Health

Sleeping through the night in three easy steps

| by The Pediatric Insider

The Pediatric Insider

© 2011 Roy Benaroch, MD

Sleep….what every parent of a young baby needs. And ironically, if you’re not getting enough sleep, you probably don’t have the energy to slog through any of the “help your baby sleep” books. Fortunately, we’re here to help. You want to teach your baby how to sleep through the night? I’ll tell you the three necessary steps. Do this, and you and your baby will soon get a good night’s sleep, or at least get closer—sorry, no guarantees here. Babies have their own plans, and their own personalities, and there is never a one-size-fits-all solution for everyone. Still, these ideas should help any baby get closer to a full, solid night’s sleep.

You can start these sleep-training ideas at any time. If getting a solid night’s sleep is a priority, the younger you start training, the better.

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Step 1: Ensure that Junior is getting enough calories during the daytime. Think of it this way: he knows how much he needs in a 24 hour cycle, but he doesn’t really care if he eats more in the day or night. “Oh, don’t worry, Mom,” baby might say. “Don’t rush to feed me this afternoon. I’ll just wake you up earlier tonight!” As babies get to 3-4 months of age, they will be able to go longer between day feedings. Do not allow this. Don’t let them stretch out the day feeds until the night is one solid block of sleep.

Nurse frequently. During the day, if Junior is awake and it’s been more than 2 hours since the start of the last feeding, it’s time to eat again (if baby is asleep, wake at 3 hours past the start of the last feeding.)  Start solid complementary foods at 4-6 months (earlier is not better).

Step 2: Don’t react to every little noise babies make as they sleep. You will stir a bit, baby will fuss a bit, and then you’re both wide awake. As soon as you feel comfortable, move your baby to his or her own room so you don’t keep waking each other up. If baby wakes and makes a little noise, don’t rush in immediately. Take your time. At least sometimes, Junior will put herself back to sleep without your going to see her. Give her a chance to soothe herself!  If you must share a room, try to lie quietly when you hear your baby start to make noise.

There’s a persistent half-myth that bottle fed babies sleep better. I call it a half-myth because it is in fact true, but not true for the reason people expect. Bottle fed babies do sleep through the night faster—but that is because it takes mom several minutes to go to the kitchen, warm a bottle, etc. By the time she makes it to baby, at least sometimes the baby will go back to sleep. For nursing moms, it can be quick and convenient to get a feeding started—and that’s a good thing, most of the time. But if you’re trying to sleep train, don’t be so quick to begin nursing the moment your baby starts to wake at night.

Step 3: I saved the most difficult for last. It’s time to allow your child to learn that he can fall asleep alone. Parents usually end up holding their little newborns as they fall asleep,  which isn’t at all a bad thing. Newborns may genuinely need a close warm loved one to help them make the transition to sleep. But many parents neglect to allow their own habits to change as their babies develop. They continue to hold their babies as they fall asleep, never even giving them a chance to begin to learn how to sleep on their own. If you’re holding, rocking, or feeding a baby while he falls asleep, the baby—guaranteed—will wake up again later that night after you sneak away. He will need you to come back and resume holding, rocking, or whatever to ease him back to sleep.

The concept here is “independent sleep associations,” referring to the kinds of things we’re used to having around as cues to help us fall asleep. It would be very hard for most of us to fall asleep without a pillow—because we’re used to having a pillow when we fall asleep. And if someone were to steal your pillow in the middle of the night, you can bet you’d wake up quick. If your baby depends on you as a sleep association, she will not stay asleep if you leave the room. You’ve got to camp out all night. Maybe that’s what you want to do. But if you’d like to have your own nighttime for yourself and your spouse, you cannot be a sleep association for your baby.

I’ll make it simple with some good rules of thumb: by two months of age, you should sometimes be putting your baby down when awake; by four months of age, you should usually be putting your baby down awake; by six months of age, always put your baby down while awake. If you never try, it will never work. It does not get easier to start working on these independent sleep associations as babies get older.

So what do you do when your baby isn’t falling asleep on her own? Follow the plan, and keep it simple. Put your baby down with confidence and no apologies. Say “Good night, honey, I will see you tomorrow.” Then leave. Do not go and check every few minutes—that teaches your baby that hysterics will bring mommy in running. The lesson here is: it is night, you are in your bed. It is time for sleep. This is the way it is. Now, you cannot make a child sleep—but you can control your own reactions. When Junior learns that this is the way it is, the crying stops, and the sleeping begins. Keep in mind that the older your baby is when you start this, the more stubborn she will be, and the longer she will cry.

Is it cruel to let babies “cry it out”? I do not think so. There will be hundreds of other occasions each day when your baby wants you to do something, and you’ll do it right away; there will be dozens of times each day when you’ll quickly respond to crying with hugs and reassurance. There are genuinely times when tough love is needed. When your 2 year old wants a candy bar at Target, she’ll throw a tantrum when you say no. Your teenaged daughter will scream “I hate you!” when you refuse to let her spend the weekend in Panama City with her boyfriend. Letting your baby cry at bedtime is not more cruel than other times when saying “no” is the right thing for a parent to do.

In fact, it may be more cruel to not let your baby learn to sleep through the night. For parents, lack of sleep contributes to marital discord, stress, and depression. You’ll be less patient and less engaged with your baby during the day when you’re exhausted. Furthermore, if you’re not getting a good solid night sleep, then your baby isn’t getting good sleep either—which compounds the cranky. In the long run, parents and babies need to get their solid sleep at night. Parents who delay sleep training are preventing their children from learning an important life skill while making family life miserable. Who’s being cruel?

Some babies will make this easy. Other babies will fight sleep and make this a more difficult transition. Exactly when to sleep train is a personal decision, depending on the parents’ plans and priorities. But if you want to get your young baby sleeping through the night, you don’t need a great big book to read. You just need to follow the three steps above, consistently, every night. It may seem rough at first, but soon you and your baby will all a better night’s sleep.

A shorter version of this was originally published on WebMD.

Filed under: Behavior