“Sleeping like a baby” is a well-known idiom but nobody really knows where it comes from. It is especially strange to mothers who, as we all know, experience first-hand what sleep deprivation entails. Sleep is a mythical subject, one which experts agree is similar to discussing the universe or the very deep sea; there is still so much to be discovered. New research plays a role in changing our perceptions and understanding of sleep on a daily basis. Sleep might be such a relevant topic in today’s parenting spheres because of the controversial information surrounding what one can do to make changes to a baby’s sleep routine, as well as the fact that it touches every single parent in a very real way. Thankfully, there is a great deal that we can do and we can help by advising parents. As we grow into knowing better, we do better.
1.Understand that a baby sleeps differently
Babies spend more time in the REM sleep (active sleep) phases than adults because they have so much information to process. This means that a parent may think that the infant is sleeping, when in fact, when the baby is put down it causes the infant to wake up because it has not yet settled into a deep sleep.
Babies have sleep cycles during the night (where they go through a cycle of REM and four NREM stages), but their cycles are considerably shorter and are only 45 minutes long compared to 1.5 hours for adults. As such, many daytime naps are also only 45 minutes long. While in quiet sleep, babies are less likely to be awakened by noise and other disturbances. Quiet sleep represents the end of the baby’s sleep cycle. When it’s over, babies either begin the cycle again (re-entering active sleep) or they wake up.
As a result, babies are much more easily awakened and newborns just sleep any old time, on and off, all through the day and night. By the age of four months, babies will probably be sleeping for 6 to 8 hours at night, and by the age of 6 months, babies should typically be able to sleep for between 10 and 12 hours.
2.Babies form strong associations with sleeping
Babies tend to form very strong associations with their sleep environments. It can thus be beneficial for parents to enforce and encourage positive associations that are manageable in the long term. The last half hour before bedtime is very important. Parents should focus on what their child is seeing and experiencing through the senses of smell, sight and touch. A consistent approach to bedtime, as well as making it a calm and spa-like environment will help in the production and onset of melatonin, the sleep hormone. Something as simple as keeping the room temperatures constant can help the child’s body not to produce a sudden surge of cortisol which in turn can inhibit melatonin production.
Babies also form associations with comfort items (a positive sleep association) and may be very reliant on sucking as a sleep association. This could lead to more night waking if the infant is unable to reintroduce the bottle, teat or dummy on his own.
3.Nutrition is vital for good sleep
It is becoming more evident that adequate nutrition is good for babies’ sleep. A hungry baby will not sleep well. Very often poor sleep in infants is associated with breastfeeding problems which can be assisted by a lactation consultant or expert. Parents should be advised prior to any sleep interventions, to make sure that they look into any and all possible feeding problems. Formula feeding should not be introduced just because a parent believes that it would make the infant sleep better, as this is in fact a myth. Breastfed babies can also sleep well if one takes a holistic approach to sleep and makes sure the child receives adequate calorie intake during a 24 hour period. Parents should also be encouraged to wake very sleepy newborns after a three hour period during the day to drink, and to encourage full feeds when nursing.
4.Timing becomes increasingly important
Along with the natural circadian rhythms of our bodies (our awake sleep cycles) comes the understanding of how light influences our perception of night and day. Infants should be exposed to natural light and a different set of circumstances for day and night to establish their own normal body clocks.
It is important to remember that babies function according to their own internal biological rhythms and that it will take a few months for their circadian rhythms to be established. They are unaware of what their parents are being told and it often takes several months for a baby’s day-night pattern of wake and sleep to become established. During this time many parents just need reassurance that their baby is normal, and that their baby’s sleep patterns are developing as expected. In cases where parents are unhappy with their infant’s sleep progress it may not be that the baby is problematic, but that parents’ expectations regarding sleep and babies’ needs need to be managed.
5.The fourth trimester
Dr. Harvey Karb, an American paediatrician and child developmentalist (author of the “The Happiest Baby on the Block) believes that the first three months of a baby’s life is really the last trimester. The Fourth Trimester Theory proposes that human babies are born earlier than they should be, compared to other mammals. This is basically because their heads would grow too big for safe delivery if they stayed in the womb for much longer, so they are born before they are ready. It means that they are, essentially, more like a fetus than a baby when they are born. In terms of sleep, this means that we need to try to recreate womb-like conditions as much as possible. Otherwise, the baby will be distressed and may cry and fuss much more, or even suffer from colic-type symptoms. Additionally, the baby may be having difficulty adjusting to being outside the womb. Implementing the 5 S’s – as Karb calls it – can help settle the baby. The 5 S’s are swing, swaddle, shushing sound, side and sucking.
6.Safety: The dreaded S word
A very real concern for parents is the possibility of sudden infant death syndrome. All possible safety measures should be taken and parents must be educated about sleep safety – such as to not sleep on a couch.. New research is showing though that parents should not be discouraged to bed-share if the mother is breastfeeding and the infant is not exposed to primary or secondary smoke. Bed-sharing in the newborn phase could lead to better sleep for the whole family and a healthier breastfeeding relationship.
Taking an holistic approach to sleep practices, starting off with these fundamentals may very well lead to some mom’s and infants that will “sleep like a baby”.
By Petro Thamm
Director of Good Night: Child Sleep Consultancy and African Representative for International Association of Professional Sleep Consultants