Sleeping through the night
Dr. P: My 3-week-old is awake all night and sleeps only for a few hours at a time during the day. I'm exhausted! Is there anything I can do to make her sleep longer,
especially during the night?
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I feel for you. Caring for any infant is a ton of work, but it's even harder when you are sleep deprived and exhausted.
What's going on
It would be nice if falling asleep was as simple as flipping an "off" switch in the brain. (It would be even nicer if an "on/off" switch was affixed to the outside of every baby's body!). Alas, it's not that simple.
In fact, the processes that regulate sleep patterns are quite complex. They involve the brain responding to various hormones in the body and to environmental stimulation. Plus, different parts of the brain must be turned on and turned off in a coordinated fashion. Only when the brain is mature enough to regulate all of these processes does a regular sleep pattern and the ability to sleep through the night emerge.
(An ex-boss used to say that, like all department chairmen, "I sleep like a baby. I wake up every three hours and cry.")
The good news / bad news is that the ability to sleep through the night typically occurs around 4-6 months of age. Until that time, it's unrealistic (and unfair) to expect your baby to be a great sleeper or for you to be able to do much about it.
The average newborn sleeps around 15-16 hours or so, but that sleep may occur unpredictably, at any time, and for just a few hours at a time. As the brain matures over the first months, you'll thankfully begin to see a pattern emerge: longer periods of sleep (hopefully at night); more activity in the day, less at night; more sleep during growth spurts (much of growth occurs during sleep).
What does this mean?
Have realistic expectations. Every baby is different and you could luck out, but for most the first months will likely be no picnic when it comes to your baby's (and, therefore your) sleep.
Since it takes 3-6 months for a baby's brain to mature enough to establish a regular pattern and to sleep through the night, it usually doesn't make sense to let them "cry it out" or use other methods to try to teach them to sleep through the night at an earlier age.
But that doesn't mean you can't set the stage for good sleep patterns to emerge when the time is right. Here's how:
- Help to regulate her day-night sleep cycle.
- During daylight hours, keep things stimulating and active.
- Play with her a lot when she is awake.
- Try to keep her awake after feedings (often a losing battle!).
- When it's dark, become a more 'low key' parent.
- Feed her in a semi-darkened room.
- Cut down on all stimulation e.g., keep light and noise soft and low.
- Keep life boring. Hopefully, she'll come to learn that daytime is fun time and night time is boring, so I might as well sleep when it's dark outside.
- Begin to teach your baby to fall asleep on her own, without getting used to (and then becoming dependent on) being held, rocked, fed, etc. The goal will be that when she awakens in the middle of the night at 9 months of age (as most babies do), she will be able to get herself back to sleep without the need for you to come in and rock, feed, or soothe her.
- After a few weeks (when everyone is not so sleep-deprived and things are settling down) begin to try to put your baby to bed awake and drowsy whenever you can, so she can learn to fall asleep on her own. Remember that teaching an infant to fall asleep on her own is learned over months. Your goal should be try to put your infant to bed when awake and drowsy if at all possible (which it often may not be). But, if you are reasonably consistent, over a few months she still will get the message.
- And keep in mind, that promoting such independence in falling asleep is for the good of the family and for your own sleep. Your infant will do fine and get plenty of sleep no matter what you do or don't do. If you are not worried about your baby's eventual ability to fall asleep on her own, feel free to skip all of this "sleep hygiene" advice!
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"There never was a child so lovely, but that his mother was glad to get him asleep."
Ralph Waldo Emerson (American philosopher, 1803-1882)
Related Topics: Why a Good Night's Sleep is Important for Children, WebMD Video: Is Your Child Sleep-Deprived?
Technorati Tags: infant sleep, co-sleeping, family bed
22 Comments:
I especially like your last thought, about all the sleep training being for the good of the mother and family. Such important words, especially for the sleep-deprived anxious mothers that are sometimes faced with sleep nazis from whichever side of the cry-it-out front.
Good sleep is important for everybody in the family. I counsel parents that if they want to solve a child's sleep problem, they are going to have to endure a certain amount of pain.
Don't forget about dad. He's the person in the family whose sleep is most often neglected. Everybody needs to sleep.
best,
Flea
Great tips. Of course this is from a mother who has kids that sleep through the night at very early ages so I don't have to deal with the extended sleep deprivation.
