Sleeping through the Night
Most paediatricians agree that ‘Sleeping through the Night’ actually means your baby sleeps for 6 or more hours in one stretch (5 hours for newborns). It’s important you realise this fact or you might set unrealistic goals.
Why do babies need so much sleep?
So why do babies need so much sleep ? Babies have a great deal to learn in a very short space of time. During waking hours, there is too much going on for babies’ brains to digest or reflect on the huge amount of information being received. During sleep the brain can organise and make sense of the vast array of experiences without distraction. Sleep is also a time for renewing the chemicals in the brain and the body, ready for another active day. (Hames 2002).
Listen to your own baby’s name in one of our personalised lullaby’s
P. Hames (2002). “Help your baby to sleep.” HarperCollinsPublishers Ltd.
It is important that we understand the reasons why newborn babies wake in the night. In the first few months they have many essential needs, yet their ability to communicate is extremely low. For example, their miniscule tummies digest milk extremely quickly and if the stimulus for hunger does not wake the baby, he will not get the level of nourishment needed at that vulnerable age (Sears 2006). Likewise, babies are still learning to regulate temperature and it’s an important survival mechanism that they awaken if they are too cold or hot during the night. The same applies to many stimuli that also have the potential to wake the baby.
Therefore, these mechanisms are not there just to annoy the parents, but to ensure the well-being of the baby! As we are next dragging ourselves out of bed to tend to baby, we should take comfort in the fact that his innate, built-in defence-mechanisms are evidently working just fine!
When an adult falls asleep, her higher brain functions decelerate which allows her to enter the phase known as deep sleep. During this time her body hardly moves, breathing is slow and regular, and her muscles become relaxed and loose. After around an hour and a half later and her brain becomes more active and she enters into a period called light sleep. It is during this time when she may slip into REM (rapid-eye-movement) sleep where most dreams occur. These deep/light cycles continue throughout the night, at around two hours intervals, so that the average adult spends around 6 hours in deep sleep and 2 in light sleep.
Here are some common things to check when your baby wakes during the night and cries out for you.
• Nappy. Does he need a change?
• Appetite. Does he genuinely need a feed? If so feed him. (Depending on what developmental stage he’s at, this may be merely an attention-seeking tactic).
• Clothing. Check his clothes for areas that may be causing discomfort- tags, button etc. Are the clothes 100 % cotton? If not, he may be sensitive or allergic to the synthetic fibres.
• Milestones. Has he reached any developmental milestones recently, such as sitting, crawling, walking, talking, teething etc? These go hand in hand with a few sleepless nights I’m afraid! Teething problems can be strongly suspected by the appearance of a wet bed sheet under baby’s head, a drool rash on the cheeks and chin, swollen and tender gums, and a slight fever. Consult your doctor or pharmacist to find the right medication to ease the pain.
• Separation Anxiety. This deserves a post of its own.
• Temperature. Is he too hot or cold? Be careful not to overdress him and see the table at the end of this post for the right temperatures.
• Dressed for sleep. In the early months, many babies like to “sleep tight,” securely swaddled in a cotton baby blanket. Older infants like to sleep “loose,” and may sleep longer stretches with loose coverings that allow them more freedom of movement.
Babies learn best through routine and this is the age when baby is ready to get into the habit of eating and sleeping according to a fairly consistent timetable. The best way to accomplish the challenge of getting your baby to go to bed at a regular time is to follow a well organised day with a consistent bedtime routine. A bedtime routine can include all or some of the following: bath, feed, story, massage, cuddle, lullaby. It culminates with the baby in her place for sleep on her own or with you. A little trial and error is needed to see which techniques relax your baby. In time you will develop a unique bedtime ritual of your own but you should follow this advice:
• Set a bedtime and try and keep it as consistent as possible. Bedtimes can vary from as early as 7pm to as late as 9pm. Your lifestyle and work commitments may determine this for you. The important factor is consistency. Don’t set a late bedtime thinking baby will get exhausted and sleep right through. This is bad news and usually doesn’t work. She’s far more likely just to get overtired.
• Try and make the elements of the routine come in the same order: babies love predictability and will be much calmer if there are no surprises.
• Also try and make sure it’s practical. There’s not much point in having a routine that’s easy to follow at times and difficult at others.
