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31 WAYS TO GET YOUR BABY TO GO TO SLEEP AND STAY ASLEEP EASIER
Over the years of putting our own children to sleep and keeping them asleep,
and counseling thousands of other moms and dads on various styles of nighttime
parenting, here are some time-tested, proven attitudes and techniques. Most of
these are applicable to infants and toddlers of all ages.
NIGHTIME PARENTING DECISIONS
Develop a realistic attitude about nighttime parenting. Sleeping, like
eating, is not a state you can force a baby into. Best you can do is to create a
secure environment that allows sleep to overtake your baby. A realistic long-
term goal is to help your baby develop a healthy attitude about sleep: that
sleep is a pleasant state to enter and a secure state to remain in. Many sleep
problems in older children and adults stem from children growing up with an
unhealthy attitude about sleep—that sleep was not a pleasant state to enter and
was a fearful state to remain in. Just as daytime parenting is a long-term
investment, so is nighttime parenting. Teach your baby a restful attitude about
sleep when they are young and both you and your children will sleep better when
they are older.
Beware of sleep trainers. Ever since parenting
books found their way into the nursery, sleep trainers have touted magic
formulas promising to get babies to sleep through the night – for a price and at
a risk. Most of these sleep-training techniques are just variations of the old
cry-it-out method. And technology has found its way into nighttime babycare by
providing tired parents with a variety of sleep-inducing gadgets designed to
lull a baby off to sleep alone in her crib: oscillating cradles, crib vibrators
that mimic a car ride, and teddy bears that "breathe." All promise to fill in
for parents on night duty. Be discerning about using someone else's method to
get your baby to sleep. Before trying any sleep-inducing program, you be the
judge. Run these schemes through your inner sensitivity before trying them on
your baby, especially if they involve leaving your baby alone to cry. Does this
advice sound sensible? Does it fit your baby's temperament? Does it feel right
to you?
If your current daytime or nighttime routine is not working for you, think
about what changes you can make in yourself and your lifestyle that will make it
easier for you to meet your baby's needs. This is a better approach than
immediately trying to change your baby. After all, you can control your own
reactions to a situation. You can't control how your baby reacts. Use
discernment about advice that promises a sleep-through-the-night more convenient
baby, as these programs involve the risk of creating a distance between you and
your baby and undermining the mutual trust between parent and child. On the
surface, baby training sounds so liberating, but it's a short-term gain for a
long-term loss. You lose the opportunity to get to know and become an expert in
your baby. Baby loses the opportunity to build trust in his caregiving
environment. You cease to value your own biological cues, your judgment, and
instead follow the message of someone who has no biological attachment, nor
investment, in your infant.
Especially in the first six months, avoid sleep trainers who advise you to
let your baby "cry-it-out." Only you can know what "it" is and how to respond
appropriately to your baby. Using the rigid, insensitive "let-him-cry-it-out"
method has several problems. First, it will undermine the trust your baby has
for nighttime comfort. Second, it will prevent you from working at a style of
nighttime parenting until you find the one that works best for you and your
family and third, it may keep you and your doctor from uncovering hidden medical
causes of nightwaking. Nightfeedings are normal; frequent, painful nightwaking
is not. (See related lessons:
Hidden Medical Causes of Nightwaking,
Letting baby "cry it out" yes, no?, and
4 Possible Hidden Causes of Colic.
Stay flexible. No single approach will work with all babies all the time
or even all the time with the same baby. Don't persist with a failing
experiment. If the "sleep program" isn't working for your family, drop it.
Develop a nighttime parenting style that works for you. Babies have different
nighttime temperaments and families have varied lifestyles. Keep working at a
style of nighttime parenting that fits the temperament of your baby and your own
lifestyle. If it's working, stick with it. If it's not, be open to trying other
nighttime parenting styles. And, be prepared for one style of nighttime
parenting to work at one stage of an infant's life, yet need a change as she
enters another stage. Be open to trying different nighttime approaches. Follow
your heart rather than some stranger's sleep-training advice, and you and your
baby will eventually work out the right nighttime parenting style for your
family.
Decide where baby sleeps best. There is no right or wrong place for babies
to sleep. Wherever all family members sleep the best is the right arrangement
for you and your baby. Some babies sleep best in their own crib in their own
room, some sleep better in their own bassinet or crib in the parents' bedroom,
other babies sleep best snuggled right next to mommy in the parents' bed. Many
parents prefer a co-sleeper arrangement. Realistically, most parents use various
sleeping arrangements at various stages during the infant's first two years. Be
open to changing styles as baby's developmental needs and your family situation
changes.
