This is a guest post by Keriann MacElroy of Dream Factory Sleep Solutions.
If you've got an infant, you're probably realizing that parenting and sleep deprivation goes hand in hand. Still, even though exhaustion is a given (until your children reach around age 18 or so), you may still have some questions about why your baby is doing certain things, and what you can do to help her.
In this guest post, we asked Keriann MacElroy, Certified Pediatric Sleep Consultant and owner of Dream Factory Sleep Solutions based in Dallas, TX, to share her top 10 questions about baby and sleep (for the first six months of life). Read on—her answers may even help you catch a few extra winks tonight!
The truth is no one sleeps through the night. Even adults wake up a few times a night while transiting through sleep cycles, so you can expect the same from your baby. The question to ask is: WHY is your baby waking? Is she waking due to hunger, or because she needs your help falling back to sleep? It is normal for babies to wake to feed at least once a night through the age of 6 months. However, many babies can go all night without feeding much sooner. Ask your pediatrician if your baby is ready to go all night without feeding. For babies who are gaining weight at a healthy rate and getting the appropriate number of calories during the day, then it might be possible for your baby to achieve 8–12 hours of sleep at night by 4 months of age.
This is often the follow-up question to #1. First, I encourage you to confirm with your pediatrician that your baby is at an appropriate age and weight to go all night without feeding. If nutrition is not a concern, but your baby continues to wake for feedings, it is likely your baby is using feeding as a sleep prop. Feeding to sleep is the most common sleep association, so you are not alone if you find yourself in this boat! The best way to discourage a feeding-sleeping association is to keep your baby awake for all feedings. This includes middle of the night feedings. If you aren’t sure if your baby is waking due to hunger or just needing to comfort feed, then offer feedings, ensuring your baby is not drifting off to sleep on the breast or bottle.
Babies are born with a startle reflex (the Moro reflex) which causes them to suddenly jerk their arms, legs or neck involuntarily. This sudden jerking can lead to frequent waking during sleep. Swaddling can be a useful tool to reduce waking due to the Moro reflex, however swaddling is a temporary fix. The Moro reflex peaks around one month of age and starts to dissipate around the two month mark. Swaddling is really most effective in the first 10 weeks of your baby’s life. After that, your baby may start relying on being swaddled for sleep and it can be a harder habit to break. It is especially important to eliminate swaddling once your baby can roll over, which can happen as early as 3 months old. I recommend breaking your baby of the swaddle between 10 – 12 weeks of age.
Most new parents will at some point wonder if their baby is sleeping too much or too little. Here are some normal ranges: Newborns (0–12 weeks) should be getting anywhere between 14–18 hours of sleep in a 24-hour period. Typically, that results in 10–12 hours of nighttime sleep (with feedings) and 3–5 naps per day. For three to six month olds, 14–16 hours of sleep in a 24-hour period is appropriate. This age range usually takes 3 naps a day.
From day one! The transition from day sleep to night sleep can be confusing with a newborn since they seem to sleep all day anyway. Make a conscious effort to do a brief bedtime routine that can help your baby understand the difference between night and day. A bedtime routine in which you do the same activities in the same order every time can be a clear signal to your baby that day has ended and night is beginning. Over time, he will learn that night means longer stretches of sleep.
Most parents asking this question are referring to Cry It Out, which is the most commonly known method for sleep training, and the method most hotly debated in mom circles. Luckily, there are many different methods to encourage healthy sleep habits that don’t involve leaving your baby alone to cry. It is never too early to help your baby develop healthy sleep habits that will be sustainable throughout childhood. If your baby relies on you to put her to sleep every time, you may find that it becomes more difficult to put your baby to sleep or keep your baby asleep over time. Being mindful of the habits your baby is forming as her sleep develops can be helpful. Start by encouraging healthy sleep habits at bedtime, as sleep is more instinctual at night. Once she is used to falling asleep in the crib or bassinet for nights, you can graduate to trying for one nap a day in the crib or bassinet. If you start encouraging healthy sleep habits early on, then it will be the norm for your baby and you won’t have to break bad habits later.
About 80% of parents that come to me for help with their little one’s sleep complain that their child slept great until the 4-month sleep regression, and it never improved from there (and some of these kids are now preschoolers)! Three to four months is actually a time of developmental PROGRESSION with your baby’s sleep patterns. Newborns fall asleep easily and go instantly into a deep stage of sleep. Around 4 months of age is when your baby’s sleep patterns change to more adult-like sleep stages. This means that instead of going straight to a deep sleep, they first enter a lighter stage of sleep (REM) and then to a deep sleep, and back to a lighter stage. As your baby transitions through these sleep cycles, he will likely experience brief awakenings. (You do this too, you just don’t remember). The problem arises when babies have trouble finding their way back to sleep and need their parents’ help every time. This permanent change in sleep patterns means your baby needs to learn a sustainable method to fall back asleep in the middle of the night.
Laying your baby down drowsy (but awake) is a common method to help babies learn how to fall asleep independently and avoid negative sleep associations. However, this method is best used on newborns. After about 12 weeks of age, if you are still laying your baby down drowsy, then your baby may still have a loose sleep association. After all, drowsy really is the first stage of sleep. For 3 months and up, I recommend laying your baby down wide awake so he can find his way from awake—to drowsy—to asleep all on his own. Laying your baby down wide awake for sleep is the best way to avoid negative sleep associations.
Simply put, there is no truth to this old wives’ tale. There is no evidence that solid food will change your baby’s sleep patterns. Since we know that hunger is not the only reason babies wake in the middle of the night, introducing solids before your baby is ready is not an appropriate solution. The American Academy of Pediatrics (AAP) recommends introducing solids sometime between 4–6 months. Breastmilk or formula should remain the primary source of nutrition until at least 6 months.
For SIDS prevention, the AAP recommends that you should never lay your baby on her tummy for sleeping. Many babies do like tummy sleeping, and once your baby starts rolling on her own and getting herself in that position, there isn’t a whole lot you can do to prevent tummy sleeping. Even if she starts tummy sleeping on her own, you should continue laying her on her back initially. Back sleeping is the safest sleep position for SIDS prevention.
Dream Factory Sleep Solutions works with expecting parents through parents of elementary age children to help establish healthy, independent sleep skills that will serve children for a lifetime. If you are interested in getting personalized guidance to improve your child’s sleep, you can start by booking a free evaluation call here or email firstname.lastname@example.org.
Keriann MacElroy is a social worker by trade with experience working in fostercare, adoption, and supporting families with children who have special medical needs. She is a Certified Pediatric Sleep Consultant and owner of Dream Factory Sleep Solutions based in Dallas, TX. Having once been a sleep deprived parent herself, Keriann now takes joy in helping exhausted families all over the country find sleep and rest. You can learn more about Keriann and her services at www.dreamfactorysleep.com