Readers' Questions: Drowsy Babies

Over the last few weeks, we’ve received several comments in response to our post “Why do some babies hatebeing drowsy?” from parents who have noticed that their babies seem to resist falling asleep or wake easily right after drifting off. Today, we’d like to address 2 of these comments.

Reader #1: My problem with my 2 month old is she not only fights off sleep, she will wake herself up by forcing her head up and going from side to side or making her body jump, even if she has completely fallen asleep.

This baby seems very active! When she is moving that much while sleeping she is most likely in active sleep. At 2 months old, she is still goes into active sleep first, which means that immediately after drifting off she starts dreaming. When babies are dreaming, they may move around a lot. It is normal for them to twitch and move their bodies and they may even make sounds or sucking noises. Although this may seem strange, dreaming is an important part of brain growth and development.

Because their brains are so active while dreaming, they can also wake easily while in active sleep. All babies (and adults) cycle through active sleep, quiet sleep, and waking throughout the night. Therefore, she may wake again when another round of active sleep comes around. If the baby is uncomfortable for any reason  she might wake up during this light sleep.

So, what can you do?  First, if she falls asleep in your arms, wait until you see signs of deep sleep before putting her down. When in deep sleep, she will be less sensitive to the position change and may stay asleep longer. Second, keep her as comfortable as possible! Make sure she is dressed appropriately (temperature and comfort level), has a clean diaper, and that anything else that might make her uncomfortable is taken care of. Remember, 2-month olds only sleep for about 2-4 hours at a time, so it is normal for them to wake during the night.

With such an active baby it’s also important to keep her sleep environment safe. With so much movement she could move herself right off of a bed or couch. Follow the AAP safe sleep recommendations here.

Reader #2: Please give me some help. My 14 week old son fight his sleep. What can we do, I am too tired. Somebody help. Thanks.

Waking up with young babies is hard. Adults are used to sleeping for long stretches and it can be frustrating that babies don’t sleep that way.  Having a baby who gets irritable when drowsy can make waking even more difficult because it may be harder to get the baby back to sleep during the night.

Like we explained in the original post, some babies have a hard time winding down after they’ve spent time interacting with the people around them. At 14 weeks, the reader’s baby is learning so much and it may take longer for his brain to transition from playing and learning to resting. The tips we listed in the original post can help. When this baby is getting tired, the parents can help him transition to sleep easier by minimizing stimulation (turning off the TV, keeping the noise to a minimum, etc), making sure he is comfortable (clean diaper, dressed comfortably, etc), and following a bedtime routine. Doing 3 or 4 things the same order every time the baby is going to sleep can help his brain calm down enough to sleep.

We also suggest that this reader ask for help from friends or family. Caring for a young baby is not easy and her comment shows how tired she is. Whenever you are feeling overwhelmed, ask for help! Asking someone to come over just few an hour or two so you can rest can make a big difference.

Here are a few more posts readers with similar questions might find useful:

The Science of Infant Sleep Part II: Big Changes in Sleep Patterns (6 to 16 weeks)

The Science of Infant Sleep Part IV: Falling Asleep versus Staying Asleep

Tips for Nap Time

Tips from the Trenches: Surviving Sleep Deprivation

Back to Basics Part 2: The Many Moods of Babies

Today is part 2 in a series that takes us back to the basics of Baby Behavior. As we revisit the first series of posts that we wrote in July 2009, we’ve added links to related posts that we've shared since those early days. Part 1 in this series explained the Reasons Why Babies Don't Sleep through the Night. Today's post will explore the Many Moods of Babies.

In the original post The Many Moods of Babies, we introduced the topic of infant states (or moods) and talked about the 4 different states that babies move in and out of when they are awake: Drowsy, Quiet Alert, Irritable and Crying. We explained how to tell when your baby is in each of these states and shared what you can do to keep your baby comfortable and happy no matter what state she’s in.

