Sleeping

BELOW YOU WILL FIND:

This page is intended to share different techniques and theories related to babies and their sleeping habits and patterns. It is based off of my own personal experience and three books:

Already Beginning a Routine

Initially, when my LO was born I was just waiting for her to wake and I was on-call ready to feed. Since I am a definite Type-A personality I was of course keeping logs of when I was feeding her, how long she fed for and when she was pooping, but I didn't realize that for a newborn this was the beginning of a routine itself. 
After reading Tracy Hogg’s book, Secrets of the Baby Whisperer, and Gary Ezzo's book, On Becoming Baby Wise it was clear to me that having my newborn on a routine would help me figure out why she was crying and also help prevent “unexplained” fussiness many parents talk about. This new routine would better help me understand what she truly wanted and needed. Both of these books promote the belief of having a child on a routine as a way to keep baby and the family happy and in harmony. (NOTE: If a routine does not sound like your "cup of tea" then you may prefer the book The Happiest Baby on the Block by Harvey Karp M.D. which is less scheduled and focuses more on demand-feeding. It gives parents useful tools to help babies sleep, discusses the theory of the missing 4th trimester and promotes letting your newborn guide the structure of their feeding, activity and sleep time).
Since I already shared with you that I thrive on structure, I followed a combination of routines pulled from Hogg's and Ezzo's books but I still stole a few bits-and-pieces from Karp's book as well (such as the 5 S's). 



Below I will summarize and share what I learned from Hogg’s and Ezzo's books about getting a 1-4 month old as well as a 4-9 month old on an E-A-S-Y routine. 
Please Remember: This as a loosely designed routine that should be adapted to work for your newborn and family. It is not meant to be an exact schedule or a clock-driven routine by any means. A friend once gave me the solid advice that I would never have an perfect E-A-S-Y routine day-to-day and to just try and always keep with a predictable E-A-S-Y pattern (eat, activity, sleep & your time).....such great advice!

E is for Eat

Breast-feed or bottle feed during this time. In the first few weeks/months feeds can take up to 45 minutes but as a baby's suckle becomes more efficient, that time will be cut almost in half hurrah!  Click here to look at Hogg’s Feeding Guide for an idea of how much your baby will feed at each age.

A is for Activity

After your baby is done eating, it is important to prompt them to engage in some activity. This may be more difficult for newborns and may be limited to a few minutes of cooing, looking at all of the smiling faces or staring at the ceiling fan (a favorite of our baby girl). Once your little one gets older, activity time will gradually increase and by about 4 months this time will total around 2 hours (including feeding time). Be sure to watch your little one closely for "sleepy cues" to guide you regarding when to put them down to nap/sleep.  Too much activity and you will have an over-stimulated baby who wants nothing to do with naptime/sleep.

S is for Sleep

Sleep is the magical time when our babies grow and develop their brains. All babies are different and naps can range from 20 minutes to 2 1/2 hours. Solid naps during the day time will actually help baby sleep better at night. Remember that keeping your baby up late won’t make her sleep longer it may in fact make it harder to put him/her to sleep or cause more interrupted sleep later in the day/night.

Y is for Your time

After your baby is asleep you have a small window of time to yourself. I cannot urge you enough to take this time to relax and even nap if possible (especially if you have a newborn). I know it is difficult to leave the house a mess so if you must you can use this time to tidy/clean. I found that I was happiest when I used this time to do something I love such as read, bake or oh yeah.........SHOWER!!! 
NOTE:
For the first month with your newborn you do not need to try and to get a routine going,  just focus on feeding and cuddling your little one. However, as you begin to become a less sleep deprived zombie most of us are begging for some predictability in our days! 
Below is an example from Hogg’s book of what  an E.A.S.Y Structured Routine may look like for a 4 wk-4 monthold. Remember BE FLEXIBLE!!!!!.
E.A.S.Y. Routine 4 weeks to 4 months
3 HOUR ROUTINE
E – 7:00 – Feed
A – 7:45 – Diaper change, some playing, talking, watching for sleepy cues
S – 8:15 – Swaddle and lay baby in crib. May take baby 15-20 min. to fall asleep
Y – 8:30 – Your time (nap)
E – 10:00 – Feed
A – 10:45 – See 7:45 above
S – 11:15 – 2nd morning nap
Y – 11:30 – Your time
E – 1:00 – Feed
A – 1:45 – See 7:45 above
S – 2:15 – Afternoon nap
Y – 2:30 – Your time
E – 4:00 – Feed
A – 4:45 – See 7:45 above
S – 5:15 – Catnap (about 40-45 min)
Y – 5:30 – Your time
E – 6:00 – 1st Cluster Feed
A – 7:00 – Bath, bedtime ritual
S – 7:15 – Another catnap
Y – 7:30 – You eat dinner.
E – 8:00 – 2nd Cluster Feed
A – None
S – Put baby right back to sleep
Y – Enjoy your time until the Dream Feed (between 10-11).

