Parenting • Sep 20, 2012

Solving Baby’s Sleep Problems

When my first son came home from the hospital, I was surprised by how noisy he was when he slept at night.  The grunting, snorting and wiggling were not at all like what I had seen of OTHER people’s sleeping babies.  I waited for the day when he would move out of our bedroom and into his own, so that I could sleep well again.  How little I knew!  Now I know.  When you become a parent, sleep will never be the same.

Throughout his first year, my first son did not sleep well, and was not an “easy” baby.  I could not get him to fall asleep in a crib without tears – both his and mine – and when he did fall asleep, I was so worried about when he would wake up, I never felt relaxed.  I was told by friends, and by my pediatric training, to let him “cry it out,” but after several miserable attempts it became obvious to me, my husband and my son, that I had no stomach for letting my little guy cry without attention.  Driven to distraction by sleep deprivation and frustration I began reading books on infant sleep.

I think I read every book about infant sleep that has been written.  Driven by the doctor in my heart, I also read the medical literature on sleep.  Very little of what I read was helpful in a practical sense.  Many parenting books left me feeling guilty that my son’s sleeplessness was my fault, some made the problem worse, and some actually gave advice that was inappropriate – from a developmental standpoint.  One book gave practical, medically and socially sound advice that was helpful and achievable.  That book was Good Night, Sleep Tight by Kim West.  I recommend it to friends and parents to this day.   One dad liked the book so much he actually bought an app, and put the book on his iPhone for easy reference.  Because I’ve read all of the books on the market about infant sleep, let me save you some time and share with you what I have learned.

(**If you are – as I was – a new mom desperately Google-ing infant sleep because you are sleep deprived and frustrated, then skip to the chase.  Stop reading this and go buy the book Good Night, Sleep Tight by Kim West.  You can read what I’ve written later.)

Here are a few things I learned about the physiology of sleep, that I wish I had known before I had children.

Throughout your child’s life, remember that sleep time is brain development time.  More is better.  Some kids need less, some kids need more, but whatever they need, advocate for them getting their sleep time.

In the first 2 months of life, babies sleep on a 24-hour clock because they don’t secrete melatonin.  Melatonin is what makes us sleepy at bedtime, and regulates our sleep and wake cycles.  Light, in turn, regulates when we secrete melatonin.  If you want to help your baby make melatonin at the right time, expose them to first morning sunlight.  Then, when they begin to secrete Melatonin between 9 and 12 weeks of life, they’ll be sleepy at nighttime.  Before 9 weeks, they sleep on a 24-hour schedule.  They need about 18 (!) hours of sleep per 24-hour period.  The 6 hours of wakefulness USUALLY occur in short bursts of 1 hour at a time.  If your baby is grouchy an hour after he wakes up, he may be tired.

Don’t believe folks who tell you your newborn has day and night mixed up.  Newborns don’t care about day and night.  Just smile and tell them you’re working on it.

Sleep begets sleep!  If babies are kept up in the day to help them learn to sleep at night, they can get over-tired.  That makes it harder for them to fall asleep.  Have you ever been TOTALLY exhausted, laid down for a good night’s sleep, and then not been able to fall asleep?  Well, that happens for babies who are over-tired.  If your baby does get over-tired, help them fall asleep to catch up – a swing or a car ride can help.

Try your very best to keep to a similar schedule from one day to the next.  Put your baby down for naps in the same place, at the same time each day.  Once babies reach 2 months of age, they often begin to nap longer and at more distinct times.  They need a morning nap, an after lunch nap, and a late afternoon nap.  This will gradually convert into 2 naps per day and then down to one.  Kim West’s book outlines sleep needs and recommends schedules beautifully.  Taking naps away from children too soon usually does not help them sleep better at night.  It just makes them grumpy.

One other thing that I would share with all parents, is that sometimes, when in a very loud or bright or stimulating environment, babies will pretend they are asleep.  This is called habituation.  It is a mechanism of self protection that babies use when they are over-stimulated or tired and cannot sleep because of the noise going on around them.  We once took our six month old to a two year old birthday party at Chuck-E Cheese’s.  If there is a place on this planet where an infant may habituate, that would be it.  During the party, Simon looked like he was asleep.  After the party, he cried for hours.

Babies habituate to decrease the amount of stimulation they are getting, but it is not the same as sleep.  It takes some effort for them, and it is not restorative.  If your baby appears to be asleep at a party, and then has trouble with fussiness, crying or difficulty falling asleep, it was most likely habituation.  It can be really confusing to think your baby had a nice sleep, and then find them to be out of sorts later.  The solution is to help them through the overtired period with minimal stimulation, helping them fall asleep with a swing or a drive.  And more importantly, though sleep time doesn’t have to be perfectly quiet and perfectly dark all the time, know that baby’s sleep is most restorative in a quiet place that is dark.

Whatever you choose to help your baby sleep well, be confident that it is the best choice for your family.  Use safe sleep practices as recommended by the back to sleep program, and never use medicines to help your baby sleep without talking them over with your doctor first.  Make sure you sleep when you can, because you’ll be a better parent if you are well-rested.