Sleep is not a state you can force your baby
into. Sleep must naturally overtake your baby. Your nighttime parenting role is
to set the conditions that make sleep attractive and to present cues that
suggest to baby that sleep is expected. Try the following sleep tight tips,
which may vary at different stages in your baby's development. What doesn't work
one week may work the next.
Get baby used to a variety of sleep associations. The way an infant goes to sleep at night is the way she
expects to go back to sleep when she awakens. So, if your infant is always
rocked or nursed to sleep, she will expect to be rocked or nursed back to sleep.
Sometimes nurse her off to sleep, sometimes rock her off to sleep, sometimes
sing her off to sleep, and sometimes use tape recordings; and switch off with
your spouse on putting her to bed. There are two schools of thought on the best
way to put babies to sleep: the parent-soothing method and the self-soothing
method. Both have advantages and possible disadvantages.
Parent-soothing method. When baby is ready to sleep, a parent or other
caregiver helps baby make a comfortable transition from being awake to falling
asleep, usually by nursing, rocking, singing, or whatever comforting techniques
work.
Advantages:
Baby learns a healthy sleep attitude – that sleep is a pleasant state to
enter and a secure state to remain in.
Creates fond memories about being parented to sleep.
Builds parent-infant trust
So-called "Disadvantages": Because of the concept of sleep associations, baby
learns to rely on an outside prop to get to sleep, so—as the theory goes—when
baby awakens he will expect help to get back to sleep. This may exhaust the
parents.
Self-soothing method: Baby is put down awake and goes to sleep by himself.
Parents offer intermittent comforting, but are not there when baby drifts off to
sleep.
So-called "Advantages": If baby learns to go to sleep by himself, he may be
better able to put himself back to sleep without parental help, because he
doesn't associate going to sleep with parents comforting. May be tough on baby,
but eventually less exhausting for parents.
Disadvantages:
Involves a few nights of let-baby-cry-it-out
Risks baby losing trust
Seldom works for high-need babies with persistent personalities
Overlooks medical reasons for nightwaking
Risks parents becoming less sensitive to baby's cries
Remember, in working out your own parenting-to-sleep techniques and rituals,
be sensitive to the nighttime needs of your individual baby and remember your
ultimate goal: to create a healthy sleep attitude in your baby and to get all
family members a restful night's sleep.
Daytime mellowing. A peaceful daytime is likely to lead to a restful
night. The more attached you are to your baby during the day and the more baby
is held and calmed during the day, the more likely this peacefulness is to carry
through into the night. If your baby has a restless night, take inventory of
unsettling circumstances that may occur during the day: Are you too busy? Are
the daycare and the daycare provider the right match for your baby? Does your
baby spend a lot of time being held and in-arms by a nurturant caregiver, or is
he more of a "crib baby" during the day? We have noticed babies who are carried
in baby slings for several hours a day settle better at night. Babywearing mellows the infant during the day, behavior that carries over
into restfulness at night.
Set predictable and consistent nap routines. Pick
out the times of the day that you are most tired, for example 11:00 a.m. and
4:00 p.m. Lie down with your baby at these times every day for about a week to
get your baby used to a daytime nap routine. This also sets you up to get some
much-needed daytime rest rather than be tempted to "finally get something done"
while baby is napping. Babies who have consistent nap routines during the day
are more likely to sleep longer stretches at night.
Consistent bedtimes and rituals. Babies who enjoy
consistent bedtimes and familiar going-to-sleep rituals usually go to sleep
easier and stay asleep longer. Yet, because of modern lifestyles, consistent and
early bedtimes are not as common, or realistic, as they used to be. Busy two-
income parents often don't get home until six or seven o'clock in the evening,
so it's common for older babies and toddlers to procrastinate the bedtime
ritual. This is prime time with their parents and they are going to milk it for
all they can get. In some families, a later afternoon nap and a later bedtime is
more practical. Familiar bedtime rituals set the baby up for sleep. The sequence
of a warm bath, rocking, nursing, lullabies, etc. set the baby up to feel that
sleep is expected to follow. Capitalize on a principle of early infant
development: patterns of association. Baby's
developing brain is like a computer, storing thousands of sequences that become
patterns. When baby clicks into the early part of the bedtime ritual, he is
programmed for the whole pattern that results in drifting off to sleep.
Calming down. Give baby a warm bath followed by a soothing massage to
relax tense muscles and busy minds. Be careful, though, because this will
stimulate some babies.
