Sleep This is an important topic for
all ages and stages. Sleep requirements vary widely throughout
infancy and adolescence, and knowing and understanding these
variations can be helpful to the process of developing healthy
sleep habits.
The first thing on parents’
minds after they know they have a healthy baby is “how
long will it be before we are sleeping through the night?”
Family members and friends who immediately give suggestions
about how to make the baby sleep longer reinforce this. There
are a myriad of books and theories about getting newborns
to sleep longer and putting them on schedules etc. Clearly,
there is no one right way to do it. In addition, every baby
is an individual and there is a range of what is normal. Understanding
that will help parents of newborns to deal with the challenges
faced in those first sleep deprived months. Remember, that
in the scheme of things, this is a very short time, although
while in the middle of it, it can seem never-ending.
Newborn babies are eating,
sleeping, peeing, and pooping machines. They often have no
concept of day and night, or seem to be confused between the
two. In fact, many women notice that the baby is more active
at night than in the day in the last couple of months of pregnancy.
The immediate newborn period is spent in the confusing atmosphere
of the hospital. Once home, the fun begins! The establishment
of good sleep habits actually starts this early. When the
baby is brought home from the hospital, a primary sleep location
should be established. For many families, the first few weeks
are spent with the baby sleeping in a bassinet by the parents’
bed. The American Academy of Pediatrics recommends not having
the baby sleeping in the bed with parents for safety reasons.
Also, this can be a tough habit to break if it goes on and
on. All newborns, unless specifically instructed otherwise
by your pediatrician, should be placed to sleep on their backs
with no loose bedding or stuffed animals to prevent sudden
infant death syndrome SIDS.
Even though a newborn may
not really understand the cues you are giving with a consistent
sleep routine, eventually she/he will, and the repetition
of it is good for everyone, including parents. Newborns need
to eat roughly every 2-3 hours during the day and no less
than every 3-4 hours at night until instructed by your pediatrician.
Some babies want to eat every 2 hours around the clock and
this can be quite tiring. Luckily, it is usually only for
a couple months at most. The pediatrician will usually be
seeing the baby within 2-3 days after discharge from the hospital
and again at 2 weeks of age, unless more frequent visits are
needed. Most babies regain or surpass their birth weight by
2 weeks and then can be allowed to go longer stretches between
feedings than 4 hours if the baby is willing. Some will be
and some won’t. If a baby can go 4 hours between feedings
during the day, they should be able to do it at night, but
they most likely will do it either in the day or the night.
Most people want those longer sleep stretches to occur at
night. Therefore, once instructed by the pediatrician that
it is ok to let your baby go 4 or more hours between feedings,
continue to wake the baby every 2-3 hours during the day for
feedings and let him/her sleep longer at night.
After feeding your baby,
make sure to burp the baby for up 10 minutes to get a good
burp out. If you are unable to get the baby to burp well after
10 minutes of trying, you are unlikely to be successful with
more trying so stop. If a baby doesn’t burp well, the
air that was swallowed into the stomach while feeding is going
to have to go through the entire intestinal tract and come
out the bottom. It will do that! It might be uncomfortable
for the baby or appear to be painful at times, but it is natural
and not harmful. It can make for a fussy baby, though. If
you have a baby like this, you might try different burping
positions, infant gas drops, burping halfway through the feeding,
changing bottles if you use them, and changing your diet if
you breast feed. See your pediatrician if gas or fussiness
is extreme for further advice.
Most sleep experts recommend
putting a baby to sleep fed, cleaned, and comforted, but awake.
This allows the baby to learn how to fall asleep on his own,
without having to rely on someone to do it for him. While,
at the beginning, it can feel so wonderful to rock the baby
to sleep, you are not going to want to be doing that in another
few months or years, especially if you have or are planning
on having other children. You can rock the baby to relaxation
and sing or pat as part of the bedtime routine, but put the
baby down on his back in his crib or bassinet relaxed but
awake. Most babies in the first month or so of life like to
be swaddled while sleeping, so learn how to do it the way
your baby likes it. Some like hands free some like hands in
the blanket. Baby will let you know. Just remember, no loose
blankets in the crib for babies under 1 year.
When to put the baby in his/her own
room? This question plagues many parents, and there is really
no right answer. However, if the baby is in your room, you will
likely hear every peep and groan she makes while she sleeps.
While these don’t wake her up, they will probably wake
mommy up. This leads to very poor rest and real sleep deprivation
for an already tired mommy. Most babies have a rather loud cry
when they are hungry or in need of something, which will wake
up most moms even if the baby is in another room in the house.
If you are fearful you won’t wake up you can get a baby
monitor, but remember you will hear all the noises the baby
makes with those. If you know that the baby has been fed, burped,
changed, cuddled, and is not hungry, a little crying is ok.
For the middle of the night feedings especially, try to stimulate
the baby as little as possible. Don’t turn on the lights
in the room, if possible, or dim them way down. Feed the baby,
burp, and change as usual, but resist the temptation to play
with the baby. Sing and cuddle gently and quietly and lay the
baby on her back in the crib to sleep swaddled, and leave the
room. This avoids over stimulating the baby, which can make
it difficult for the baby to settle down to sleep, and it sends
the proper message that it is nighttime and we sleep during
this time. Find some words or a song that you associate as comforting
and repeat these every time you are laying the baby to sleep,
even in the daytime for naps. This will be associated with calming
and comforting and sleep for the baby too eventually, and is
a powerful tool for both you and the baby to develop and keep
good sleep habits. As the baby gets older, you can add more
on to the sleep routine like reading, bathing, etc. For more
information check out www.kidshealth.org/parent/growth/sleep/sleepnewborn_p3.html.
