Infant Sleep Tip #7

Infant Sleep Tip #7: Put your baby down drowsy but awake at least once every 24 hours (ideally bedtime or first nap).

Holding our baby as she falls asleep in our arms is one of the most precious parenting moments we get. Feed, nurse, rock, bounce her down in your arms as much as you want those first few weeks/months, without any guilt about “creating bad habits.” Your young baby and you both benefit from that close contact and time together.

At some point – and there is a huge range for this – parents and/or babies do better falling asleep on their own. Some parents need a break to care for other children, work, cook, or simply take a few minutes for themselves. Likewise, some babies may only sleep for short times in someone’s arms.

I remember frequently swaying my firstborn to sleep as she cried, only to have her wake again as soon as I transferred her to her crib. At some point, I realized that she was crying herself to sleep regardless, so why not just have her fall asleep in her crib and avoid the transfer drama? I felt less guilty about the crying if she was in my arms, but it was starting to feel ridiculous. And I was exhausted. That was what prompted me to try a new approach.

Bear in mind that the easiest time to fall asleep in the 24-hour period is at bedtime, provided she’s not overtired, or first nap. When you are ready, try putting your baby in her crib/co-sleeper/bassinette drowsy but awake at one of those times.

What does drowsy but awake mean? Imagine a scale of 1 to 10, with 1 being wide awake and 10 being sound asleep. Aim for a 7. She should be fed, clean, snug, and ready for sleep. You can do some singing, bouncing, etc. and when you see her eyelids getting heavy, try putting her down. She might fuss or cry a bit, but you can try some patting and shushing, or of course you can pick her up and try again then or another time. A few sleep experts encourage multiple pickups and putdowns, though depending on temperament, for some babies this can be very stimulating. With alert babies, less is usually more.

More tips to follow soon. In the meantime, wishing you and yours a wonderful holiday.

Rebekah

Infant Sleep Tip #6

Happy August to all. Hope your families have been able to enjoy the abundant sunshine and summer action. Life with 3 young ones has proven to be as fabulous – and as full on – as friends had promised. So I apologize for writing so little recently.

Infant Sleep Tip #6: Encourage soothing techniques other than feeding.

When we hear our babies crying, many parents and caregivers instinctively reach for a bottle or the breast. While comfort feedings can be a wonderful bonding time for you and your little one, it’s important to remember that we have lots of options in our soothing toolbox. This can be a game changer for nursing moms, who were feeling like they were walking pacifiers, partners of nursing moms who were feeling inadequate because they didn’t have the “secret weapon,” and all caregivers who were feeling like they were perpetually overfeeding their baby just to keep them from crying. 

So what are our options? Wear your baby, swing, rock, swaddle, sing, shush, offer a pacifier, massage, take a walk outside, repetitive soothing sounds or music, bounce, or let a partner, friend, or grandparent try their luck. Sometimes a change of chemistry or scenery is all it takes.

If you haven’t found a carrier that is comfortable for you yet, make that one of your first goals. Many swear by the k’tan wrap, Ergo (the new Ergo 360 allows for a forward facing hold as well as all the other positions, which is great when your baby is eager to check out the world), the Beko Gemini, or Moby wrap. As some carriers are expensive, try out friends’, buy a slightly used one, or go to a local store where the salespeople have real know-how. If all the options are overwhelming, I strongly recommend www.carrymeaway.com. The website offers excellent explanations as well as an online form you can fill out for a personalized recommendation from the Sling Lady. They also offer email and phone support and free returns, making it super parent friendly. Laurel was a great support to my family in helping us find carriers that would be comfortable for both my husband (who is 6’2”) and me.

Dr. Harvey Karp in Happiest Baby on the Block offers detailed explanations for the benefits of the 5 S’s – swaddling, side or stomach, shushing, swing, and sucking. Some babies may benefit from all of them done simultaneously, while many babies are comforted by one or two of these techniques.

There is no one size fits all here. Each baby has preferences and naturally those preferences will change over the course of the day, weeks, and months. But mixing it up and trying new techniques can be hugely liberating.

Infant Sleep Tip #5

Happy spring to all! My apologies for being slow to post more infant sleep tips. My household has been busier than usual this month, partly due to my son’s recent obstructive sleep apnea (OSA) diagnosis and subsequent tonsillectomy and adenoidectomy. Much more on that very soon. Suffice it to say, I am now on a crusade to tackle pediatric OSA.

But for now, here are another tip for your infant’s sleep. If you missed the first few, please click here.

Infant Sleep Tip #5: Create a quiet, sleep-friendly environment.

