they should get the same congratulations at 4 a.m. While you can’t stop all physically driven waking, encouraging your child to safely practice his new found skills during the day can help.

4. Separation anxiety
Around the same time that children are able to crawl and walk away from you, they develop a powerful need not to go very far. Being away from you becomes a source of anxiety for babies between 7 to 8 months of age. “Separation anxiety” remains strong for most children until they are about 18 months of age, becoming less intense as they become preschoolers. For some children, this anxiety is a problem both day and night. Routines and quick reassurance can go a long way in helping babies back to sleep.

5. Growth spurts
Older infants sometimes have growth spurts, especially when they are recovering from illness. Babies often eat less when they are sick and they need to “catch up” for all those lost calories. During periods of rapid growth and recovery, older infants may need to be fed more frequently for a few days. If they don’t get enough to eat during the day, they may wake to feed at night. By watching for hunger cues, parents can help babies get more of the calories they need during the day. If your older baby suddenly starts waking up for feedings at night and the new pattern lasts for more than a few days, check in with your doctor or lactation consultant to make sure that feedings are going well.

Next time: We’ll talk about why babies love to do the same things over and over and over….

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