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Thursday, December 23, 2010

Teaching Your Baby to Sleep

Teaching a new baby to sleep can be a difficult and trying time for families. Knowing how and when a baby is able to learn to sleep on their own and stay asleep throughout the night is a very important part of starting healthy sleep habits that will last until adulthood.

It is true that some babies begin to naturally sleep throughout the night at a very young age such as just a few months or even weeks old. This is unfortunately not the case for the majority of babies, and that leaves a lot of parents tired, frustrated, and unsure. If you and your baby are ready for a good nights sleep there are many things you can do to teach your baby how to fall asleep and stay asleep on their own. Please remember that everything here is a guideline, not an absolute rule. If you do your best to follow, but are not perfect that is okay. Every parent and child is different and sometimes your feelings or your child's needs must come first. If you want to achieve success with any of the methods suggested here, do your best to follow the guide as written, but do not be critical of yourself if you make a mistake.

The New Baby:

The very young infant already has an idea of natural day/night, sleep/awake patterns from being in the mother's belly. These ideas may not be correct, but they are inherently there. Babies are used to movement throughout the day, and rest throughout the night. You may have noticed during pregnancy that your baby would often become active and keep you up at night. This is because of the lack of motion in your body. During the day when you are talking, walking, and just moving about it is very calming and relaxing to your unborn. At night when you lie still is when baby is no longer being rocked and soothed by your motions so he's ready to play! This also can be a contributing factor to young babies getting their days and nights mixed up.

Starting from birth, your baby follows the "eat, sleep, poop" pattern. Ah, how nice to be a baby! Try nursing the baby right when he awakes, instead of after he has been up for a while. This way the baby will not associate nursing with sleeping or begin to rely on nursing to sleep. If your baby does fall asleep while nursing, don't fret. Just continue the effort.

At night, very young infants need to nurse. Studies have shown that young babies give off a higher amount of growth hormone. This shows that they do more of their growing at night rather than during the day. Because of this, it is necessary that they nurse frequently. Following the same advice, try to nurse the baby as soon as he wakes. Keep the lights very dim, or off altogether so that the baby begins to understand the light patterns of day and night. When the baby is awake at night, keep playing and other activity to a minimum. After nursing, changing any necessary diapers (or cloths if infant potty training) snuggle the baby back up and place him back to bed. For the youngest infants this is generally in a cradle/bassinet, or a co-sleeper. Be sure to follow AAP guidelines for safe sleeping for your little one such as no stuffed animals, loose blankets, etc. A pacifier has also been shown to reduce the risk of SIDS in young infants.

Continue in this wake/nurse/change manner throughout the night. There are many thoughts and views on whether or not babies on breast milk sleep less than babies who are on formula, and whether nursing mothers get less sleep than ones who do not. These are simply thoughts and recent studies have shown that infants and mothers sleep are not affected by whether they are nursing or not, so it is absolutely healthiest and best for your baby beyond contention that you nurse your infant as long as you are medically capable.

It may be helpful to have two different sleep areas, one for bed time and one for nap time. Also, begin a nighttime routine: dinner or dinnertime feeding, bath, and a book in the rocking chair before bed is an example of a nice routine. Come up with something that works for your family and provides a general wind-down period for your baby that you can do consistently every night.

Ready to Sleep:

Around six months of age the infants need for nighttime nursing decreases. The operative word here is need. At six months of age the baby will still want to nurse and still have the habit of nursing throughout the night. The need for the nursing has decreased. The baby's growth patterns have changed a bit and now he is able to go longer periods in between feedings while still remaining healthy. There have been some studies, and even the AAP themselves have stated, that babies are capable of sleeping through the night at three months of age*. Yes, they are capable, but it is not in the babies best interests for health reasons to purposefully put a stop to night time nursing at this young age. The AAP recommends nursing continue until around age 2. At around six months of age you will notice a change in the babies nursing patterns during the day where he may start going longer periods in between nursing sessions. This is a wonderful and opportune moment to begin teaching your child how to sleep.

One of the most referenced and utilized methods for teaching a child how to sleep through the night and fall asleep on their own is often referred to as "cry it out". Do not let this term frighten you. This by no means is a method where you let your child cry all night long until they fall asleep. "Crying it out" means many things, and is done in many ways. Here we will explain the two most effective methods for most children. Now, there will be crying. As a parent you should understand that your child will cry. He will fall down and cry. He will spill his milk and cry. You will take a dangerous object out of his hands and he will cry. This is a part of life for every child. When you ask a baby to do something that they do not want to do, they will cry. When you try to change the habit of nursing all night and teach your baby to fall asleep without your help, they will cry. I promise you, however, that they are okay. You will not be tormenting your child, traumatizing, or anything of that nature. You will be making them angry. And that is a part of growing up. But after three days when your child does not cry, falls asleep, sleeps all night, then wakes the next morning bright eyed and happy, you will know that it was worth the tears.

The first method I suggest to any parent is the three day, 5 minute method.