I've found that babies tend to sleep through the night once they reach about 15 pounds.
For new moms, the only wy to get sleep (though it will never be enough) is to sleep whenever the baby sleeps. Forget the cleaning, farm out the older kids to daycare or school or babysitters, and SLEEP!!
So can I assume this post is up for grabs for Peds Grand Rounds? I'm going to use it unless I hear otherwise(if that's okay).
I don't want to change to topic, but how do I ask a question about a different problem.
Patty
Hi Patty,
You can post questions about your child on our Pediatrics: Steven Parker, MD board. :-)
I have a 2yr old who still gets up at night, sometimes multiple times. I definately believe that in setting good, healthy patterns there will be a certain amount of pain along the way before you achieve the final result!
I love your approach... "reasonably consistent". Parents need to know that helping a child develop good sleeping habits can take a few months. There are too many 'systems' in place that teach parents that it should only take a week or ten days to correct a child's nighttime behavior. Falling 'off the wagon' once in a while isn't going to ruin the child forever. Parents will find more helpful childrens health articles at www.yourchildrenshealth.com. - Miranda, mother of one
I to am rasing a granddaughter. She gets up about every 2 -3 hours for about 2ozs of milk. Then back to sleep again. Alot of times she lays and whimpers out. After having tubes put in her ears she has become some what content with playing and not always being held or her crying. Im just worn out and would like to know how to get some rest.
I found that with my second daughter, co-sleeping with her for the first several months gave me a chance to sleep more.
And with nursing while lying down in bed, we both slept alot more than I did with my first daughter, who did not co sleep with us.
I slept so much better and I think my daughter did too when we co-slept. I wouldn't do it any other way if the opportunity arises again!
I have a 3 year old boy who seems to sleep allot in my eyes, But I am not sure, I pick him up from my former wifes house at 530 pm and he often falls asleep on the way home by about 550 pm and sleeps through the night...I know he doesnt take naps during the day on a regular basis like he used to and he wakes up around 630 or 7 in the am.. I dont know if this is too much sleep or if there is something I need to do differently, anyone have any thoughts?
to get your new borns asleep you should keep a daliy routine and then they will soon learn to sleep on there own.
I have a 5 and a half month son who still wakes up once a night wanting a bottle. He is eating three meals a day and having about 4 to 5 6oz a day. What should I do?
I have a 6 month old son that still wakes up once a night wanting a bottle. He is eating three meals a day and having about 5 6oz bottles a day. What should I do
my almost nine month old still gets up every 2-3 hours, sometimes every hour. my doctor says some babies just arent good sleepers, but i am going nuts! I need sleep thru the night, so does my son...of all the 'fail proof' books, dr. advice, methods which do you suggest?
my 8 month old son does not sleep at night or the day just a few hours during the day if iam lucky and may 2 hours at one time at night he wants to eat everytime he wakes up thats the only way i can get him back to sleep i have tryed the "cryin it out" he did so for 3 weeks nothin changed maybe even made it worst i have tryed walkin and rockin and drivin everything that every baby book i have seen i dont know what to do anymore i need to sleep and i know he does to how do i do it this is my last resort please help us
I have a 4 week old that sleeps all day long, no matter what I do to try and keep her up and is up all night long. I am doing ok on sleep right now but I go back to work in 5 weeks and I need to get some sleep at night when I return.... Getting longer and longer each night.....
My nine month old daughter wakes up every couple of hours at night screaming. She doesn't seem to be awake but it takes 20 minutes of soothing her for her to fall asleep again. I've tried putting her to bed later, getting her really tired. We've tried the bath's, cereal bottls - everything. She plays hard during the day but will not sleep through the night. It is becoming extremely frusterating given that her older sister shares a room and will wake up to it. Any suggestions or help would be extremely appreciated!
To Airmanperryswife:
Please feel free to join our Parenting message boards, where other parents with younger kids will be glad to share with you.
I have a 10mo old who always used to be a very good sleeper. He used to sleep 10-12hrs. a night until he started teething at around 9mos. Since then he wakes a few times a night. He doesn't seem to want as many bottles during the day but instead wants them at night. We have tried putting him to bed later but he does not fill himself up therefore he wakes a few hours later hungry and upset. Any ideas on what I should try? We are getting very exhausted and worn out since we also have a 3yr. old and crying it out doesn't seem to be a very good option.
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