What the Experts Know about Infant Sleep
Also, some babies continue to wake up every few hours and need help to go back to sleep. So, if your baby is struggling in these areas, know you are NOT alone! Understanding how infants sleep at this age can help you establish reasonable expectations and goals.
Good sleep habits do not just easily happen for every baby; some will need help learning how to fall and stay asleep – and that’s okay! It all starts with knowing there are things you can do to help.
Forming Good Sleep Habits Early – Learning to Self-Soothe
Learning to go to sleep without help is called “self-soothing” and while this might sound cruel or heartless, be assured, it is not. Learning to sleep independently is an important developmental milestone. Other examples of self-soothing behaviors are finger sucking, pacifier sucking, cooing, rocking, and babbling.
Babies rouse frequently in the night because their sleep cycle is short, particularly in the light sleep phase. What this means is, babies often will awaken for no apparent reason (like hunger) and can learn to go back to sleep on their own.
Helping baby fall asleep on their own and then go back to sleep when they lightly awaken, lays the foundation for consistent good sleep – not only for your infant, but for you and your entire family.
Of course, for many families, this is easier said than done and once a baby has gotten used to falling asleep a certain way – such as while breastfeeding or being rocked – it can be a hard (but not impossible) habit to break.
For struggling families, sleep training is often recommended by pediatric healthcare providers as a way to address sleep issues by breaking old habits and forming new ones.
While breaking old habits is never easy, you can rest in knowing that much research has been done and results have shown safe sleep training methods are effective although typically only in the short term because baby’s sleep evolves as he grows.
Forming New Sleep Habits
For instance, it might be tempting to bring a fussy baby into bed with you – and this might actually work – but it’s not safe! You could accidentally smother baby with your bedding or body. Sleeping in your room in their own crib or bassinet is healthy and best for baby.
Creating an Enjoyable Bedtime Routine
The overarching idea is to create a calm and consistent bedtime routine that both you and your infant will come to expect and enjoy. This routine, coupled with a comfortable sleeping environment, will help cue your baby that it is bedtime and time to sleep.
Sleep Training Methods
First, discuss your concerns with baby’s pediatric healthcare provider and decide together what might work best for you, your baby, and your family.
Sleep training is a broad term used to describe many different methods used to train a baby to fall asleep (and go back to sleep) on their own.
The good news is most of the common methods that have been studied have been found to have some degree of success and no method has been found to cause harm to the baby, either physically, emotionally, or mentally.
Some of the most common (and studied) methods are briefly described here and most differ in how long the baby is allowed to cry, and what parents are “allowed” or suggested to do when they do cry.
Some are more gentle and “tearless” while others are more extreme, such as the “cry it out” or “extinction” method.
Breaking old sleep habits (such as being rocked to sleep, going to sleep with a bottle, or nursing a baby to sleep) may result in an unhappy baby at the beginning of the training, but will eventually pay off (often within a week).
One important key to successful sleep training is consistency in the training once you start – it can take upwards of a couple weeks to see good results for some methods, and not all methods work for every baby!
Here are some sleep training methods that have been studied with a brief description of how it works:
The Cry-It-Out Method
It has been shown to be effective and safe but can be hard for parents to listen to a lot of crying at the beginning. Parents lay the drowsy baby in the crib after feeding and bedtime routine and ignore crying until morning. Parents monitor the baby for safety and illness-type concerns until the baby goes to sleep, which on average the first night can be 45 minutes or more! A baby monitor with a camera works well here. This method often works after a few nights.
The Ferber Method: Graduated or Modified Cry-It-Out
Parents lay the drowsy baby in the crib after a bedtime routine, say good night, leave the room, and ignore crying for a specific period of time before briefly intervening.
The infant is soothed and patted, but not taken out of crib. Length of crying allowed is slowly progressed (increased) before returning to the room, generally progressing from 3 minutes, to 5, then 10, to 15 as needed. These methods are also quite effective and easier on parents.
The Parental Presence Method
Support means picking up and maybe briefly holding baby. The chair is slowly moved farther and farther away from the crib each night. These methods are effective and produce less crying for most, but typically take longer to see results.
The Pick-Up, Put-Down Method
Forming healthy sleep habits takes work and breaking not-so great habits even more work – but is well worth it if it leads to better sleep.
Talk to baby’s healthcare provider, come up with a plan, and then start! Be compassionate and loving, as well as consistent and tenacious: Don’t give up! Eventually, your little one will be sleeping through the night, and so will you.
Routines for an Enjoyable Bedtime
In the bedtime routine consider all or some of following strategies to help baby fall asleep on their own:
- Start your routine before your baby is overtired, which can make settling and falling asleep more difficult. Watch for sleepiness cues such as rubbing their eyes, yawning, or getting fussy.
- Plan to start your bedtime routine 30-60 minutes before bedtime.
- Keep the routine the same each night as much as possible.
- Decrease the lights, activities, and noise. Make sure the bedroom is fairly dark at bedtime.
- Give baby a bath or wash their face and put them in their pajamas plus perhaps a blanket sleeper—baby should wear one more layer than you to be comfortable for sleep.
- Feed baby, but do not let baby fall asleep in your arms or lay baby down with a bottle.
- Offer and encourage a pacifier–this also decreases the risk of sudden infant death syndrome.
- Sing or quietly talk to your baby while preparing for bedtime, but do not let baby fall asleep in your arms after age 4 months.
- Play soft music, read a book, or sing some songs/lullabies together.
- Try using a fan or other rhythmic/white noise in the room.
- Make sure the room is comfortably cool, but not cold.
- Finally, lay baby in their crib or bassinet when they are drowsy but not yet asleep.
Sharon C. Hitchcock, DNP, RNC-MNN
Sharon C. Hitchcock, DNP, RNC-MNN, is a nurse with more than 35 years of experience. She teaches obstetrics at the University of Arizona College of Nursing.
The information contained on this article should not be used as a substitute for the medical care and advice of your health care professional.