Since we’ve written the above post, we’ve added more details about the quiet alert state and how babies in this state love to learn and interact with you. Keep in mind, all of this learning is hard work for babies! We’ll talk more about the importance of giving babies breaks in the next post which will focus on cues.

Because some of us had personal experience with babies that hated to be in the drowsy state, we wrote a post that explained why some babies hate being drowsy and provided tips for keeping those babies as happy as possible.

As those first months went by, we talked about other things that can influence how your baby tolerates being in certain states in a series about infant temperament. We explored the different elements of an infant's temperament, such as adaptability (how quickly babies’ adjust to new experiences) and intensity (the strength of babies’ emotions when dealing with the world around them), all of which help form an infant’s unique personality. Then we gave suggestions on how to handle all types of babies’ temperaments and talked about the importance of understanding the differences between your own personality and your baby’s in a post titled: Babies with Personality! How Temperament Influences Babies' Relationships.

We hope we’ve helped you understand your babies’ many moods (and personality) a little better. Remember, babies aren’t really mysterious once you know the Secrets of Baby Behavior. Now that you’ve reviewed the basics about infant states and temperaments, what other questions do you have about understanding your baby?

Next time: We’ll revisit your baby’s unique language: cues

Why Do Some Babies Hate Being Drowsy?

We've had several readers ask us questions about drowsy babies. Specifically, they want to know why their drowsy babies become fussy and irritable while others become quiet, relaxed, and easily drift to sleep. We'd like to use this post to focus on this challenging infant state.

The Drowsy State
Babies move in and out of 6 different "states" or moods: crying, irritable, quiet alert, drowsy, active sleep, and quiet sleep. You can tell what "state" a baby is in by the way she moves, breathes, and the noises she makes. I'm sure you all know that babies become drowsy when they are tired. Tiny babies tire very quickly, especially when they've had to deal with a lot of stimulation. Drowsy babies will stop paying attention to things around them, open and close their eyes, yawn, breathe faster then slower, and rub their faces with their hands. Some babies, especially younger babies, also get cranky, fussy, and increasingly frustrated.

Why Some Drowsy Babies Get so Irritable
Babies are hardwired to learn and socialize with the adults who care for them. They stare at their parents' faces, watch their mouths, try to copy their movements, and often calm down when they hear mommy's or daddy's voice. As babies get older, they become fascinated by every new object they see and try to touch, taste, drop, and explore everything in their reach. Babies work hard as little scientists, experimenting day and night to determine cause and effect. They love to play repetitive games and will giggle with excitement when they "discover" how to make their daddies' tickle their tummies or to elicit their mommies' smiles. Anything that gets in the way of that work may irritate babies. Unfortunately, babies can't maintain that learning state forever. They'll start to get sleepy, even though their brains and bodies will push them to learn more and more. For some very social and determined babies, sleepiness is so annoying, they'll start to cry.

Why Some Babies Fight Sleep
Some babies have a much harder time than others in changing their states, particularly calming themselves and getting to sleep. Fortunately, as babies get older, they get better at these important skills. However, all babies (even babies who regularly fall asleep easily), may struggle with sleep when they have been overstimulated or exposed to a stimulant like caffeine. Babies who are overstimulated (by vigorous play near nap or bed time, big changes in routine, or spending time in a crowd) have a hard time dealing with all the excitement. Their bodies react by releasing chemicals that stimulate their brains. Some babies will process these chemicals quickly, but others will not. Adults may have the same experience after watching a scary movie or attending a large party. In those circumstances, we can't fall asleep either. Some babies (and I had one) want the social time to last forever and fuss and cry and fight sleep with all their might.


5 Quick Tips for Dealing with Babies Who Hate Being Drowsy

1. Prevent over stimulation or any prolonged stimulation, particularly at bed time and nap time.

2. Avoid exposing your baby to stimulants like caffeine.

3. To calm your drowsy baby, maintain social play but slow the pace, gradually narrowing the type and duration of stimulation your baby receives. Limit what your baby sees, hears, and touches. Try slowly narrowing your interaction to include only one sense. Let her look quietly at your face OR hear your voice as she nestles into your shoulder.

