 The most common ‘problem’ reported to me by parents is frequent nighthawking’s, we can deal with anything if we can get some sleep at night, we expect sleep to be broken in the newborn stage but months or years of broken sleep can really take its toll on the whole family. I want to share 3 steps you can take that improves nighttime sleep – without doing any nighttime coaching. Firstly – let’s get realistic Although it may feel like everyone else’s baby is sleeping through the night and taking long naps every day, the truth is that’s not the norm, a recent analysis of the most credible studies found that it is common for babies to be waking on average between 1-3 times until 18 months and still waking a couple times at night (infrequently) until 24 months [i] Naps can also be a real bone of contention for parents, naps can range from 20 mins to 2 or even 3 hours at a time, but frequent short naps can be just as rejuvenating as less frequent longer naps, a true nap pattern begins to emerge around 4/5 months but it doesn’t feel like there is any pattern or routine until more like 6 months to most parents. Sleeping needs and patterns are individual and different from baby to baby, so if your baby is thriving on short cat naps this is ok, there is no need to ‘fix’ this, if they are grumpy and grouchy then supporting longer naps at optimal times might be useful. If you are struggling with naps or frequent nighthawking’s how you structure your day can be a game changer. 1: Structuring the daytime (while being flexible) The purpose of naps is to reduce sleep pressure – the drive to fall asleep that builds over the hours of wakefulness. Children will have different limits on their sleep pressure depending on their age. A newborn may only be able to stay awake for 45 minutes before their sleep pressure builds to the point where they need to go to sleep again. If baby does not go to sleep when their sleep pressure begins to rise, they will release cortisol to stay alert. This sometimes makes going to sleep harder, however if an older child is going down for naps when their sleep pressure has not built up fully, they may protest taking a long time to fall asleep or fall asleep ok but take short crappy naps – there is a balance between overtired and not tired enough. It is also useful to take a pragmatic approach and aim for naps equally split over the day rather than aiming for a short morning and long lunchtime nap – this is usually hard to maintain and there is no evidence that this is helpful for babies. With this in mind, the best piece of information I can give you is a rough guide by age of how long a baby can cope with being awake before their sleep pressure builds fully. You can download a comprehensive guide to naps from newborn to age 3 at the end of this blog. It is also relevant to mention awake windows and very little about nap guidance in the sleep world is evidence-based, they come from experience/opinion and if you are feeling stressed out about wake windows then see my blog about alternatives
Most children are ready to drop their nap entirely by about 3 years and often sooner.
In addition, introducing sensory play in the waking hours, with tummy time, rolling practice, messy play, action songs and being out and about seeing the world really helps our babies sleep well for naps and nighttime. TIP: while short naps are common and welcomed, if you baby is taking a long time to fall asleep (over 20 minutes) at nap time this is very likely NOT overtiredness causing this, your baby is simply not tired enough and needs more sensory input and/or longer time awake. What about feeding? I never worry about 4 or 3 hourly feeds, in fact it rarely works out well and most parents get really concerned about a baby still sleeping who is due a feed according to the clock - feeding and sleep end up competing - so timed feeds can make parents anxious and that helps no one. While some babies might naturally fall into feeding patterns it is more likely every 2-2.5 hours in the daytime with longer blocks in the nighttime, as your baby grows we want to make sure they are getting the opportunity for more feeds in the 12 hours of day than in the 12 hours of night and also recognise that some feeds will be longer or shorter at different times of the day or on different days – this is normal. Some families prefer structure and rather than set times or spaced feeding schedules I like to follow a flow of 1: wake-up, 2: offer a feed, 3: sensory play, 4: sleep and so on throughout the day. What this might look like in practice: 5-month-old
What this might look like in practice: 9-month-old
2: Optimal Bedtime Ritual A regular bedtime ritual is one of the most important things to help a baby sleep well. An Ideal bedtime ritual, will boost connection with cuddles, feeding and lullabies but be short and predictable too. This gives everyone plenty of time to wind down from the day, but will not drag on so long that your baby starts to get overtired. We also know from clinical research that better sleep outcomes are associated with the more nights a week that a ritual is implemented[i].
Ritual example: 6:30 p.m. Bath time 6:40 p.m. Pajamas 6:45 p.m. Milk feed (keeping baby awake – you can swap the bedtime feed to step one, prior to the bath if it is difficult to keep awake) 7:00 pm. Stories / Song 7:05 p.m. In cot (awake) 3: Settling Approach There are two schools of thought on settling, one is that you MUST put your baby down awake and allow them to self-settle to sleep, the other is that we MUST help them to sleep by feeding or cuddling – which is right? Well in all honesty both – I mean in an ideal world most parents would wish for cosy cuddling to sleep then placing baby down soon after and their baby stays asleep and sleeps for longish blocks of time. BUT - The reality of doing a transfer can be tricky….if it is working for you please don’t fix it, if however it is not working it might be time to make a change. Commonly what I hear is that my baby was a good sleeper, sleeping well and then suddenly it seems to have regressed, this is usually more to do with your baby growing, needing less sleep than previous and becoming more aware - so what was working well (feeding to sleep, drowsy but awake, rocking) no longer works. In my experience how your baby falls asleep at bedtime has an impact on the frequency of waking’s in the nighttime, this is also backed up with evidence and research [ii] The understanding behind this, is that if your baby falls asleep by feeding to sleepy or drowsy then rocked and sung too, they will likely wake and signal for the same activity or device that helped them to fall asleep initially for all nightwakings, these strategies often work so well because babies develop a neural pathway that is being reinforced with repeated continuation and so it is easy to get them back to sleep and quickly, but in some cases it might be the reason that when they wake - they signal rather than move into the next sleep cycle. So what to do about that? Gently and over several weeks set things up so your baby can settle to sleep without these activities or devices, it does NOT need to be a Cry-it-Out approach or even a Controlled Crying (Ferber) approach, it can be much gentler, slower and responsive than that. Here is a check list of the steps you might make:
Once you have made changes to the daytime schedule and how your baby falls asleep for naps and at bedtime you will likely see a big improvement in the frequency of unmanageable nighthawking’s – please let me know how you get on and download the freebies for more detailed information. Links for freebies: Comprehensive Nap Guide – Newborn to 3 Years http://sleep.nadiaedwards.co.uk/_naps [i] Mindell, J. A. et al. (2015) ‘Bedtime Routines for Young Children: A Dose-Dependent Association with Sleep Outcomes’, Sleep, 38(5), pp. 717–722. [ii] Adair, R. H. and Bauchner, H. (1993) ‘Sleep problems in childhood’, Current Problems in Pediatrics, 23(4), pp. 147–170. Sadeh, A. et al. (2007) ‘Infant sleep and parental sleep-related cognitions’, Journal of Family Psychology, 21(1), pp. 74–87. Sette, S. et al. (2017) ‘Predictors of sleep disturbances in the first year of life: a longitudinal study’, Sleep Medicine. Elsevier B.V., 36, pp. 78–85. St James-Roberts, I. et al. (2015) ‘Video evidence that London infants can resettle themselves back to sleep after waking in the night, as well as sleep for long periods, by 3 months of age’, Journal of Developmental and Behavioral Pediatrics, 36(5). Comments are closed.
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