The ‘circadian rhythm’ is the 24 hour internal clock that controls various biological processes, including sleep, wakefulness, and digestive and hormonal activity. The natural signal for the circadian pattern is the change from darkness to light.
There are some simple techniques for helping your baby synchronize her sleeping patterns with the adult way of doing things and therefore she will safely reach the stage where she sleeps through the night more quickly.
During the day, open the windows and let the light fill the rooms. Generate lots of hustle and bustle and try to get outdoors for some playtime. At night do exactly the opposite as sleep-time approaches. Start turning down the lights, be as quiet as possible, turn off the television and reduce talking to absolute minimum. Feed, cuddle, massage and hold baby as quietly as possible. You can also quietly play her favourite lullaby just before bedtime. Baby will soon learn to associate this with the process of falling asleep.
These straightforward procedures remove distractions and so facilitate the baby’s awareness of the ultimate clock-setters, your local sunrise and sunset. With time, the sun’s rhythm will trigger chemical reactions that reset your baby’s internal clock.
A. Lavin, S Glasser (2007). “Baby & Toddler Sleep Solutions.” Wiley Publishing, Inc.
Newborn babies do not sleep through the night. They have legitimate and essential night time needs that need to be catered for. If they cry out in the night, you should always go and check on them.
However, after your baby reaches a certain age, you should begin to think about reducing the amount of night-time demands that you instantly rush to satisfy.
After reaching the four month mark, most babies are physically prepared to sleep through the entire night. They don’t really need middle of the night feeding anymore and most have acquired the ability to comfort themselves back to sleep if they do wake up. Therefore, if baby is still waking up frequently throughout the night it’s probably because you are still jumping out of bed at her first cry, to give her a feed and a cuddle. She’s learned that every time she cries, her favourite person and her favourite meal are by her side in seconds. Many babies are obviously not going to give this arrangement up too easily!
There is a theory that advises you not to respond to a newborn baby’s cries during the night because it will teach him to comfort himself back to sleep and therefore, he won’t bother you as much. I have to say, this is the worst advice I have ever come across.
A newborn baby in the early stage of growth is very vulnerable and it is the parents’ duty to satisfy every need of their offspring. Letting him ‘cry it out’ could be very psychologically and physically damaging to the child in the early stages of development.
However, later on in the baby’s development (from around six months onwards) the baby will need to learn to comfort himself on his own, however, as far as the right and safest way to look after your newborn is concerned: give him everything he needs, and yes that obviously means some sleepless nights in the beginning.
One your baby has reached the six month mark you may want to consider some basic sleep training methods.
When baby is at least six months of age and developing well, you can start reducing the night-time feeds as these are no longer essential to health and growth.
If baby is used to a 1.00 am feeding, his stomach will hunger for food at that time every night. One of the best techniques for helping your baby to sleep through the night is to reset his ‘stomach clock.’ The aim is to reduce baby’s night time food intake without letting him go hungry. Regardless of the age of the baby, he will generally take in the same amount of calories per 24 hours. If you gradually reduce the night time feeding, baby will just eat more during the day to make it up. This is called calorie shifting.
If you have decided it’s the right time to start reducing the night-time feeds here’s what to do if you’re bottle feeding: Start by reducing the volume of milk or formula in the bottle by one or two ounces (30-60 mls) each feeding. You could start with just the bedtime feed and move onto the other night-time feeds or you could attempt them all at once. Keep reducing the volume of milk/formula by one ounce (30 mls) per night over the course of the next week, until there are no more feeds.
Colic is diagnosed when an infant is healthy and well fed yet cries in excess of three hours a day for more than three days a week. It is a harmless condition but is obviously very upsetting for parents and carers. It affects around 20% of babies and usually appears around 2 -4 weeks of age and can last for three months. There is much speculation around the causes, although experts agree there is not one universal cause that affects all babies. (BUPA health information sheet 2003). However, one recent study found that many colicky babies had inflamed intestines, caused by food allergies. When the problem food was eliminated from the diet, the baby recovered almost immediately. For breastfeeding mums, this means also cutting the problem foods from her diet. The usual culprits are proteins from cow’s milk, soya or other troublesome foods. Mums can alter their diet and reintroduce foods one at a time to see if the problem food can be found. If you bottle-feed you may want to try a new formula (Lavin, Glaser, 2007).
