Welcome to Part II of my post-partum blog, in which I tackle the fascinating (if you’re a parent) and sometimes controversial subject of baby sleep. I remember having conversations with my friends about babies and sleep in which they told me not to count on any of my opinions holding water when my baby was born. And, for anyone who has met me, you’ll know I have a lot of opinions!
Having watched friends and clients parent for so many years, and having read every book I could get my hands on (from the useless to the excellent, and indeed one memorable book which included the horrifying suggestion by one ‘guru’ to hold your baby’s mouth closed at night when you want them to stop feeding!) I had lots of theories about how to help my baby learn how to sleep. I also knew without sleep myself I wouldn’t be able to be the parent I wanted to be; not as patient or good humoured, not as capable of singing and playing with my baby and not as able to think clearly about my choices day to day. Mostly, I’m happy to say that so far I have a baby who was demand fed and still slept through by 3 months, who adjusted to daylight savings over a 3 day period so remained happy to wake between 6-7am and not earlier, and whose sleep was disturbed when ill, but when well again went back to sleeping through the night. However, when I needed reassurance and questions answered when he was very small, and help with his napping during the day as he grew, I also knew where to go to get great advice. I think part of his ability to sleep, self-settle and nap is the luck of his nature, and part of this is also the 5 weeks his father and I spent doing Kangaroo Care with him which I am convinced gave him the best start in life which was possible (he was born at under 4lbs, and we didn’t want him to go into an incubator; Kangaroo Care is amazing as among the other benefits he didn’t lose any weight after his birth).
Here are some of the additional things I was aiming for: I wanted to be able to take my child out and have him be able to nap in a pram or a car, and sleep in a travel cot. I wanted to be able to go out to eat with my child, and have them be able to sleep where appropriate even if it was in a restaurant. Finally, and most importantly, I firmly believe that learning to settle and re-settle ones-self into sleep is a life skill and a gift I could give my child.
1. I believe one of the first things you need to do is to teach your baby how to sleep, and most importantly how to self-settle, as they aren’t born with this skill. Teaching your baby that he is OK on his own, as well as that you are there for them, gives them more than one resource if they are upset. I believe that if you don’t teach them this skill, then they think that the only way they can make things better when they are upset is with your help. The ability to self-settle is a life skill, which the books I have read talk about leading to the ability to play independently as they get older. This in turn will allow you to do necessary things like shower and eat – you will be able to pop your baby into a bouncy chair and do these things without all hell breaking loose!
2. Babies need to be able, sometimes, to cry in order to let their hormone levels reduce and then stabilise, their cortisol levels to die down to an appropriate level and their adrenalin to dissipate. If you seek to stop your child crying at all times and at all costs, then they will find it hard to settle themselves to sleep when they are babies, learn to calm themselves to the point that they are OK again if they hurt themselves when they are older, and generally learn that crying is an OK emotion to experience without trauma. I found that knowing the physiological importance of crying, and being able to differentiate between ‘Protest’ and ‘Distress’ crying, allowed me to judge when to intervene appropriately to soothe my child, and allowed me to let him cry when he needed to wind down without feeling too guilty or upset. As time went on and I saw the benefits of this approach, his minimal (literally minutes) protest crying became easier to deal with, and also allowed me the perspective to see when I wanted to go in to soothe him because I was finding his crying hard to deal with rather than letting him do what he needed to do for himself. I must stress here that I do not believe in ‘crying it out.’ I didn’t, and do not leave my child crying in distress, to the point of vomiting or in any discomfort. No protesting he did lasted longer than 10 or so minutes and this protest crying was intermittent, low and varied in pitch, and palpably different from his upset cry to which we always respond instantly.
3. Protest crying is a cry which changes in pitch, duration and intensity, and most often but not always has pauses. I would not necessarily go into my baby when he was doing this. A distress cry is a ‘wah, wah, wah’ sound, a sound with a repetitive and constant pitch and seemingly not requiring them to draw breath. This I would always, immediately, respond to. We found that very quickly, if we put him down and left the room and he made a distress cry, there was something wrong such as a wind bubble, a hand which was in the wrong place, or he had wedged himself somewhere uncomfortable and we trusted him to tell us when he needed us. As time went on, we would put him down and he would burble to himself and now he is 8 months old, chat happily until he has gone to sleep.
4. If your baby is fed, is not too hot/cold, is in a safe place, and you know he needs to sleep, then I think it is OK to leave him to do this provided he is not distressed. It is important to know the above physiology of your baby, otherwise leaving him to learn to settle just feels like you are neglecting or traumatising him.