Tank up your baby during the day. Babies need to learn that daytime is
for eating and nighttime is mostly for sleeping. Some older babies and toddlers
are so busy playing during the day that they forget to eat and make up for it
during the night by waking frequently to feed. To reverse this habit, feed your
baby at least every three hours during the day to cluster the baby's feedings during the waking hours. Upon baby's first
night waking, attempt a full feeding, otherwise some babies, especially
breastfed infants, get in the habit of nibbling all night.
TRANSITIONING TECHNIQUES
Many infants need help making the transition from being awake to falling
asleep, which is really a prolongation of the bedtime ritual that conditions
baby that sleep is expected to soon follow.
Nursing down. Nestle next to your baby and breastfeed or bottlefeed him
off to sleep. The smooth continuum from warm bath, to warm arms, to warm breast,
to warm bed is a recipe for sleep to soon follow.
Fathering down. Place baby in the neck
nestle position (nestle baby's head against the front
of your neck with your chin against the top of baby's head. The vibration of the
deeper male voice lulls baby to sleep) and rock your baby to sleep. If baby
doesn't drift off to sleep while rocking, lie down with your baby, still in the
neck nestle position, and let baby temporarily fall asleep draped over your
chest. Once baby is asleep, ease the sleeping baby into his bed and sneak away.
Rocking or walking down. Try rocking baby to sleep in a bedside rocking
chair, or walk with baby, patting her back and singing or praying.
Nestling down. For some babies, the standard fall-to-sleep techniques are
not enough. Baby just doesn't want to be put down to sleep alone. After rocking
or feeding baby to sleep in your arms, lie down with your sleeping baby next to
you and nestle close to her until she is sound asleep. We call this the "teddy-
bear snuggle."
Wearing down. Some babies are so revved up
during the day that they have trouble winding down at night. Place your baby in
a baby sling and wear her around the house for a half-hour or so before the
designated bedtime. When she is fully asleep (see limp-limb sign) in the sling, ease her out of the sling onto her bed. For babies
who are used to nursing off to sleep in a mother's arms, fathers can wear their
baby down to sleep and give mother a break.
Wearing down is particularly useful for the reluctant napper. When baby falls
asleep in the sling, snuggled with his tummy against your chest or draped over
your chest once you lie down, you both can take a much-needed nap.
Swinging down. Wind-up swings for winding down babies are a boon to parents who have neither the
time, energy or creativity to muster up rituals of their own. Tired parents will
pay anything for a good night's sleep. Once in a while a moving plastic seat may
be more sleep inducing than a familiar pair of arms. Sometimes high-need babies
associate a parent's body with play and stimulation and will not drift off to
sleep in a human swing. For them the mechanical one is less stimulating, if not
downright boring, and therefore can be a useful part of a sleep-ritual
repertoire. Yet remember, high-need babies are notoriously resistant to
mechanical mother substitutes and will usually protest anything less than the
real mom. Before you actually spend money on a swing, you might want to borrow
one for a week or two to see if the spell of the swing will last. You may
discover that you are uncomfortable with mechanical mothering and decide to get
more creative. Still, swings have their moments.
Driving down. If you've tried all the above transitioning techniques and
baby still resists falling asleep, place baby in a carseat and drive around
until she falls asleep. When you return home and baby is in a deep sleep, carry
the carseat (with the sleeping baby) into your bedroom and let baby remain in
the carseat until the first nightwaking. If she is in a deep sleep (witness the
limp-limb sign – hands unclenched, arms dangling loosely at her side, facial
muscles still), you may be able to ease her out of the carseat into her own bed.
Mechanical mothers. Gadgets to put and keep baby asleep are becoming big
business. Tired parents pay high prices for a good night's sleep. It's all right
to use these as relief when the main comforter wears out, but a steady diet of
these artificial sleep inducers may be unhealthy. We remember a newspaper
article extolling the sleep-tight virtues of a teddy bear, with a tape player in
his stuffing that sings or makes breathing sounds. Baby can snuggle up to the
singing, breathing, synthetic bear. Personally, we are not keen on our babies
going to sleep to someone else's canned voice. Why not use the real parent?
STAY ASLEEP TECHNIQUES
Now that you've learned all the tricks of the nighttime trade to get your
baby to sleep, here are some ways to keep your baby asleep. Because of the
characteristics of babies' sleep cycles and easy arousability from sleep, you
will notice that we purposely omit what we call the "harden your heart" method: put your baby down to sleep awake in a crib in
his own room, put cotton in your ears, and let him cry himself to sleep. When he
awakens, don't go into him. He will soon learn to put himself to sleep and back
to sleep. We believe that this method is unsafe, runs the risk of baby losing
trust, and, for infants with persistent personalities, doesn't work. Try these
tips to help your baby sleep increasingly longer stretches at night.