4. Start a bedtime routine with a slow steady reduction in stimulation. Many experts suggest 45 minutes may be needed for a baby who struggles with getting to sleep. Don't worry, this won't last forever!

5. Try sustained stimulation, like white noise and steady motion, to help soothe babies who are fighting their need to sleep.

Next time: A Preview of Upcoming New Series!

The Science of Infant Sleep Part III. Relationships that Influence Babies' Sleep

In this series, we've been sharing information about how and why infants' sleep patterns change as they grow. In this post, we'll focus on the how characteristics of babies, parents, and sleep environments interact to influence how infants sleep.

In other posts, we've talked about why a "one size fits all" sleep intervention is not likely to work for all babies. That's because there is no one reason why babies sleep the way they do. Their own bodies and abilities, how and when they are cared for, and where they sleep, all work together to help or hinder babies' sleep. Parents need to keep this bigger picture in mind.

Baby Characteristics

While parents can and do shape many of their babies' behaviors, babies come into the world as unique human beings with combinations of traits all their own. Your baby's sleep patterns will be affected by her age, health, physiology (like her ability to make and respond to hormones), exposure to medications or stimulants (like caffeine), her development, stomach capacity, day time activity level, feeding pattern, intake, temperament, and sensitivity to the environment. Each of these factors can influence her sleep patterns differently.

Family Characteristics

Parents and other caregivers are, of course, as unique as their babies. Some important characteristics that may influence infant sleep include parents' own physical and emotional health, cultural and family experiences, sensitivities to baby behaviors, and infant feeding practices. Most of these factors affect babies' sleep because they have powerful influences on parents' day and night time infant care behaviors.

Sleep Environment Characteristics

Babies' sleep patterns may also be influenced by their physical environment. Sounds, sights (like lights from a TV), movement, comfort, and temperature of the places where babies sleep all make a difference for sensitive babies. These factors affect babies differently depending on whether they are in a lighter (active) or deeper (quiet) state of sleep and babies' bodies influence how long they stay in each type of sleep.

Interactions and Babies' Sleep

All this means that babies' sleep patterns emerge when all of these factors come together, like puzzle pieces. We can't always predict what babies will do. For example, older babies with bigger stomachs may wake when they are sick, teething, or sleeping in a room that is too hot or cold even after they have slept for longer stretches for awhile. City-dwelling younger babies may stay asleep despite loud noises and lights because their bodies have adapted to what goes on around them. Parents' interactions can make a difference too. Parents checking on babies in active sleep might inadvertently wake their babies or babies might sleep longer at night for parents who make sure that their babies have lots of daytime activity. But parent interactions can only go so far if babies bodies are not ready to sleep longer or they are sleeping in an unfamiliar environment (like grandma's house).

Next time, we'll wrap up this series and talk about what all this means for tired parents, how sleep patterns change in older babies, and the research we found about putting babies down partially awake.


Next time: The Science of Infant Sleep Part IV: Older Babies, Falling Asleep versus Staying Asleep

The Science of Infant Sleep Part I: The First 6 Weeks

For nearly all parents, the first six weeks after their babies are born seem to be the longest and toughest in their lives. Struggling to understand their babies' needs, parents are awakened at random intervals day after day and night after endless night. It is no wonder that sleep is the most common topic discussed during early visits to the pediatrician. Parents want know when their babies will sleep through the night. In this first installment of our new series on the science of infant sleep, we'll take a look at the research related to why infants sleep the way they do at different ages and what, if anything, parents can do to help their babies sleep a little more.

Before we start, it is important for parents to know that we are not likely to provide "the answers" to parents' sleep concerns. Instead, we'll bring you up to speed with the latest information from the ever growing body of research related to infant sleep. We're taking a developmental approach as we did with the series on the development of language. We'll start with the prenatal period through the first 6 weeks.

