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. Well....you 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 happen...no really...it will. In the meantime, remember to get some help at home. More sleep is just a few weeks away.

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

Tips for Dealing with a Waking 9-Month-Old

Last time, we shared some reasons why a 9-month-old may wake and refuse to go back to his crib. In this post, we promised to share some tips to help the tired parents with older infants. Some of you may be expecting us to produce sure-fire ways to get that baby back into the crib, sleeping through the night - sweetly, quietly with no tears or stress. Well...most of you will know that we can't do that, because we tell you the truth.

Our reader asked:
"My 9-month-old often refuses to let my husband put him back in his crib at night. I have to go in and nurse him every time he's up in order for him to go back to bed and sometimes even then he doesn't want to go back in his crib!"

Since the beginning of our blog, we've had many posts about sleep. You can read through some of them by clicking here. These posts always seem to attract strong opinions and we realize that each family manages the night time hours in their own way. For some of our readers, "sleep training" may seem to be the logical answer to a baby's refusal to go back to sleep. We've already shared our reasons why that would not be our first choice. Other readers would tell any mom waking with an older infant to sleep with the baby. You may have noticed that we haven't talked about co-sleeping, which the American Academy of Pediatrics opposes. Co-sleeping is both a simple act and a complicated issue and we believe that others are better at examining the pros and cons of that practice and that our readers can make their own informed decisions. So, we'll stay focused on understanding, and working with, the baby's behavior (that's what we're here for after all).

It is important to understand that it is not unusual at all for a 9-month-old to wake once at night. Many mothers find the infrequent night nursing is fine for them, others search for ways to phase the night nursing out of their lives. This is a process that takes a little time.

Some ideas:

1. We're going to assume that this baby is growing well, feeding well, and not showing any hunger cues when he wakes at night. Growth spurts can cause babies to feed more frequently for a few days (even at night) so you might want to give it some time and see what happens. Some older babies may be uncomfortable and wake while teething. If you have any concerns about your baby's health, growth, or development, you should talk to your baby's doctor.


2. During the day, give your baby as much opportunity as possible to practice new physical skills, like crawling, pulling up, and climbing over things. The drive to practice these skills can cause older babies to wake. Make sure that the day time naps aren't stretching out so that you can get more done. It is easy to let that happen but you'll be up more at night that way.


3. Keep up a regular bedtime routine. Follow the same pattern of activities each night, ending with your drowsy (or sleeping) little one in the place where you would like him to sleep.


4. Trying leaving something small in the place your baby sleeps (like a burp cloth) that you've been handling or wearing (nothing big like a blanket or pillow - those objects aren't safe for babies). Sometimes anxious babies can be calmed by something that smells like mom (or dad) or other familiar objects.


5. Check the room for blinking lights or other changing sights or sounds that might stimulate your baby in the night. Consider a soft steady night light (turned on during the bedtime routine) and some low level white noise to cover any little sounds that might disturb your baby during periods of lighter sleep.


6. Your baby may want to nurse to go back to sleep because he is anxious or having difficulty calming himself. This would be quite normal for older babies because they don't yet have the skills to understand or control their emotions. While nursing may be both familiar and effective in helping him relax, it is not the only way to calm your baby (if you would rather not nurse). You or your husband can use "repetition to soothe" techniques like stroking, rocking, talking softly or singing to your baby. Your husband can establish a new calming routine that he uses at night when needed. Your baby will not like the change at first (so you might want to start the process when you've had a chance to get some rest or don't have to wake up early the next day) but if you gently persevere, your baby will adapt to the new routine.

Next time: JenB Returns!

8-10 months: Learning to stand; the view from the top is very exciting!

We’ve mentioned many times that “every baby is different,” and it is probably more apparent between 8-10 months than at any other age! One baby may skip crawling altogether and go straight to standing or walking, while another may be perfectly content not to try to stand on her own for a few more weeks. Either way, change is in the air as babies work hard to achieve developmental milestones, and just as parents think they’ve got a nice routine worked out, sleeping and feeding patterns become disrupted once again. Yes, it’s frustrating, but when your baby is focused on achieving each exciting step, fatigue and hunger just aren’t the priority!