Day one:
Begin with your bed time routine. When it's time to go to bed, place the baby in their crib or chosen sleep vessel, awake but sleepy. We recommend at this point that a baby be in their own room and crib. It is much harder to teach a baby to sleep on their own if you are right there where they can see you. It is also harder on you when your baby wants you and you are right there, but are trying not to go to him.

When you put your baby down have the lights dim or off. You can choose to have soft classical music or lullabies, a sleep machine, whatever you choose to help soothe your baby. Let the baby know it is time to go to sleep, say goodnight, give them a kiss, and leave the room.

If your baby plays or babbles, that is fine, just leave them be. If your baby begins to cry then wait five minutes. After five minutes, go into the baby's room, snuggle the baby back down in the bed trying your absolute best not to pick up your baby, tell them again it is time to go to sleep, say goodnight, give them a kiss, and leave again.

If/when the baby cries again, wait ten minutes. Now, I'm going to warn you that when your baby is crying ten minutes can feel like an hour. It is very hard to stay away, but you can do it! Remind yourself that it's only ten minutes, and try to keep your self distracted, watch TV, listen to two songs, read an article, come here and chat with some mama's, anything you need to make it through the ten minutes.

After ten minutes, go back to the baby's room again. Trying not to pick him up, check that the baby is still clean and dry in the diaper area, lay the baby back down, tell them again it is time to go to sleep, say goodnight, give a kiss, and leave again.

If/when the baby cries again, wait fifteen minutes. Hold yourself at bay, you can do it! After fifteen minutes repeat the same pattern of lying the baby down, telling them it's time to sleep, and so forth. If the crying continues, then wait fifteen minutes again and again until the baby has fallen asleep.

This first night is the hardest of the three nights. Just do your best, and be strong. That being said, if your child has trouble, such as vomiting from becoming too upset, aggressive behavior, such as head banging, or anything of the like, then the method either needs to be adjusted for that, or a different method should be followed. Do not feel as if you have failed if these things occur. Remember, all children are different and though this method will work for the majority, that is not everyone. Do what is best for your family.

Day two:
Day two is very similar to the first. Follow your bedtime routine and place the child to bed sleepy, but awake. Tell them it is time to sleep, say goodnight, give a kiss, and leave. If the child begins to cry then start off waiting at ten minutes. Follow the same procedure after ten minutes as you did the first night. If the baby cries again, wait fifteen minutes, and continue to follow the fifteen minute pattern as you did the previous night. This time, the baby should fall asleep sooner than the first night.

Day three:
Begin with your bedtime routine as before. If crying occurs this time then start with fifteen minutes and continue fifteen minute increments as before. The child should fall asleep sooner still, and many children will hardly cry at all before falling asleep.

Voila! You have taught your child how to fall asleep on their own. It was hard, but you made it! And now your bedtimes will be that much more calm and comfortable for you both.

What to do should your child awake during the night:
If/when your baby wakes during the night, the procedure is more or less the same. Let them cry for five minutes then go to their room. Check to make sure the child is dry in the diaper area, change them if needed, and if possible do this in their bed, quietly and quickly, lights off or dim. Then, just as before, put the baby to bed and leave. If they remain awake and cry, wait ten minutes, then fifteen, and continuous fifteen minute increments as before. By the third night, if they awake, go straight for the fifteen minutes from the time they begin crying. If your baby cries for five minutes, then stops for five, then continues, start the clock over. In three days to a week your child should be sleeping on their own throughout the entire night. Also keep in mind that sleeping through the night is between six and eight hours. If your child is waking after six hours, then they may be ready to be up. You should not expect an infant to sleep ten straight hours through the night. As long as you have reasonable expectations and understandings, your family will be much happier.

If your child vomits, becomes aggressive, or injurious to themselves
Do not continue to let your child cry should these things occur. Instead the method may be adapted or changed altogether. Perhaps you wait only the five minutes, and you do pick the child up for a moment to help them calm themselves. Use your best judgment and knowledge of your child to do what you feel is best. Things that should remain the same however, to best promote a natural sleep cycle, are dim or no lights, quiet, soft sounds, and constant reminding that it is time to sleep. No playing, or other activities during this time.

As always, if you have any questions, concerns, or need any assistance with the ideas discussed in this article, please feel free to contact My Family and Me at any time.
This article is no way intended to diagnose, treat, or prevent any health problems or diseases. This article was written to be advisory in nature and used as a helpful guide or source of information. It is up to the individual to decide whether or not to follow the suggestions put forth in this article.
*Sleeping Through the Night: The Consolidation of Self-regulated Sleep Across the First Year of Life
Jacqueline M. T. Henderson, PhDa, Karyn G. France, PhDb, Joseph L. Owens, PhDa, Neville M. Blampied, MSc
Other sources:
What to Expect the First Year by Heidi Murkoff, Arlene Eisenberg, Sandee Hathaway, Sharon Mazel
Sleep Problems in Children (Copyright © 2007 American Academy of Pediatrics, Updated 8/06)
New Mother's Guide to Breastfeeding (Copyright © 2002 American Academy of Pediatrics)

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