Your baby’s environment strongly affects her sleep. Whether she sleeps in your room or her own, the space should be peaceful, safe and generally free of stimulation. This means room darkening shades and calm soothing colors in the bedroom and on her sheets. In short, the sleep environment should be B-O-R-I-N-G! Comfortable, cozy, but boring! Avoid mobiles, lights, crib toys, and busy patterns. When I walk through the bedding department at stores, the incredible number of boldly patterned crib and bedding accessories always surprises me. At bedtime, we want the message to the brain to be “Slow down,” not “Stay up and focus on the fuchsia colored giraffes lining your crib!” This is particularly true if your child has an alert temperament.

We also want the crib to be a place for sleep and maybe a few minutes of quiet play after waking. It’s not a place to park the baby while you wash the dishes or a pen for the baby to play in when she begins to crawl. Those associations make a difference.  Again, we want the message to be clear: this is the place where you sleep.

As Dr. Harvey Karp recommends in Happiest Baby on the Block, white noise can be very calming, particularly for alert babies because it helps them shut the world out. If you have a busy, noisy household with older children, barking dogs, ringing phones, or street noise, white noise can be a game changer. I recommend white or gray noise because they are constant and buffer noise best. Sounds like crashing waves, chirping birds, etc., which may sound nice to us, do not work well in this regard. Be mindful of the volume – which should be relatively low – the sound is meant to buffer noise, not block it out completely.

Motion sleep can trip up parents. Babies are very portable. They can sleep wherever you put them – car seats, strollers, swings, carriers, and noisy cafes. But even though they can do this, it doesn’t mean they should. It’s ok some of the time, especially in the late afternoons when their naps are shorter and less restorative anyhow. But try to have them nap in a quiet crib or bassinet most of the time – especially after the first few months. Motion sleep keeps the brain in a light sleep and as babies mature, they need deeper sleep as well. Think about it, when you doze off in a car, do you feel as refreshed as if you had slept in a bed?

Getting her out of the car and into the crib may mean that you will be more housebound, until your baby develops more predictable nap patterns. If you go stir crazy, invite a friend to visit, make a deal with your partner so you can get some time off. You don’t have to be super rigid; an occasional stroller or car nap is fine. But respecting your baby’s need for quality sleep is important and will pay off in spades.

Enjoy this time with your little ones. More tips coming soon!

Infant Sleep Tip #4

Infant Sleep Tip #4: Manage day and night feedings so that caregivers can get some rest too.

Even though she’s ready to hit the sack around 6 or 7pm, a later evening feeding works well for babies and parents. Rouse her for full, boring feeding 2-3 hours later (around 9-10pm), then put her straight back to bed. Then YOU go to bed too!

Babies can naturally take one long stretch per 24-hour period. At first the long stretch may just be 4 hours, but it will lengthen over the upcoming months to 5, 6, 7 hours and will eventually become her night sleep. We want to encourage the long stretch to be at night after that last 9-10pm-ish feeding. If she takes it during the day in the form of an epic nap, she will legitimately be up all night making up for calories didn’t receive during the day. (Yes, that means wake a sleeping baby from a nap so that she doesn’t sleep through a daytime feeding.) And if she does her long stretch from 6-10pm, then you haven’t benefited from it. So encourage her little body to take its long stretch after that last evening feed.

Note: If mom really needs some more sleep, see if another caregiver can do the next feeding (probably around 1-3am) so that mom can get a solid stretch herself. If breastfeeding, this can be a bottle of expressed breast milk. As the saying goes, “if mama isn’t happy, ain’t nobody happy.” Knowing how intense as the first few months can be, we need to do what we can to support ourselves. An uninterrupted 6+ hour stretch of sleep can do wonders for a mom coping with baby blues, postpartum depression, or simply trying to regroup after a challenging postpartum time.

Infant Sleep Tip #3

Happy New Year! This is the third part of a series dedicated to laying a good foundation for sleep with babies under six months of age.

Infant Sleep Tip #3: Look for natural day/night cycle to emerge – usually 6am-6pm or 7am-7pm

Most babies fall into a 6am-6pm or 7am-7pm (or thereabouts) schedule. During the day, we want to focus on full feedings every few hours, outside time, floor time to practice new skills, and napping at appropriate intervals. When you notice your little ones starting to fall apart around 6pm or 7pm, she’s probably ready to call it a day.

Many parents mistake this fussiness as a need for one more nap. But after a 12-hr day, her central nervous system is taxed, and it is time to get her into a less stimulating, more sleep friendly environment. Bring her to the bedroom, give her one last feeding, change her diaper, dim the lights, turn on some white noise (especially if the rest of the house is still up and at ‘em), sing her a song, swaddle her up (if she’s into that), and put her to bed.

Infant Sleep Tip #2

This is the second part of a series dedicated to laying a good foundation for sleep with babies under six months of age.