Dress for the occasion. Try various ways of
swaddling your baby at night. In the early months, many babies like to "sleep
tight," securely swaddled in a cotton baby blanket. Older infants like to sleep
"loose," and may sleep longer stretches with loose coverings that allow them
more freedom of movement. Oftentimes, dressing a baby loosely during the day,
but swaddling him at night, conditions the baby to associate sleep with
swaddling. A baby who gets too hot or too cold may become restless. Adjust the
layering according to the temperature of the room and the sleep habits of your
baby. Allergy-prone babies sleep better in 100 percent cotton sleepwear.
Quiet in the bedroom. Since most babies can block out disturbing noise,
you don't have to create a noiseless sleeping environment, yet some babies
startle and awaken easily with sudden noises. For these babies, oil the joints
and springs of a squeaky crib, put out the dog before he barks and turn the
ringer off on the phone.
Darkness in the bedroom. Use opaque shades to block out the light, which
may get you an extra hour of sleep if you have one of those little roosters who
awakens to the first ray of sunlight entering the bedroom.
Sounds to sleep by. Repetitive, nearly monotonous sounds that lull baby
to sleep are known as white noise, such as the sounds of
a fan, air conditioner, or even tape recordings of womb sounds or vacuum cleaner
sounds. Also, try running water from a nearby faucet or shower, a bubbling fish
tank, a loudly ticking clock, or a metronome set at sixty beats a minute. (These
can all be tape-recorded.) Try music to sleep by, such as tape recordings of
waterfalls or ocean sounds, or a medley of easy-listening lullabies on a
continuous-play tape recorder. These sleep-inducing sounds remind baby of the
sounds she was used to hearing in the womb. (See
11 Ways to Soothe Fussy Babies for more sleep-inducing tips.)
Music to sleep by. Try a continuous-play
tape recording of your baby's favorite lullabies, so when she awakens she can
resettle herself to the familiar sleep-inducing sound of the tape-recording. You
can make a medley of your own lullabies that have been proven sleep-inducers.
Leave a little bit of mother behind. If you have a separation-sensitive
baby, leave a breast pad in the cradle, or play a continuous tape recording of
yourself singing a bedtime lullaby.
A full tummy (but not too full). While stuffing baby with a glob of
cereal before bedtime seldom works, it may be worth a try. A tablespoon or two
given to a baby over six months of age may get you an extra hour or two. Tiny
babies have tiny tummies, a bit bigger than the size of their fist. So, your
baby's digestive system was designed for small, frequent feedings, which is why,
in the early months, babies feed at least every 3 to 4 hours at night and more
often during the day. (See Foods for Sleep)
Lessen physical discomforts.
1) Clear the nose. In the early months,
babies need clear nasal passages to breathe. Later they can alternatively
breathe through their mouth if their nose is blocked. Bedroom inhalant allergies
are a common cause of stuffy noses and consequent nightwaking. Dust-free your
baby's bedroom as much as possible. (Remove fuzzy blankets, down comforters,
dust-collecting fuzzy toys, etc.) If your baby is particularly allergy-prone, a
HEPA-type air filter will help. As an added nighttime perk, the "white noise"
from the hum of the air filter may help baby stay asleep.
2) Relieve teething pain. Even though you may not yet be able to feel baby's
teeth, teething discomfort may start as early as three months and continue off
and on all the way through the two-year molars. A wet bedsheet under baby's
head, a drool rash on the cheeks and chin, swollen and tender gums, and a slight
fever are telltale clues that teething is the nighttime culprit. What to do?
With your doctor's permission, give appropriate doses of acetaminophen just
before parenting your baby to sleep and again in four hours if baby awakens.
3) Change wet or soiled diapers. Some babies are bothered by wet diapers at night, most are not. If
your baby sleeps through wet diapers, there is no need to awaken her for a
change – unless you're treating a persistent diaper rash. Nighttime bowel
movements necessitate a change. Here's a nighttime changing tip: If possible,
change the diapers just before a feeding, as baby is likely to fall asleep
during or after feeding. Some breastfed babies, however, have a bowel movement
during or immediately after a feeding and will need changing again. If you are
using cloth diapers, putting two or three diapers on your baby before bedtime
will decrease the sensation of wetness.
4) Remove irritating sleepwear. Some babies cannot
settle in synthetic sleepwear. A mother in our practice went through our whole
checklist of nightwaking causes until she discovered her baby was sensitive to
polyester sleepers. Once she changed to 100 percent cotton clothing, her baby
slept better. Besides being restless, some babies show skin allergies to new
clothing, detergents and fabric softeners by breaking out in a rash.