NOTE: This routine assumes your baby is healthy and doesn’t have special needs, isn’t below birthweight, etc.

E.A.S.Y. Routine 4-9 months

4 HOUR ROUTINE
E – 7:00 – Wake up and feed
A – 7:30 – Activity (play and developmental)
S – 9:00 – 1 1/2 – 2 hr nap
Y – Your time
E – 11:00 – Eat
A – 11:30 – Activity (play and developmental)
S – 1:00 – 1 1/2 – 2 hr nap
Y – Your Time
E – 3:00 – Eat
A – 3:30 – Activity
S – Catnap between 5 -6 pm (this nap may disappear between 6-8 months)
Y – Your Time
E – 7:00 (cluster feed at 7 and 9 pm if going through a growth spurt)
A – Bath time
S – 7:30 –8:00 Bedtime
Y – Your Time
E – 11:00 Dream Feed (until 7 or 8 months, or whenever solids are firmly established.

The 45 Minute INTRUDER & Wake to Sleep

If you have read the Babywise series then you are probably aware of concept known as the 45 minute intruder. If not, I am sure you have dealt with the intruder at some point in your baby’s sleep development. This post is intended to share what I have learned about the 45 minute intruder and the strategies I have tried in order to “get a handle” on it. The main reason I am writing about this phenomenon is that I found very little information to troubleshoot this problem in the Babywise book,  and most friends I spoke to either thought 45 minutes naps were normal (which meant their child did it too) or they seemed surprised and remarked that their child always slept 1.5-2hours (which meant they did not share this issue).

Understanding the 45-Minute Intruder

Babies generally sleep in cycles during the day. Normally they fall asleep and go into a deep REM cycle that lasts about 45 minutes. As babies wake from the first cycle they must put themselves back to sleep in order to get the remaining healthy sleep they need for brain development. (This is based on decades of research that notes that a baby’s  normal nap should be 1.5 -2 hours). Sounds easy, right???

When many babies begin to stir at around 45 minutes, they find it difficult to fall back asleep and finish their nap. Many times parents mistakenly believe when baby wakes after only 30-45 minutes of sleep that baby is no longer tired (especially if the child begins to cry or play in their bed/crib). This is not necessarily the case. Most babies are still very tired and need to move into the next phase of sleep to get a good nap otherwise after a hour or so of being awake they may become overtired and that can lead to chronic fatigue, crying or an overall “fussy” baby.

It is common for babies to begin to habitually wake at the 45 minute mark for a few days or a week between the ages of 4-8 months (our LO began this around 5 months). This happens at this age as babies are becoming more alert and aware of their surroundings which makes going back to sleep particularly difficult. Around 5 months the 45-minute intruder began to create chronic 45-minute naps, and it became very disruptive. When our LO does not get good sleep, then she will tend to be very fussy and tired during the next cycle (which is not typical of her mood and is of course stressful for me too). This makes it very difficult for our family to stay on a stable 4-hour cycle and plan our day, her wake activities and bedtime. The good news is that this is temporary for most babies but it can be challenging to problem solve the issue.

 Things I Found Helpful

 Too Tired or Not Tired Enough?

If you are confident that your baby is not hungry, then you may be dealing with a baby that is either too tired or not tired enough. This is, of course, confusing.

In the early months babies tire quickly. Most newborns do not cope well with more than 1- 1.5 hours of wake time. If you are keeping them up for longer than that they may get overtired. Overtired babies do not do anything well, including sleep. The cure for this is to put them down sooner, rather than later. Let them get more sleep, so they can get more sleep. It sounds strange but in the early weeks and months, sleep begets sleep.

As baby gets older (between 3-5 months) they will have established a rather predictable routine and their daily rhythm will be well established. They will normally go to bed around the same time, wake at the same time, nap at the same time, etc. etc. If you baby is not napping well at this point it is very possible that your baby is getting too much sleep.

If your suspect that your baby is getting too much sleep I suggest you read Solve Your Child’s Sleep Problems, by Dr. Ferber. Simply put, it corrects all the lies that we believe. Dr. Ferber is a sleep expert at Harvard’s Boston Children’s Hospital. He tells you what is normal and what is not. This is important because what we hear in the community is not the norm. What we generally hear from our family and friends are “success” stories. Stories about angel babies that sleep through the night straight out of the womb and are perfect in just about every way. This is not the norm.

 Many parents, especially first-time parents, struggle with many aspects of helping their baby establish healthy sleep patterns. Most eventually figure it out, largely through a trial and error process, but it may be painful along the way. These “negative” stories, although more common, are shared much less often because people generally don’t like to talk about their failures and struggles.

