Thursday, February 21, 2013

Quick Tip: Don't Move Bedtime Up too Soon

If you've been reading this blog, you know that babies typically start to concentrate one longer stretch of sleep during the night time hours sometime between 3 and 4 months of age. Of course, parents are more than ready to get a little more sleep by then and it is easy for them to believe that babies should always sleep for 4 to 5 hours once they can "achieve" that first concentrated stretch. Parents who have been putting their babies to bed at 11 pm or midnight in order to sleep until 4 or 5 am, might think they can now move the bedtime up closer to 7 or 8 pm, enjoy some time together, and get two or even three long stretches of sleep each night. might want to wait on that.

When your baby first starts concentrating a long stretch during the night time hours, you might find that you only get one longer stretch. If you put your baby to bed at 8, she might give you that long stretch until midnight or 1 a.m. then, wake up again at 3, 4:30, and 7 am! You're not doing anything wrong, your baby just isn't ready to have several long stretches of sleep yet. To avoid some frustration, you might want to wait to move up your baby's bedtime until she becomes more consistent with combining shorter periods of waking with longer stretches of sleep. For lots of babies, that happens when they are around 6 months old. It will will. In the meantime, remember to get some help at home. More sleep is just a few weeks away.

Heraghty JL et al. The physiology of sleep in infants. Arch Dis Child. 2008; 93: 982-985.

Thursday, February 14, 2013

Happy Valentines Day!

We hope you all get to enjoy some quality time with all of your (big and little) valentines!

Friday, February 8, 2013

Reader Questions: Sleep Review

Over the last few weeks, many readers have sent in questions about infant sleep, several focusing on how older babies sleep.  So, today we will review some information about normal sleep at different ages. Then we will share some tips for tired parents and links to past posts about infant sleep.

Sleep Duration
All babies are different, but there are some general patterns of infant sleep duration at each age. The following is an excerpt from a past post we wrote about infant sleep. (Click here for the full post)
  • Newborns (birth to 6 weeks) wake frequently and erratically. Parents of newborns must be realistic, prepared, and ready to ask for help!
  • By 2 months, most babies are sleeping longer stretches, but waking 2-3 times during the night.
  • By 4 months, many babies start to sleep more like their parents, falling asleep into a deeper sleep and sleeping for 4-5 hours at once. Unfortunately, teething and changing routines can increase waking intermittently around this time.
  • By 6 months, some babies sleep for 6 hours while others are still waking more frequently, though not every night. There are so many changes typically occurring at 6 months, new skills, new activities, new travels, new teeth...older babies sleep well for a few nights, then wake again. It is no wonder that "sleep training" is so popular among parents of babies around this age. 
  • About 80% of babies sleep through most nights by 1 year of age.

Remember that sleeping through the night by research definition is about 6 hours of continuous sleep!

Why Babies Wake Up During the Night
Young babies wake up for 3 important reasons:
  • To eat frequently
  • They dream a lot (which helps their brains grow and develop) and wake easier when dreaming
  • Waking often helps them stay comfortable and safe

These reasons are described in more detail in one of our very first posts! Click here to read more about why it is important for young babies to wake up.

Older babies who are healthy and growing well may still waking at night. If your older baby wakes frequently at night, check the following:
  • Lights from TVs or video games flickering on the wall (steady nightlights are usually ok)
  • Caffeine in the breastfeeding mother's diet
  • Changes in daily routine or no consistent routine
  • Baby is overstimulated or overtired
  • Too much sleep during the day
  • The need to practice new motor skills
  • Noise, but only if it is sudden and quite loud (babies quickly get used to familiar noises)

For more information about the developmental reasons older babies wake, read our previous posts  Baby Behavior Mysteries: A 9 month old resists his crib and  provides Tips for dealing with a waking 9 month old.

Tips to Deal with an Older Waking Baby
The following is another excerpt from a past post (Click here for the full post) that offered alternatives to try in place of sleep training. Using these tips can help everyone get a little more sleep.
  • Establish routines!  Repeated activities and experiences are calming to babies and help them establish body rhythms that are closer to those of their parents. Bedtime routines allow babies time to shift naturally from a drowsy state into sleep. Babies will differ in how much time they need to become ready for sleep; many take at least 20 minutes. Believe it or not, you'll miss the bedtime routines when your children outgrow them.
  • Reduce or eliminate caffeine for breastfeeding mothers (don't worry, you'll get to have that morning mocha again). Babies' bodies take a lot longer to get rid of caffeine than we do. Remember there is caffeine in tea, sodas, energy drinks, and other products. Read labels.
  • Make sure that baby isn't overstimulated close to bed time (this is easy to do if parents typically get home late from work). Watch for indications that your baby is drowsy and start your bedtime routine right away. If you wait too long, you might end with a screaming, overtired baby who will be less likely to sleep than a baby put to bed earlier.
  • Make sure that baby spends plenty of time awake during the day. Give babies plenty of chance to be active, moving, and practicing their new skills during the day.
  • Include a special bedtime toy in your bedtime ritual, something that is safe to leave with baby as he drifts into sleep.
  • Don't end your routine with baby being completely asleep. When babies are put down when they are very drowsy but before they are asleep, they may be better at putting themselves back to sleep if they wake in the night. This doesn't work with babies who hate feeling drowsy and resist sleeping at all costs! I had one of those! The trick is that the baby must be very drowsy or very accustomed to this as an end to the night time routine.
  • Recognize that most babies make noise when drifting to sleep or they are dreaming, don't assume that intermittent noises mean your baby needs you immediately. Give your older baby a few moments to fall asleep or get back to sleep on his own.
Additional posts about infant sleep:

We hope this review of infant sleep was helpful in answering some of your sleep questions. If not, let us know and we will do our best to provide the most up-to-date, evidence-based information!