5) Remove airborne irritants. Environmental irritants may cause congested
breathing passages and awaken baby. Common household examples are cigarette
smoke, baby powder, paint fumes, hair spray, animal dander (keep animals out of
an allergic child's bedroom), plants, clothing (especially wool), stuffed
animals, dust from a bed canopy, feather pillows, blankets, and fuzzy toys that
collect lint and dust. If your baby consistently awakens with a stuffy nose,
suspect irritants or allergens in the bedroom.
A warm bed. Placing a warm baby onto cold sheets can cause trouble.
Especially in cold weather, use flannel sheets or place a warm towel on the
sheets to warm them, and remove it before placing baby on the warmed sheets.
Create the right bedroom temperature and humidity. A
consistent bedroom temperature of around 70 degrees F is preferable. Also, a
relative humidity of around 50 percent is most conducive to sleep. Dry air may
leave baby with a stuffy nose that awakens him. Yet, too high a humidity fosters
allergy-producing molds. A warm-mist vaporizer in your
baby's sleeping area helps maintain an adequate and consistent relative
humidity, especially with central heating during the winter months. (And, the
"white noise" of a consistent hum may help baby stay asleep.)
WHAT TO DO WHEN BABY AWAKENSWHAT TO DO WHEN BABY AWAKENS
When your baby awakens, develop a nighttime
parenting approach that respects your baby's need for nighttime trust and
comfort, in addition to the need for baby and parents to quickly get back to
sleep. While some babies are self-soothers, being able to resettle easily and
quickly without outside help, others (especially those high-need babies with
more persistent personalities) need a helping hand (or breast, or whatever tool
you can muster up at 3:00 a.m.). Try these back-to-sleep comforters:
Laying on of hands. Determine what your baby's nighttime temperament is.
Is your baby a born self-soother who awakens, whimpers, squirms, and then
resettles by herself? Or is your baby, if not promptly attended to, one whose
cries escalate and becomes angry and difficult to resettle? If you can get to
your baby quickly before she completely awakens, you may be able to resettle her
back to sleep with a firm laying on of hands. To add the finishing touch, pat
your baby's back or bottom rhythmically to match your heartbeat. Remove your
hands gradually – first one and then the other – easing the pressure slowly so
as not to startle baby awake. Sometimes fathers, perhaps because they have
larger hands, are more successful in this hands-on ritual.
Honor your partner with his share of nighttime parenting. It's important
for babies to get used to father's way of comforting and being put to sleep (and
back to sleep) in father's arms, otherwise mothers burn out. A father's
participation in nighttime parenting is especially important for the
breastfeeding infant who assumes the luxury that "mom's diner" is open all
night.
Detect hidden medical causes of nightwaking. If you've tried all these
techniques and your infant is still waking up frequently – and painfully –
suspect there may be an underlying medical problem contributing to your baby's
nightwaking. (See Hidden Causes of Nightwaking) One of the
most common hidden medical causes of nightwaking (and colicky behavior) in
babies is a condition known as gastroesophageal reflux (GER). Due to a weakness
of a circular band of muscle where the esophagus joins the stomach, irritating
stomach acids are regurgitated into baby's esophagus, causing pain like adults
would call heartburn. Clues that your baby may be suffering from GER are:
painful bursts of nightwaking fussiness, particularly after eating; frequent
spitting up (although not all babies with GER spit up regularly); frequent bouts
of colicky, abdominal pain; frequent bouts of unexplained wheezing; and hearing
throaty sounds after feeding. Another hidden medical cause of nightwaking is
allergies to formula or dairy products, either in milk-based formulas or in
dairy products in a breastfeeding mother's diet. Clues that milk allergies may
be causing nightwaking (and colicky behavior) are bloating, diarrhea and a red
rash around baby's anus, in addition to many of the signs described above under
GER. If your baby is not only waking up frequently, but waking up "in pain,"
discuss these two medical possibilities with your doctor, since both can be
diagnosed and treated, giving everyone in the family a more peaceful night's
sleep.
The above tools not only help your short-term goal of getting your baby to
sleep, but, more importantly, create a healthy sleep attitude that lasts a
lifetime. A baby who enjoys this style of nighttime parenting learns that sleep
is a pleasant state to enter and a secure state to remain in. Therein lies the
key to nighttime parenting.
AskDrSears.com is intended to help parents become better informed consumers
of health care. The information presented in this site gives general advice
on parenting and health care. Always consult your doctor for your individual
needs.