Infant Sleep Tip #2: Create a flexible feeding and sleeping routine

A flexible routine does not mean a minute-by-minute schedule, but rather a sensible framework so that full feedings and sleeping are prioritized. Almost every sleep book on the market agrees that in general, an “eat – active time – sleep” cycle (in that order) is beneficial. In other words, feed your baby “up.” When she wakes, give her a full feeding (and burping). Then encourage her to stay awake for a short period. This is the time to engage with your baby, give her some tummy time, take her outside, etc. How long this active time should last is dictated by her age (wakeful windows get increasingly longer) and your baby’s cues. When she starts to show her sleepy cues – yawning, rubbing her eyes, zoning out, mild fussiness, etc. – you’ll know it’s time for her to rest. This cycle can be continued throughout the day, at least until the afternoon when her central nervous system is more taxed.

The beauty of this routine is that it makes parenting easier. Infants don’t differentiate their cries right away, so it can be hard figuring out why she’s not happy. However, if you know she has had a full feeding, she’s been appropriately stimulated, and now she’s fussy, she’s probably ready to sleep. On the other hand, if she’s had a partial feeding because she fell asleep during the feeding, it’s hard to read her cues. Is she hungry again? Did she not rest enough? Is something else wrong?

The “eat – active time – sleep” cycle brings other advantages too. It helps to disassociate falling asleep and eating (though it’s fine for infants to fall asleep at the breast/bottle sometimes). And for babies dealing with reflux, having upright time after feedings is crucial.

Infant Sleep Tip #1

Most of my sleep advice is directed toward children six months and up. By that age, babies are decreasingly reliant on nighttime feedings (though some may still need a few) and more responsive to behavior modification. That said there are some basic, developmentally appropriate ways in which we can begin to lay a solid sleep foundation with babies under six months. And in the case of parents returning to work, coping with postpartum depression or blues, or simply burnt out from sleep deprivation, some early interventions may be necessary.

Over the next few posts, I will focus on how we can gently introduce positive sleep habits for our very young babies. Hopefully new and expectant parents will find these suggestions helpful. On a personal note, my third baby is due in a few weeks so I’ll be using these techniques right along with you!

First, a word about sleep advice from well-intentioned family and friends…

Like parenting in general, how we approach sleep is very personal. Parents must decide for themselves what they feel comfortable with, what meshes with their values and philosophy, and what works for their child’s unique temperament and feeding needs. Lots of friends and family like to opine about sleep, but it is essential that parents listen to their gut and understand that just because an approach worked for one family, does not necessarily mean it’s a good (or healthy) fit for theirs.

There are significant individual differences between all children (and adults!), particularly in babies under six months. This is why one size does NOT fit all and what worked for a friend and her baby, may not work for you. For example, some infants may be able to consume large amounts of breast milk or formula, enabling the baby to go 3.5 hours without another feeding. Another baby with a smaller capacity may truly need to eat every 2 hours. Both are healthy and normal for this variable age group, but clearly the babies have very different feeding needs. Alternatively, one baby’s mother might have an abundant milk supply, while the other’s mother’s supply might be perfectly adequate, though not sufficient to stretch out feedings. Attempting to do so would actually put their otherwise healthy baby at great risk. For this reason, any recommendation from a book, friend, or family member for scheduled feedings should be taken with a big grain of salt.

Infant sleep

Your infant will probably sleep much of the time, but she won’t sleep deeply. Infant sleep is not well organized neurologically, which means it’s a very light slumber. Hold her, rock her swing her, do what feels right and comfortable for the first few weeks/months. When you are ready, start weaving sleep friendly routines and patterns into her life. This is a gradual process so don’t expect huge, dramatic changes in her sleep patterns immediately. But you are laying the groundwork for improvement in the coming weeks and months.

Infant Sleep Tip #1: Establish a healthy feeding pattern as soon as baby is born

With young babies, everything revolves around feeding, including sleep. Making sure their feeding needs are being met is essential to their health and growth, as well as any sleep success. Most infants need approximately 6-7 full feedings between 6am–10pm, plus more at night depending on their growth and individual needs. “Full” is the operative word here. If breastfeeding, this usually means emptying both sides. The goal is to avoid snacking throughout the day, though shorter cluster feedings in the late afternoon are perfectly fine.

If there is any concern or doubt about whether the baby is getting sufficient calories during each feeding – or if breast or bottle-feeding become challenging – consult your pediatrician and/or lactation consultant promptly.

Note: Babies usually have growth spurts around 3 and 6 weeks, and 3 and 6 months. It is essential that they receive additional calories at these times and if breastfeeding, that they go to the breast more to up their mother’s milk production so that she can meet their need.

More infant sleep tips will be coming in my next posts. In the meantime, wishing everyone a good night’s sleep.