Usually, by 2 months, the
worst sleep deprivation has passed, at least we hope. If you
have been trying to establish good sleep patterns, you have
probably been rewarded with 4-6 hours or more of sleep at
night. If not, hang in there. Continue to practice what you
have been doing, or get started right now! Babies learn everything
by repetition, including sleep habits. Understand that some
kids really are excellent sleepers and some are not. Some
will sleep well at night, but catnap during the day. Try to
establish good naptime sleep routines as well as nighttime
sleep routines. By 2 months, you should be able to tell when
your baby is sleepy. It can be clues like rubbing the eyes,
looking away from you when you try to play, looking tired,
yawning a lot. Don’t ignore these clues. When you see
the baby, and later the child, exhibiting these behaviors
acknowledge them! Say to the baby, “I think you are
getting sleepy.” Let’s get ready to take a nap”.
“Let’s get ready to go night night.” Then
start getting the baby ready for sleep. Whether that includes
feeding, diaper changing, singing, cuddling, do the routine
in the same order with a minimum of active stimulation, and
put the baby down in his/her usual sleeping place awake, but
relaxed, and leave. Most babies take 2 daytime naps once they
are beyond the feeding every 2-3 hours during the day. Some
kids are like clockwork with their sleep times, others vary
widely. Try to stick to roughly the same schedule during the
day so the baby can learn to regulate his clock both during
the day and at night. For more information check out www.kidshealth.org/parent/general/sleep/sleep.html.
Talk to your baby’s
pediatrician if you are having problems with your baby’s
sleep.
This age group can be a
challenge when it comes to sleep because they are testing
limits and boundaries in every aspect of their lives and sleep
is no exception. Remember to lower the crib mattress to the
lowest setting to avoid climb outs. At this point, it is ok
to put soft toys and soft books in your child’s crib,
just don’t overcrowd the place. It is great for the
child to have something to entertain herself with when she
wakes in the morning or the night or from a nap. There is
nothing wrong with a baby having some alone time in the crib
while awake. The crib should be your child’s special,
safe place, and a place of refuge and comfort. Don’t
use the crib as a punishment ever. During the day, if you
feel that the child needs to take a nap, start the nap routine,
and put the child in the crib. Even if she doesn’t fall
asleep right away, it is ok. At this age, many children resist
going to sleep for naps and at night because they don’t
want to miss a minute and they are just contrary by nature.
Pay close attention to your child’s “tired cues”.
When you see them, acknowledge them verbally and start the
nap routine. Try to have a fairly consistent bedtime as well
as a bedtime routine. Children are very affected by the light
patterns outside and will usually start to get tired as it
starts to get dark out. Respect this and try to adjust the
family schedule accordingly. You and your child will reap
the benefits now and into the future.
Don’t allow your child
to take a bottle into the crib. It is a terrible habit that
promotes tooth decay, over eating, and dependence on the bottle.
If your child already has that habit and he has teeth, you
must break the habit as soon as possible. Talk to your pediatrician
about how to do it. A suggestion is to progressively dilute
the milk or juice in the bottle with more and more water each
day/night until there is just water in the bottle. The child
will usually reject it at this point. Even if the child does
drink a water bottle in the crib, at least it won’t
rot his teeth.
In this age group, most
kids sleep between 10-13 hours in 24 hours. Usually, they
divide it between night and naps, but there are no hard and
fast rules. As far as when to transition your child out of
the crib into a toddler bed, the rule of thumb is safety first.
If your child, at whatever age, is making efforts to climb
out of the crib and you think he might actually be able to
do it, lower the crib mattress as much as possible, and if
he still can manage to get out, the transition time has come.
Most kids between 4 and
5 years sleep from 10-12 hours in 24 hours. Although most
still take some kind of a nap, some kids get all that sleep
at night. Nevertheless, I recommend “quiet time”
in place of naptime. This allows the child to unwind and “chill
out” on his own, and gives a parent a break. Most preschools
have this too. Remember to continue or start the consistent
sleep time routines in this age group. Most children of this
age love a story before bed, which is a bonding time for them
with parents and promotes a love of books. Try not to allow
the child to keep extending the bedtime routine by asking
for just one more story. Establish the 1-3 stories you will
read, and they can be the child’s choice and that is
it. Also, letting a child pick out his pajamas each night
gives the child a feeling of control, which kids desperately
want.
In general, kids in this
age group need 10-11 hours of sleep, and most all get it at
night. The naps are generally gone and should be since the
child is in school all day. If your child needs a nap during
the day, try to have an earlier bedtime. Also, kids should
get up 1 hour before they need to leave the house to get to
school on time so that they have enough time to wake up, clean
up, get fed, get organized, and get out of the house without
feeling rushed. Feeling rushed in the morning is a lousy and
stressful way to start the day. Also, when there is not enough
time to get ready in the morning, something that needs to
be done will not get done. Usually, this is eating breakfast,
the most important meal of the day. Sometimes, homework assignments
will be left at home in a rush to get out of the house. Also,
try to avoid having the television on in the morning because
it is distracting and may make people unable to complete all
their morning tasks on time to leave the house. In
addition, morning breakfast together is a nice time for the
family to touch base and think about what their day is going
to be like.
Once again, this can be a tough time. Most teens really need
8 ½ to 9 ½ hours of sleep each night, but rarely
get it. Their biological clocks really do make them not tired
until later at night and then it is harder to wake up for
school in the early morning when most high schools start.
Hopefully, you have taught your teen good sleep habits all
along, but even that is no guarantee of success. Educating
your teen on what is normal and needed may be helpful. You
and your teen should check out http://www.kidshealth.org/teen/your_body/take_care/how_much_sleep.html
for more information.