5. If you ask your baby to lead your relationship, this is an insecure place for him to be. You need to lead your relationship by knowing what his basic needs are (for example an eating, playing, sleeping routine) and letting him know when to do what. His freedom comes within these activities, such as choosing which toy to play with, eating at his own pace or feeding himself rather than having you feed him, and settling into sleep at his own pace.
6. Babies have sleep cycles: 20mins is a nap. 30mins in an average babies sleep cycle during the day, and 60mins a sleep cycle at night. Somewhere between 3months and a year this elongates to 40mins during the day and 90mins at night. Between cycles, they often rouse to a greater or lesser extent. The trick here is to teach them to settle themselves between cycles.
7. Babies are noisy. Very noisy. Especially at night. This can keep you awake. If it starts to happen and you find yourself awake while your baby sleeps then don’t be afraid to move them to another room. This is what a video monitor is for, turned down to the lowest volume, or even turned off with the breathing/alarm mat still active. Believe me, you will hear them the moment they make any noise of meaning! But, the snuffling, grunting, snorting, farting, lip smacking, sucking etc etc, is tuned out.
8. Babies have something called a ‘Morro Reflex.’ If you watch them, you will see their arms jerk. They will start to grow out of this from 3months, but the reflex is there, according to some sources, as a primal thing to startle them in case they stop breathing. This is all very well, but it also wakes them up when they are trying to sleep! So, when I put my baby down to sleep for the first three months I swaddled him securely – but when he was swaddled, for the above reason, I always put him to sleep on his back on a sensor mat so if he did stop breathing I was immediately alerted. We used the Miracle Baby Swaddle, which has special arm flaps, but you can just use large muslin.
9. From the very beginning, be aware of the following things which make your life easier at the time, but long-term will make it much harder:
a. The cycle goes feed, play, sleep. If possible, I would try not to feed your baby and then put him down straight away as you will be teaching him that he needs to have food to help him relax enough to sleep. (I think the exception to this is the last evening feed, details about which will be in the next blog).
b. Always put your baby to bed awake, to a greater or lesser extent. Ideally he needs to wake up in the same place he went to sleep to avoid him being startled, insecure, unsettled and then upset and crying, and he needs to get himself to sleep so he can resettle himself. If he goes to bed asleep, in your presence, then he hasn’t learned to do this for himself, he will require you to resettle him as he will wake up and all of a sudden you will be gone, leading to a reluctance to let go into sleep as he knows that if he goes to sleep you will leave him.
c. I don’t recommend a dummy; it may soothe them and keep them quiet short term, but longer term if they use this to soothe them to sleep, they will cry for it to be replaced every time they fall asleep as it falls out of their mouth, and they can’t resettle themselves without it.
d. Try to put your baby to sleep in some light during the day and the dark at night. This is especially important for when they get older and daylight saving time begins.
e. Do the absolute minimum of rocking. So, when you are trying to get them to sleep, try and achieve this with little or no rocking, perhaps just a very slow head pat instead. When they are asleep, even when they are in a pram, practice stopping and letting them sleep while stationary. This way, they will learn to sleep under all sorts of different conditions. Remember, anything in this vein that you do, be prepared to do it always, for months or years ahead.
10. Lots of parents do a ‘dream feed’ around 10-10.45pm. This is where you pick your baby up when he is sleeping and give him a feed. In theory, he is so relaxed that simply lifting him upright will burp him so you can then simply put him back to bed. The thinking behind this is that it will allow him, and therefore you, to sleep for longer. This didn’t work at all for me, as it meant that I didn’t get a 4hr stretch of sleep, and that I had to stay up until 11pm. I therefore opted to put him down at 7.30pm, go to sleep myself at 9.30pm as 4hrs in a row is the minimum amount of sleep your brain needs to recharge, so if you can achieve this then even if the rest of your night is broken, you will feel OK.
11. I have read so many books on sleep, and although they basically all boil down to the same thing, this book by Tizzie Hall called Save Our Sleep is the book which I found most clear and helpful, not just on sleep, but with lots of handy tips and bits of information I looked up at 3am!
Keep in mind when you read this, that the content of this blog is my opinion, my belief, my suggestion, my recommendation – the common thread being ‘me,’ not ‘you.’ It is my hope that my experience will help, but it is not meant to be ‘my way is the right way,’ or ‘my way is the only way.’ In fact, what I’d really like, is to hear about your way; what has worked for you and what hasn’t? What tips or recommendations would you make, particularly with the advantage of hindsight?
I hope that whatever you choose to do, that the first months with your baby as joyous and full of wonder as mine were.
Best wishes,
Naava.