Sleep Like a Baby

“Sleep like a baby”. Have you ever heard this phrase and wondered if the person had ever spent one night with a newborn? Coping with sleep deprivation is one of the biggest challenges facing new families as a baby’s unique sleep patterns can be a source of confusion and frustration. Throw in a good dose of conflicting advice and you have a recipe for chaos. So, we decided to ask well-known pediatrician and former director of the Newborn Nursery at DHMC, Jennifer Shu, for her advice on parents’ most frequently asked questions at the Women’s Health Resource Center.

My baby will only sleep in my arms, car seat, or swing. Will she be spoiled?

While it is impossible to spoil a newborn baby and you’ll want to attend to her needs as much as possible, “babying” her too much after about 4 months can certainly have a spoiling effect and invite trouble for the future. In the first month, when all babies do is eat and sleep anyway, there is a good chance she’ll conk out pretty regularly in your arms, car seat, or swing. As she gets older, try to get her to the bassinet or crib before she falls asleep completely. Sleeping in a car seat in the car is safe and often unavoidable, but once you get out of the car it’s ideal to have your baby sleep in the crib or bassinet, as it can be uncomfortable and possibly unsafe to sleep in a semi-folded position in the car seat for a long period of time. Occasional short naps in the swing with the seat reclined may be okay, but it’s best not to turn these into a habit.

When will my baby sleep through the night?

The answer depends on how you define “sleeping through the night.” Most medical experts define it as sleeping at least one 5-hour stretch when it’s dark outside. If you use this definition, over 90% of babies will succeed by about 4 months of age. If you’re like me and consider “sleeping through the night” as an interrupted minimum of 8 hours, then your baby will probably achieve it anywhere between 1 week and 1 year of age, but usually closer to 1 year. Most babies will sleep 8+ hour stretches by the time they are eating more during the day—typically once they start to eat 2 or 3 meals of solid food daily in addition to their breast milk or formula, or roughly around 6 to 9 months of age. Many a breastfed baby will continue to wake up once or twice at night for a feeding and then go back to bed. If your baby is truly hungry (meaning that nothing except breastfeeding will satisfy him and he doesn’t just take a quick taste and use the breast as a pacifier), then make these feeding sessions as quick and unexciting as possible. He will eventually outgrow the need for many night feedings as he gets bigger.

My baby feeds 4 times each night and my neighbor only feeds once. Is this normal?

Every baby is different so this behavior can be normal for both babies, depending on their ages. Assuming we’re talking about newborns, you can usually expect to go at least 2 hours in between nighttime feedings, but ideally it will be 3 hours or more. If you find your baby is waking more frequently than that, try to comfort her (with anything but feeding) and see if she can hold out a bit longer before feeding again. It may be that your baby has her nights and days mixed up. If so, try to keep things dark, quiet and boring at night and louder, brighter and more exciting during the day. Within a few weeks she’ll become less of a night owl and take most of her feedings when the sun is still out.

My mother says it is ok to let him cry... is it?

Many new baby books, parenting experts and well-meaning relatives matter-of-factly lay out the merits of teaching babies to fall asleep on their own (without parental assistance) and allowing them to “cry it out.” Keep in mind that most of the “don’t-rely-on-sleep-aids-to-get-your-baby-to-sleep” advice is usually meant for babies as they approach 4 months of age. Instead, do what you can in the early days to get your baby to fall asleep—whether cradled in your arms, snuggled up on your chest, or in the back of your car secured in her car seat instead of her crib—and just do it (“it” being whatever you need to do, within reason, to get you both some rest), temporarily. Do try to get your baby to sleep in his crib, but there’s no need at this point to leave him to figure out getting to sleep on his own. Create a sleep routine of breast or bottle, bath and books so that your infant is relaxed and ready to rest when bedtime finally arrives. Once your baby approaches 4 to 6 months of age, it may be worth letting him try to cry it out. While this method works for many infants and is the most successful sleep training method that has been studied, remember that it does not work for everyone. You may need to wait a few weeks (or months) and consider trying the sleep training again.

My baby only takes 20 minute naps. Is this normal?

While short naps may be considered normal, they certainly are not ideal. In order to cycle through all the stages of sleep for optimum growth and rest, naps should be at least 30 minutes long and, better yet, closer to 1-1/2 to 2 hours. You may be able to consolidate your baby’s naps. For example, if she wakes up after 20 minutes, try not to pick her up right away and see if she’ll get herself back to sleep. You can also gently rub or pat her back in hopes that she doesn’t wake up completely. Also, although this concept may be counterintuitive, poor sleep may be a sign of being overtired; when babies are wound up, it can be harder for them to relax and go through the sleep stages properly. In this case, you’ll want to put your baby to sleep well before she starts rubbing her eyes or acting cranky.

Why won't my baby sleep in her crib?

Babies often won’t sleep in the crib if they’re used to being picked up and held to sleep or placed in a car seat, swing, or sling instead. This practice trains them to relax in places other than the crib, starting a bad habit and possibly being unsafe since cribs and bassinets—products designed for sleep—have been tested for safety during sleep. It would be worth your while to try, try and keep trying to get your baby to sleep in her bed. Often this may mean comforting her until she is relaxed and drowsy but not completely asleep and then putting her into the crib. If she wakes up immediately, this means she is in a light stage of sleep and will either start crying or soothe herself back to sleep. Remember that it can be a rude awakening to go from being held in a parent’s soft and warm arms to lying flat on a firm crib mattress so you may need to bend over and cuddle with your baby for a few minutes to ease the transition.