If you suspect your baby may have a food allergy, you can work with your paediatrician to find the foods causing the reaction and eliminate them (Lavin, Glaser, 2007). If your baby seems to have a lot of wind, make sure she is burped frequently. Babies who bottle feed may swallow air from the bottle. This can be reduced by feeding the baby in a different position or by trying a bottle that has been specially designed to reduce the amount of air swallowed.
To soothe babies with colic, the following techniques may be helpful:
• Carry the baby in a front sling or back pack
• Wrap baby snugly in a blanket (this is called swaddling)
• Keep the baby moving in a baby swing
• Place her near continuous noise or vibrations from household appliances like the
dishwasher, vacuum cleaner or washer-dryer
• Take her for a car ride or a walk outside
• Give her a dummy to suck on
• Give her tummy or back rubs
• Take a shower together – the warm water may be comforting
(Lavin, Glaser, 2007).
Medicines are not used to treat colic. However, medicines may help to relieve abdominal symptoms. It may be worth trying “colic drops” or “gripe water”, which are available without a prescription. A medicine called dimeticone (eg Infacol) is available to relieve trapped wind. Consult your doctor or the pharmacist first (BUPA’s Health Information
BUPA’s Health Information Team. “Colic.” Available from: http://hcd2.bupa.co.uk/fact_sheets/html/sids.html (09/10/07)
A. Lavin, S Glasser (2007). “Baby & Toddler Sleep Solutions.” Wiley Publishing, Inc.
Your baby is incredibly adaptable and can learn effectively through association. He will start to associate the process of falling asleep with the things that he has been used to experiencing immediately prior to bed-time. By making these things consistent and predictable, their very presence will signify to your baby that it’s time to sleep. For example, playing the same lullaby cd just before bedtime will help baby to associate the music with the process of falling asleep. In time, baby will fall asleep much more quickly each time he hears the music and makes the association. This is a great comforter during the dreaded night-wakings. See the post on Lullabies and Babies for more information.
Nap times are essential for babies. You may use the same techniques for helping baby nap as you learned for night-sleeping. Here are some additional tips:
-Without disrupting your life too much, try and plan nap times for roughly the same time each day. Obviously, this won’t be practical for some parents but if you can manage it then the rewards will be well worth it. Not only will it make nap times easier but babies will sleep better at night time as well.
-For newborn babies, sleeping habits are closely linked with eating patterns. You might want to consider keeping baby awake for a short time after each daytime feed. This will stop baby getting into the habit of needing a feed to get to sleep. Don’t leave it too long however or baby may get over-stimulated and possibly even hungry again and won’t be able to nap which will make him irritable and fussy. You should plan nap times for about half an hour after lunch or a snack to aid sleeping habits.
Dr Richard Ferber was the first to propose the idea of ‘controlled crying’ in 1985. Since then it has taken on many names such as, cry it out, self-soothing, sleep training, crying down and many more. Some techniques vary slightly in the details but they all work along the same basic principal as Ferber first proposed.
There are few baby-related issues that evoke as much controversy as this one. Some big names in the field frequently have fiery exchanges because of their conflicting points of view. Many will remember Gina Ford and Dr Miriam Stoppard for example, who had a fierce debate on The Today Programme over the issue.
The Ferber Method
Please read The Ferber Method (part one) before attempting this technique. As I discussed, this method should only be considered if your baby is healthy, well-fed and at least six months old. Before starting this technique you have to be sure your baby is only crying because he wants something rather than that he actually he needs something. If you suspect it might be the latter obviously give him everything he needs (a change, a feed etc). Please note, I am not advocating the Ferber Method, I am simply letting you know the best way to go about it if you decide you want to give it a try.
During the first three months of development, tiny babies rarely sleep for more than four hours without requiring feeding. At around three to six months, the majority of babies start to settle. They are awake for longer periods during the day and some with lucky parents may sleep five-hour stretches at night! The time they spend in deep sleep starts to lengthen and the time spent in light sleep shortens (Ficca et al, 2000). This means babies are able to enter deep sleep more quickly. This is called sleep maturity. (Sears, 2005).
