The holiday season is here, and most of us are consumed with making shopping lists and spreading cheer. What’s on your list this season? That cute new sweater? The bag you’ve been drooling over? What about sleep?
If you have a baby who is not sleeping well at night, why not put that on your wish list? To many a tired parent, sleeping though the night may sound like a luxury item or a far-fetched goal beyond their reach. But in reality, the fix is easier than you think. In my pediatric sleep practice, I have worked with hundreds of families and found that one (or a combination) of five things is always amiss when this milestone has not been met by a child who no longer requires a nighttime feed. Ensure these items are in check, apply them consistently, and you and your child will have mastered the art of healthy sleep and sleeping through the night.
1. Daytime Sleep
To ensure good nighttime sleep, your baby must also be getting healthy daytime sleep. Many parents assume that without naps, their child will be more tired and therefore more apt to sleep at night, but it’s actually the opposite. As sleep is cyclical, quality naps need to be in place in order for your child to achieve a good night’s sleep. Without adequate daytime sleep, a child enters the night in an overtired and stimulated state that will not allow his body to sleep in long, restorative stretches. So how do you make sure great naps happen? By scheduling naps to happen in sync with their body clock or circadian rhythms. We all have an internal clock that tells our bodies when we should be asleep and when we should be awake. If we sleep in-sync with these clocks, we have our easiest time falling asleep and staying asleep, and we can actually get in our best quality sleep. So when do these magical sleep times occur? For a baby who is between 4-18 months old and takes two naps a day, he should fall asleep for a morning nap in the 8:30-9 a.m. window, while for an afternoon nap, he should fall asleep in the 12:30-1 p.m. window.
The key to a good bedtime is that it happens before your baby can become overtired. When we become overtired, our bodies release the stress hormones adrenaline, noradrenaline, and cortisol in an effort to keep us going. As adults, we call this a second wind and often rejoice at its occurrence: Whoo hoo! We can keep on trekking without another double cappuccino and then easily drift off to sleep for the night. But for a baby or toddler, these hormones act as a high dose of stimulants and make it very hard for her to fall asleep for the night. If going to bed overtired is a nightly occurrence, these hormones build-up in the child’s blood stream. When sleep cycles shift during the night, this build up is present in the blood stream, and baby will fully wake up instead of rolling right into the next cycle. Therefore, it is critical to know how long your child can tolerate being awake before she becomes overtired and have her fast asleep for the night before these hormones rear their ugly heads. As your child ages, she can (of course) tolerate being awake longer. Every child is different, but use this chart to gauge your child’s ideal bedtime.
3. Sleep Crutches
A sleep crutch is something that your child relies on to fall asleep. When he wakes briefly at night between sleep cycles, and his “crutch” is not present, he will not be able to go back to sleep on his own. For example, if your child only knows falling asleep at night with you rocking him to a sleeping state, when he wakes at night, he’ll expect that to occur to go back to sleep. All sleep crutches are not necessarily bad – if your child can use or recreate the crutch on his own, he’ll likely be proficient in falling asleep and staying asleep on his own. Take a pacifier, for example: for an older baby or toddler who can find and replace it on his own, it should not be an issue (as long as there are rules in place against parental replacement). However, a pacifier likely poses an issue for an infant who does not yet have the motor skills to replace it on his own and instead requires a parent to replace it . . . all night long! A simple lovey that has mom or dad’s scent and that is involved in the child’s pre-sleep routine is a great tool for many babies and toddlers, as it is simple for them to find and hold on to and is very comforting. The key is either allowing your child to soothe himself completely on his own, or finding something that he can utilize without your assistance. Again, if your child relies on you or your presence to fall asleep at bedtime or naptime, he will rely on you when he wakes at night. Children need to learn to fall asleep on their own.
We want to create the ideal sleep environment so that there is no question as to why your child is waking up. Basically, we want to take the “what ifs” away. Is my child awake because he is cold? Because it is too loud? Too bright? He lost his blanket? To alleviate any of those questions – let’s just make sure the set up is right from the beginning! Your child’s room should be as dark as possible for all sleep – yes, for naps too. Only use a night-light if it is truly necessary (please note, your child isn’t capable of being afraid of the dark until he reaches age two) and tuck it behind a piece of furniture so that it emits a glow and is not in direct view. His crib should be clear of any mobiles, toys, stuffed animals, and distractions. For a baby older than one, a blanket is ok if he can replace it on his own or will not be cold if it is kicked off – otherwise use a wearable blanket to ensure his comfort. The ideal temperature for sleep is 65-70 degrees depending on how your child is dressed. Music is ok during the pre-sleep routine, but should be turned off before your child falls asleep, as music during sleep doesn’t allow the brain to enter deep sleep given that it is actively trying to listen. Instead, use white noise to block out ambient household and street noises. White noise should only be as loud as a running shower and should be at least four feet from your child’s head.
Consistency is key when it comes to teaching a child your expectations. If one day you expect her to fall asleep on her own, and the next day you rock her to sleep, she will be very confused. Or if at bedtime, you put her sleep in her crib, but in the middle of the night, you put her to sleep in your bed, then she’ll expect that she can always sleep in your bed. Remember, babies and young children can’t tell time. So you must come up with a consistent plan for your child’s sleep, which includes a consistent pre-sleep routine, a consistent sleeping location, and a consistent set of expectations for how she will fall asleep and stay asleep. Having this in place and sticking with your expectations will make it easiest for your child to understand that she has the skills to sleep on her own.
Sleep is a work in progress, as a child’s overall sleep needs will require alterations as he grows. If the five components above are in check, you will always have a healthy sleep regimen in place that will only require minor adjustments or small tweaks to ensure that your child is always getting the best sleep, and no major issues will ensue. Sleep is a marathon and not a sprint. There will be ups and downs, but if a healthy framework is in place, your child will always make it to the finish line.
Amy Lage is a graduate of the University of Massachusetts Amherst and a Family Sleep Institute certified Pediatric Sleep Consultant. She is founder of Well Rested Baby (www.wellrestedbaby.com). She offers a host of services including in-person, phone, email and Skype/FaceTime consultations that can be tailored to meet any family’s needs and schedule. This breast-feeding enthusiast, fashion lover, and beach bum lives in Beverly Farms, Massachusetts, with her husband Jeff, their six-year-old Stella, their 3 1/2-year-old Harley, and their two dogs. Be sure to follow WRB on Facebook and Twitter for more great sleep tips!