Reading the Ferber book opened my eyes to what is normal and what I could reasonably expect from our baby at different ages of development. Even better the book goes on to give lots of different examples of problems and how to fix them. I cannot recommend this book highly enough if you are having any trouble with sleep.

All of this to say, most of the stories we hear make us think as parent that baby should sleep 12 straight hours at night and then take (3) 2-hour naps during the day. This is just way too much sleep for any baby other than a newborn in the first weeks of life. The average 3 month old baby sleeps less than 10 hours at night and by the age of 6 months total nap time is just over 3 hours.

Wake to Sleep

In order to utilize the Wake to Sleep method for extending short naps you go into your baby’s room about 30 minutes into the nap (this is shortly before he/she starts to rouse from the first REM sleep cycle). From here you have a few choices: 

Option 1.) You can pat your baby gently on the back until their body relaxes which may take up to 20 minutes. If he doesn't relax with the patting, The Baby Whisperer suggests moving onto the pick-up/ put down method if your LO is over 3 months in age. This method was too disruptive for my alert little baby so we used an alternate method noted in the Baby Whisperer book.

Option 2.) You can move or pick up your baby slightly (just enough to barely wake him/her) and then as quickly as possible GET OUT OF THE ROOM. This allows your LO to resettle while they are still tired. Then they are more easily able to fall back into the next cycle of sleep. Use this method 2-3 days in a row and your baby will quickly begin sleeping for longer and longer naps. NOTE: You will have to use trial and error to figure out the exact time to go in and the exact method that works for your but once you do it is a LIFESAVER.

Feeding and Hunger

This is a common problem that disrupts naps in babies under 12 weeks of age. A young baby who is consistently waking up at 45 minutes may be hungry and therefore is unlikely to fall back to sleep. In a typical 4-hour cycle there are two things that you can do to address this problem.

First, try and reorganize the 4-hour routine so that baby eats about 30-45 minutes after getting up from a nap. This may be hard at first but your baby will quickly readjust. This accomplishes 2 things. First it removes the association with waking and then immediately eating. Second it moves the feeding a little closer to nap time, which means baby is likely to have a little fuller stomach during the nap.

A second strategy is to add in cereal and/or age-appropriate baby foods. Do not do this immediately after nursing but give a baby a 30-45 minute break between nursing and taking food. The overall goal is to have more of baby’s food closer to the initiation of the nap. This makes it less likely that baby will wake hungry after 45 minutes. Rather baby will wake hungry after 1 1/2 hours… hopefully.

Establish a Very Predictable Routine

Having a structures sleep and wake routine is critical in the early days of sleep training. If you want your baby to take predictable naps, then you have to help him/her. This means that the naps should start at more or less the same time everyday (I figure you should be using the words “about” in front of your baby’s schedule, ex: she wakes at about 7 and then naps at about 9ish) and the number of naps should be the same every day. During this period of training you will need to forgo lots of little day trips in order to help your LO truly begin to get on a routine. Catnaps in the car on the way to the grocery store, skipping naps several days a week, or mixing up the time that baby goes down for a nap will all interfere with developing healthy naps. The good news is that if you have weeks like this (and you will) you can always get your baby back on a good routine….with hard work and persistence of course.

Reduce Nighttime Sleep

According to Ferber, most babies 3-6 months of age only need about 10 hours of sleep at night. If your baby is sleeping 11, 12, or more hours at night, then they are probably getting all of the sleep they need at night. Try backing up the time they get up in the morning or pushing the bedtime back to reduce the overall nighttime sleep.

Plan to do this for several days or maybe even a week or two before you assess the success. With my 6 moth old’s schedule she was getting about 14 hours of this total sleep time at night. This sounds in theory like an okay situation but in reality what I had was a baby who was not very well rested during the day and would get fussy quite easily. I knew what I needed to do. I had to keep her awake a little more at night to create a later bedtime AND I had to get her up a little earlier in the morning (good-bye 8:00am wake time).

I started by keeping her up only 15 minutes more at night and I also stretched each daily active time by about 10 minutes as well. I also woke her at 7am to be sure she was not getting too much sleep at night. TA-DA...within two days, problem solved. I kept extending her bedtime by about 5 -10 minutes a day until she finally got to a 8:15ish bedtime. All is well and naps are restored!!! :-) Happy Baby= Happy Mommy

Avoid Extra Long Naps

While it may be nice for baby to take a 3-hour nap, this will likely interfere with later naps. We generally do not wake our son from a deep sleep but we do open his door and “help” him wake up on his own between 1-5 and 2 hours.

Darken the Room

We are suspicious that this may have been the final key to our success. There is a lot of light in our LO’s room. I do not sleep well in a well lit room, so it only makes sense that this may be a problem for babies too. We put some darkening curtains in our LO’s room and this seemed to make a big difference is her ability to fall back to sleep on his own.
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