How Do Babies Sleep Before They Are Born?
Since ultrasound technologies have become so advanced, researchers know far more than ever before about babies' prenatal behaviors. Distinct sleep states are likely to appear during the last trimester of pregnancy with "active sleep" (lighter sleep with rapid eye movements) being dominant. As any mother knows, fetal sleep cycles do not necessarily to coincide with their moms' sleep cycles. Many moms nearing delivery will tell you that their babies' movements wake them up at night.

What Controls Newborn Sleep Patterns?
In older children and adults, sleep cycles are controlled by specific areas in our brains based on circadian rhythms sensitive to light/dark cycles and by other mechanisms that increase the need for sleep after longer periods of being awake. These controls make us more likely to sleep during the night but also allow us to sleep during the day if we've gone too long without sleep. Another control system influences how long we remain in different types of sleep. Newborns, who are just as happy to sleep during the day as at night, do not seem to develop effective circadian rhythms until they are around 6 weeks old or later. They also are unable to stay awake for long periods of time. Parents of newborns think that their babies wake and sleep randomly, and for the most part, that's true.

Light Sleep, Dreaming, and Brain Development
Newborns sleep very differently from adults. They fall asleep dreaming and may keep dreaming for 20 or 30 minutes. We fall asleep into a "quiet" state of sleep and dream more later in the night and close to morning. Because dreaming happens in a lighter state of sleep, newborns are much more likely to wake up in response to noises, changes in temperature, and movement. When they are dreaming, newborns can make quite a few little noises and their eyes, facial muscles, arms, and legs will move a lot. Some babies may wake themselves up by their own movements. That's why swaddling, which restricts babies' movements, can help newborns sleep a little better. As babies get older, they don't move around quite as much when they sleep and swaddling is no longer necessary.

The brain activity related to dreaming is important for babies' development. Babies brains develop in part because of brain activity in response to stimulation. While babies are awake, they get stimulation from what they see, hear, feel, and taste. While they are asleep and dreaming, babies' brains are active, allowing for brain development to continue even when babies can't stay awake for very long. As babies get older and are able to stay awake for longer periods of time, they spend less time dreaming. During quiet sleep, babies move very little and they are harder to wake.

How Can Parents Help Their Newborns Sleep Longer?
Newborns spend a great deal of time in a lighter state of sleep, waking relatively easily. This is important for babies development and makes the baby likely to wake to feed, to stay warm, and to move as needed. Newborns are not much influenced by light and dark cycles and need to feed frequently. All this means that newborns are going to wake up...a lot...and there isn't much that parents can do about it. But, there are a few things that can make this exhausting time just a bit easier.

• Swaddling can help newborns sleep a little longer because they are less likely to wake themselves up


• Breastfeeding mothers should avoid caffeine because newborns take much longer to process caffeine than adults do


• Holding newborns who have fallen asleep until after their bodies and eyes stop moving will help babies stay asleep when they are put down. Babies in quiet sleep are much less likely to wake easily


• Parents should pay attention to their newborns' noises to learn when they are still asleep and just making noises versus when they are waking up for feeding or other care

Even using all of these tips, parents of newborns will find that their babies will wake frequently. The very best preparation is to arrange to get some help from family and friends to get you through this tough time. Fortunately, things change quickly and more sleep is just around the corner.

Next Time: Big Changes in Sleep Patterns (6 to 16 weeks)

Tips for Nap Time

Written by Jennifer Goldbronn

Recently, a reader asked “Do you have any tips for nap time? My baby is a very good sleeper at night, but needs a little help falling asleep for naps.”

Babies (and mothers) need naps! As a sleep-deprived mother myself, I would recommend napping with your baby, but, as a busy, working mom, I also realize it’s not always that simple.

