Sleeping Through The Night: Infants
The common advice given to new parents is to “sleep when baby sleeps.” What can you do, however, to ensure baby actually sleeps? There are a few key behaviors that can establish the pathway to great sleep- the earlier you start them, the more reliable sleep will be.
The first pattern that is essential is paying close attention to their sleep onset associations- these are the touch, scent, and sound conditions that are present when they fall asleep. Infants can become entrained to a wide variety of sleep onset associations- we all know of some families that have been stuck driving their car or strolling baby in a stroller to get to sleep. The best way to establish healthy sleep onset associations is to consider what the ideal sleep environment would be for your baby. If you want the baby to sleep independently in a crib, then all of the conditions with sleep onset should be consistent with that environment. If you want to co-sleep or have a family bed, then you will need to anticipate that they will need those conditions when they sleep. All infants wake several times through the night (even grownups do!), but they will only become wide awake if the conditions have become inconsistent with their normal sleep onset environment. This is why a baby who is rocked to sleep may not settle during the night unless they are rocked to sleep again.
Some Key Sleep Tips:
1. If you do not intend to co-sleep, it is important for baby to learn how to fall asleep independent of contact with parent, because they will rely on that contact when they have awakenings each night. You accomplish this by gradually increasing the amount of time that you let lapse between comforting the baby. Week 1- 2 minutes, Week 2- 6 minutes, Week 3- 10 minutes, and so on. Do this for sleep onset at nighttime and naps.
2. It is also essential that you try to train them to self soothe, by encouraging their own soothing behaviors. For example, many babies likes to stroke their bedding or blanket when they are soothing, so it is helpful if their bedding is a comforting texture.
3. Never nurse/feed them to sleep. Put them in their crib when they are awake and encourage them by patting her/him or swaddling them. This will help her to be able to put herself back to sleep when she wakes up during the night.
Tips for establishing a circadian rhythm:
1. Limit all light exposure after 11 PM to only emergency situations. Retinas are the strongest internal clocks that babies have right now, so using light to train him/her to what day is will be your best friend.
2. Amping up morning feedings will help to firm up the rhythm, and train them when to actually expect their big meal.
3. A good pattern for your day is to feed upon awakening, then have play/wake time, followed by nap- repeated every 2 1/2-3 hours. She will become accustomed to eating upon awakening and will not associate eating as a sleep onset activity. For nighttime, feed her when she awakens and then put her right back to bed with minimal interactions. Obviously, in the first several weeks, waketime is usually only 20-30 minutes before she goes right back into a nap. This pattern makes it easier to establish a nap rhythm as she matures.
In research studies, we see some benefits to starting healthy sleep habits at younger ages (around 3-4 months) but the overwhelming majority of studies have started at 6 months of age (for a comprehensive review of research on infant sleep interventions, check out the Jodi Mindell et al article for SLEEP in 2006).
Looking for help with your baby’s sleep? Get connected with Dr. Daley or Dr. Raines below.