Separation anxiety is a perfectly normal stage in a child’s development and can start anytime from at around 12 -20 months. Baby’s increased awareness causes her to realise that you may leave her at any time. This shows she has mastered skills such as recognising the difference between family and strangers, knowing how essential you are to her life and anticipating the feeling of loneliness that will follow from your departure. Unfortunately, she cannot comprehend that the departure is only temporary so it causes her great distress and panic to know that you might not return. Separation anxiety gradually diminishes as the child realises that you come back each time. However, during the condition, it obviously presents a large problem at bed-time.
When setbacks occur in your child’s sleep routine, you may need to go back to basics with him. Re-introduce the consistency of the bedtime rituals and do the following:
• If your child kicks up a fuss as you leave the room, say calmly and cheerfully: “I love you. It’s bedtime. I will see you in the morning.” Then smile and leave the room.
• Get ready for your baby to cry from 30 to 60 minutes but remember this is a want not a need. At this age in the child’s development you really shouldn’t give in to his demands easily or you will only reinforce his confidence in this technique’s effectiveness and you’ll increase the problem.
• In the middle of the night, analyse the cries and decide honestly, if you think he’s really in need or if he only wants attention. If you’re sure it’s just the latter, be strong and wait him out. This will give him the chance to cry it out and learn to comfort himself back to sleep. If you must go back in the room, give him a pat on the head and a soothing sentence but do not pick him up or this may signal playtime! (Please note ‘crying it out’ is not acceptable for younger babies and we advise strongly against it).
Once you’ve taken the above measures and tackled seperation anxiety your nights should be peaceful once more. The hard part is over and all that remains are a few little adjustments to reflect the physical and mental development of your child. (Lavin, Glaser, 2007)
Please note the correct spelling is: separation anxiety
We have covered Controlled Crying (also known as The Ferber Method) in some detail in previous posts. Please see However, following a recent comment on the site I thought an extra post was needed to discuss how nap times and co-sleeping fit in with the technique.
There are many reasons why parents choose to ditch the dummy but the most common reason I hear about is for helping a baby to sleep through the night. Because the dummy tends to fall out of the baby’s mouth at night time, mum and dad usually get summoned to retrieve it countless times every night!
If you have decided that you want your baby to ditch the dummy then the most effective technique is for him or her to go ‘cold turkey.’ This idea terrifies most parents because they envisage endless sleepless nights and an unwinnable battle of wills. However, most parents report that it is not nearly as bad as they had anticipated and the joy of not having to get up 15 times a night is well-worth the initial challenge.
Rather than trying to get rid of the dummy sneakily and hoping the child doesn’t notice, it is far better to explain to the child what is going to occur and to get them involved so they feel like it is their decision to get rid of it because they are a big boy or girl now and so no longer need it. It is remarkable how much even very young babies understand so it is always worth doing. Asking Father Christmas or the Dummy Fairy to take the dummy away so that a younger baby can have it works for some parents and it is not uncommon for them to leave a token of their gratitude behind!
Be prepared that the first few days might be quite tough and come up with a list of ways to distract your baby – games, cuddles, stories etc. so that you are providing the extra comfort that the dummy offered. Make sure you get rid of the dummy and any spares and are not simply hiding it so that you are not tempted to give it back.
How to Stop Co Sleeping
In the recent post ‘Controlled Crying – Naptimes and Cosleeping’ I explained how the Ferber technique wasn’t suited for families with a co-sleeping arrangement due to the very nature of the method. We had a question come into the site from a lady who wanted to know the easiest way of making the transition from a co-sleeping arrangement to a cot in the baby’s own room and how soon after she could start using Ferber. I explained how the transition could be made a little easier and in this post I will continue where I left off.
In terms of naps, most toddlers during their second year will start to abandon their morning nap in favour of a longer afternoon one. It’s a natural progression and you should encourage and guide your child though the process of combining the two naps into one.
The first sign that the child has reached this stage occurs when he refuses the morning nap until later on and then hardly sleeps in the afternoon. Often, the tot will want to sleep at lunchtime so perhaps trying an earlier lunch (by 15 to 30 minutes) may allow him to eat first and then nap. If he doesn’t get fed before naptime, hunger will probably wake him. As the child grows, he may require a longer nap in the afternoon. If it is not affecting his night sleeping then it’s healthy to leave him to it. If it does start affecting it, you should start waking him up so he has time to tire himself out again before night time (Lavin, Glaser 2007).