Babies sleep 13-14 hours per day, but not all at one time! Older babies (9-12 months) generally need two naps per day, one in the morning and one in the afternoon. During the 2nd year of life, 1 of the 2 naps is usually dropped leaving 1 afternoon nap. However, this transition period may last several months and your baby may still have the need for 2 naps on occasion.

Now as you know, what babies need (a nap) and what babies want (to play all day and never rest) can be 2 very different things, and while you never want to force your baby to sleep, there are a few things you can do to help nudge him in the direction of dreamland.

1. Follow a daily routine. Babies and toddlers like routines so that they can anticipate what is going to happen next. A routine does not have to be detailed or by the clock; simply plan meals, activities, errands, outdoor play, story time, or any other activities you do on a regular basis, to be at about the same time each day so that your baby can start to predict when nap time will be. Also, taking naps at the same time each day will help stabilize his circadian rhythms (sleep/wake cycles), making it easier for his body to wind down naturally when it’s time to sleep.

2. If you don’t have a regular naptime now, watch your baby’s cues for signs that he is tired or needs a break during the day. This will help you determine when a nap or break is needed. This will depend on the time that your baby wakes in the morning, his age (as he gets older he will be able to play and be alert for longer periods of time), and his bedtime as well.

3. Warn older babies that naptime is coming. If naptime is in 30 minutes, give your baby a reminder. For example: “After we read these 2 books and have a snack, then it will be naptime.” I do that with my daughter to this day, (she is now 2 ½) and it really helps her to transition smoothly from one activity to another. Depending on the age of your baby, you can use a timer as well. Set the timer for 10 minutes and say: “We’ve got 10 more minutes to play until the timer goes off; then it will be time for your nap.”

4. Respect your baby’s developmental stages. With each new motor drive, your baby may wake more often to practice his new skill. So keep in mind that your baby may have a hard time settling down as he works hard to master crawling, standing, walking, and so forth.

5. Be consistent with naptime. Your baby likely needs a nap, although he may not WANT a nap. If your baby won’t fall asleep, you can still give him some quiet time in his crib to rest during his regular “naptime.”

6. Set a relaxing sleep atmosphere. Make sure your baby’s sleep area is relatively dark and quiet. For awhile, you can even sit near him and rub his back, or play quiet music. Younger babies may need to be rocked to sleep. If you have a newborn, remember to wait until he is in quiet sleep before you try to put him down. As your baby grows, he will learn to fall asleep on his own, and will not need as much assistance from you.

Remember to always put your baby to sleep on his back!

Next time: Another Reader Question about Sleep

Quiz Answers

Earlier this week, we posted a quiz to see how much you know about babies. Here are the answers:

1. The answer is True - Babies are born with 2 types of cries, a basic cry and a pain cry. A basic cry is a generic cry newborns use when they aren't getting what they need, but a pain cry is different. When babies are in pain, they start by holding their breath before letting out an intense scream. As babies get older, their vocal cords mature and they develop different kinds of cries. For more information about crying, read Baby Behavior Basics Part 4: Crying: Your Baby's Super Power.

2. The answer is False - Babies all over the world develop behaviors and achieve milestones at the same pace! For example, babies in the United States, China, and France all develop social smiling around 6 weeks of age. For more information read Newborn Development: Reflexes Rule and Two to Four Weeks: A Whole New World. Next week we'll continue our series on infant development.

3. The answer is 3000 - The average baby goes through about 3000 diapers in the first year of life. That is a lot of diapers (and even more wipes)!

4. The answer is True - Babies can copy facial movements within the first hour of life. When a newborn is in the quiet alert state, she is ready to interact, so it's a great time to try this out. Hold the baby close to you (remember, newborns can only see about 12 inches away) and pucker your lips. It may take a little while, but she will try to pucker hers too!

5. The answer is 4 days old - Babies can identify their native language from a foreign language by the time they are 4 days old! This is just further proof that babies develop very quickly! More information about language development is available in the From Cues to Conversation: How Babies Learn To Talk.

We hope you enjoyed this little quiz! Do you have questions about baby behavior? We would love to give you the answers, just send us a comment or an email!

