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Healthy Children

with Steven Parker, MD

This blog is now retired. Dr. P passed away on Monday, April 13, 2009. The WebMD Community will dearly miss his kind, caring, and often humorous manner.

Wednesday, April 26, 2006

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:

  1. 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!).

  2. 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.

  3. 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?

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    Posted by: Steven Parker MD at 10:25 pm

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