Social Development

By 10 months stranger anxiety is in full force. Continue to let baby take her own time getting to know new people or familiar people that she hasn’t seen for awhile. Separations may also become more difficult. As babies get more independent, they actually become more dependent on you as a safe haven. Prepare her when you leave by saying goodbye and reminding her that you will come back. Frustration becomes more intense and frequent at this age. I can remember my daughter rocking on her hands and knees crying out of frustration at not being able to get her hands and knees to move forward in coordination. It was almost comical, except for the times she awoke at 2am to practice in her crib!

Physical Development

As mentioned above, babies may wake to practice each new motor task during the night. As each new task is achieved, sleep will return to normal. Keep in mind that learning to stand brings a whole new perspective to baby’s view of the world and a whole new height for parents to baby proof (forget about hiding untouchables on top of tables or furniture now!) After babies learn to sit without any support, their next goal is crawling, followed by standing and walking. Soon they will pull up on furniture to stand and cruise along the couch. Some may even let go of the couch and take a brave step away.

Babies preoccupied by motor drives also prefer not to waste their precious learning time eating. Breastfeeding mothers may take this as a sign that it’s time to wean, but as babies become more independent, it’s important for them to have a safe place to come to between adventures, and what better place than their mothers’ arms during a feeding. Feedings can become quite the challenge when babies become mobile! Whenever possible, let him finger feed himself (with development of the “pincer grasp” baby can now pick up small objects with his thumb and forefinger.) Don’t be alarmed by messy feedings as babies practice this new skill and explore their food. That’s how they learn!

Cognitive Development

All of this new independence might make some parents start to think about discipline and wonder what is appropriate for a baby this age. I knew my daughter was ready for some limit setting when she crawled toward our dog, tried to touch his food bowl, and then quickly looked back at me with big eyes and just a twinge of a smile. Yes, I had told her to stay away from the dog’s food bowl about a dozen times, and yes, it appeared she remembered that she was doing something I wouldn’t approve of. Really the best discipline at this age is diversion. So, as I said “Yuck! No dog food!” I swooped her up and redirected her attention to a fun toy in the other room. Really, she wasn’t testing her power over me; she was just sweetly asking me to set that boundary for her so that she felt safe. The important thing when setting limits is consistency, and almost like déjà vu, I relived that very episode (baby to dog bowl, baby looks at me for disapproval, I say “Yuck. No dog food!”and steal her away from the scene to divert her attention) many, many times over the coming weeks.

By this age, babies also become goal-directed in their behavior (see dog food example above!). They also enjoy repetitive games like peek-a-boo more than ever because their understanding of object permanence and person permanence (understanding that caregivers still exist after they are out of site) are strengthening. They are better able to remember object locations and even begin to anticipate events and may try to make them reoccur. They also look for their caregivers after they leave the room. Parents can practice peek-a-boo or hiding games to help babies develop trust that their parents always return.

As evidenced by my daughter’s dog food incident, by about 9-10 months, babies are learning how to assess danger by watching their parents’ facial expressions. They begin to search for “emotional cues” from their parents as to whether there is approval or disapproval of their actions. Babies this age also love to learn by imitating and because they have developed more memory, they can watch you play with a particular toy one way on Monday, and repeat that same type of play on Tuesday themselves.

Next time: 12 months: The independent toddler starts to walk around; the drive to master walking will keep her busy day and night!

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….

Not Rocket Science

Understanding babies isn't rocket science. If it was, human beings never would have survived as a species. As a new parent, you may be thinking, if it isn't hard to figure out what my baby needs, why do I feel so lost? Maybe your baby seems to be fine one minute and screaming the next. Maybe you are wondering how much longer your baby will keep waking up at night. Maybe you wish you knew the secrets that other parents seem to know, especially those parents with the "good" babies who seem so happy all the time. Maybe you've already read magazines and books and bought toys, bags, chairs, slings, videos, and anything else that promises to keep your baby happy. Yet, sometimes your baby is not happy; sometimes the crying and the sleepless nights seem endless.

Parenting is a tough job and sadly, much of the wisdom and support that struggling parents used to get from their own familes has been lost. Expectations for how babies should behave have been distorted by idealized media versions of "perfect" babies and their well-coifed, well-dressed mothers who get rid of their "baby weight" in the first week after their babies are born.

It's time to use a little common sense and readjust our thinking. We can learn a lot from babies and the wonderful research that has been done about them over the last 30 years. In this blog, you'll hear from moms who have been in the trenches (and in the classroom), who understand what you are going through and what your baby is trying to tell you. We look forward to sharing our knowledge and experience with you and we hope that you'll share your ideas and questions with us.