Next Time: We'll continue our series on infant development with 6-8 weeks of age.

Baby Behavior Basics Part 2 - The Many Moods of Babies

Babies seem so mysterious; they may be happy one moment then crying hysterically in the next. Having a new baby can be overwhelming, especially when parents struggle to guess what their babies will do next. Fortunately, once you know a few key secrets, babies’ behaviors are no longer so confusing.

To start, let me tell you a little bit about babies’ moods (also called states). When babies are awake (see “Baby Behavior Basics Part 1 for a discussion on sleep states), they move in and out of 4 different states. Parents can identify babies’ states by paying attention to the sounds babies make and how they move and breathe. While we have all heard that “all babies are different,” most healthy babies tend to behave in similar ways in each state. Below, you'll find a summary of the 4 different states and some simple tips on how to identify them in your baby.

Drowsy
What you will see: Drowsy babies’ eyes will open and close, they won’t show interest in toys or playing. They may breathe faster, then more slowly, and they may struggle to keep their heads off their parents’ shoulders. Unfortunately, some babies become irritable and cry whenever they get drowsy. If you have one of those babies, we promise to give you more information why this happens in later posts.

What you can do: Babies in this state need to rest and take a break from what they were doing. Keep in mind that they might need some help to fall asleep.

Quiet Alert
What you will see: Quiet alert babies are relaxed, calm, and happy. Babies in this state are ready to learn and socialize with everyone around them. Quiet alert babies will melt your heart as they stare contently at your face, follow your voice, and work hard to interact and play with you.

What you can do: Babies in this state are ready to interact and learn but they may struggle to stay focused. Keep in mind that while parents get to relax during this happy time, babies must work hard to try to learn despite all the distractions in their new world. That means your baby will get tired of all the fun, long before you will. Watch for signs that your baby needs a break.

Irritable
What you will see: Irritable babies squirm and fuss. They are not content with toys or playing and may turn and arch away from anyone who is trying to interact with them. They may tense their muscles and breathe irregularly. Hungry babies often become irritable, fussing as they suck on anything they can find. Tired babies get irritable too because playing and learning is so much fun and they don’t want to stop. Sometimes babies will get irritable when they have bowel movements because they aren't used to their own bodily functions. Babies in this state are distracted and frustrated by discomfort or overstimulation.

What you can do: Try to find out why your baby is irritable and make him more comfortable. Check your baby’s diaper. If you see hunger signs, feed your baby. Give your baby a break if he is tired or over-stimulated.

Crying
What you will see: I’m sure I don’t need to explain what crying looks like. Crying babies tense their muscles, turn bright red, and make noises that are stressful to anyone around them. Babies cry to indicate distress and to tell their parents they need something (now!). While we’ll talk a lot more about crying in later posts, it is important for you to understand that babies have to make horrible noises to make adults pay attention to them! If babies started cooing when they were hungry or distressed, who would come and take care of them? As hard as it is to hear, crying is a special skill designed to make sure you come running whenever you are needed.

What you can do: Babies in this state are sending a strong signal that they need your help to feel safe and more comfortable. Try using the same soothing movement or sound to calm your crying baby. Depending on how upset he or she is, this may take awhile. Trying different things to soothe your crying baby can backfire. Instead of rocking him and then bouncing him and then singing a song, pick ONE of these soothing techniques and stick with it until your baby calms down. It will save you a lot of time and stress!

While this all may seem a little confusing, we’ll be sharing specifics about each of these states over the coming weeks. Until next time, watch your baby to see how he or she moves in and out of these states. Does your baby mind being drowsy? How long can your baby stay quiet and alert before he or she gets tired? Is your baby starting to develop patterns of behavior like fussing in the afternoons or crying in certain situations? We’d love to hear your stories and answer your questions.

Next Time: Learning and Creating Your Baby’s Special Language

Thanks to Jennifer Goldbronn for all her work on this post!