Saturday, August 14, 2010

Sleep Solution: Lay Me Down to Sleep.... Gently

One of the most commonly asked questions among parents of infants is how they can get their baby to sleep better at night. It can cause stress, exhaustion, and an sense of being overwhelmed. I am a strong advocate of using gentle methods of helping your infant sleep and of helping mom feel better about the sleep situation.

1. Change Your Expectations - The first thing that we need to consider is changing our idea of what normal baby sleep consists of. If we expect our child to sleep through the night before the age of 18 months then we just might be kidding ourselves. And 18 months is pretty much an arbitrary number but I've put it in here to let you know that anything younger than that is completely up in the air. In fact the human adult wakes up, on average, every 90 minutes. So perhaps it is all just a big joke. Our children will never sleep through the night. The sooner we accept this the easier this sleep issue will become. We know that mother's stress levels affect baby's mood. We know that mother's emotional availability affects baby's sleeping habits. And we know, or should know, that biologically human infants were made to wake often during the night. This being exaggerated for breastfed infants but still true for every infant. And if they do sleep through the night it is likely that will change during a growth spurt, a developmental change, an illness and so on. This doesn't mean there aren't the rare few who do sleep through the night with little intervention and those babies aren't abnormal. They are just ahead of the game. I guess all-in-all this is a soft way of saying that when you became a parent you gave up your right to a good night's sleep. It will likely be a long time until you get one and that is fully normal especially for the infant who is just responding to how nature made them. And, in fact, accepting this will actually help you get a better night's sleep. Yes, I realize that is quite an interesting conundrum.

2. Make a Happy Mommy - The next thing we can work on is helping mom feel better. Since we have accepted that our babies are not going to sleep through the night we can focus on making mom's (and/or dad's) mental health and mood positive. This could mean feeling better through night wakings, for the mom who has a baby that isn't napping, or just feeling better overall.

Mommy Wellness Tips:

A. Naps - Do your best to fit in a nap. Even cat naps are restorative. So if you can slip in ten minutes in the car after work that will help! Or sleep 20 minutes during LO's afternoon nap. The afternoon nap is the one where baby is likely to sleep deepest and longest.

B. Stations - Set up food and drink stations around the house. That way if you become overwhelmed you can nourish yourself easily. You *will* feel better if you drink plenty of water and keep up on your calorie intake. So, put water bottles where LO sleeps and little snack baggies.

C. Enjoyment - Find something you can enjoy during the Middle of the Night wakings. Play on the internet, watch your DVR or a DVD, read a book. Anything that can take your mind off your stress and bring you a bit of mindless pleasure.

D. Anticipation - Try to build up a sense of anticipation for your Middle of the Night wakings. Even make it fake if you must. Figure out anything you can focus on as enjoyable during the MOTN so you can wake up happy.

E. Assess - Assess Yourself! Are you hungry, too hot, thirsty? Yes, we know you are tired! But what about your other needs. If you aren't meeting them all then it can make everything more difficult.

3. Educate Yourself! Knowledge is power. The more you know the less difficult your challenges will be, the more normal they will seem, and the less likely you will try non-gentle parenting techniques. this will also leave you armed with information in case a friend or a doctor recommends non-gentle parenting techniques.

A. Read some gentle parenting sleep books.
My top three recommendations are (in no particular order):
aa. The No Cry Sleep Solution
bb. Sleeping with Your Baby
cc. Nighttime Parenting

B. Dispel common myths regarding infant sleep.
aa. Rocking your baby to sleep, nursing your baby to sleep and at night, and/or cosleeping does not create sleep issues and will not create a child who has problems sleeping in their own bed.
bb. Infants are not supposed to sleep through the night. Their sleep cycle biologically has them wake at night. It is even preventative of SIDS that they wake at night.

C. Learn how the Cry-It-Out (CIO) method works.
aa. The cry it out method creates stress hormones to be released in moms body. That is one reason you feel so bad if you have tried to do this. You biologically were designed to respond to your baby's cries.
bb. The cry it out method creates abnormal and harmful amounts of stress hormones in your baby's body.
cc. The cry it out method does not teach your baby to self-soothe. It teaches them to shut down when they have night time needs.
dd. This video is a fantastic resource on how the CIO method works: "Penelope Leach Talks about Crying".

4. Gentle Sleep Tips - Here we have the heart of the matter. Gentle tips that you can put into practice to help encourage better sleep habits. Now I'm going to admit up-front that nothing here is going to shock your pants off. They are all fairly simple ideas and are not at all uncommon. They are not methods like what you will find in books. They don't require you to keep a journal or watch a clock. They are simple tips that if brought into your lifestyle will likely make sleep a less challenging issue. The more you are able to incorporate, the better.

A. Routines - Establish three types of routine to help your baby sleep better. You want a bedtime routine, a naptime routine, and a sleepy sound. Routines help your baby expect sleep. A sleepy sound is something like a gentle shush that you do when you want baby to calm down and sleep. Only use it at this moment. It will teach them that when this sound is made it is time to calm down.

B. Natural Light - Exposure to natural light helps infants sleep better. So get your kid outside for a walk daily or sit in the park. Even if you can only expose your child to five minutes a day you should see some benefit to it. If the temperature outside is simply too hot to take your child outside then open the curtains and have some play time in front of the window. Please remember to always use sunscreen. And know that artificial light cannot replace natural light. I will also mention that the natural light in combination with fresh air seems to have the biggest benefit.

C. Dark and Unstimulating - When it is time for sleep try to make your baby's sleeping environment as calm as possible. When it is night you also want it to be dark.

D. White Noise - Some babies respond very well to white noise. However you should try several types of white noise if your baby is not responding to it at first. Some examples are: mimic of mom's heartbeat, white noise machine or CD, light music, natural white noise such as a box fan or dryer.

E. Skin to Skin - The more skin to skin time you have during the day the better. If you can't have skin to skin time then body to body time also has great benefits. So babywear if possible. If not then just hold your baby and bathe with your baby as often as possible. You should always be touching your baby when they are feeding from a bottle or breast. Okay so breast is kinda obvious. Consider all the devices that exist to keep your baby away from you: strollers, playpins, walkers/bouncers, bath chairs, etc...

F. Deep Sleep Cues - Be able to read your baby's deep sleep cues. If you can read these you will know when baby is in a deep enough sleep that you can set them down or leave the room without them waking. Of course it would be nice if you didn't need to use this but quite frankly that is not always possible. One of the most typical deep sleep cues is heavy limbs. If you can raise your baby's arm and it falls down to the side then that is a good sign.

G. Quick Arousal Response - Notice when your baby begins to stir from nap or night sleep and respond quickly by putting your hand on LO, patting LO, offering a binky (if you use one) to try and avoid a full waking.

H. Soothing and Distraction - Use soothing responses when your LO does wake up. Perhaps LO just needs a minute of mommy patting his/her tummy before s/he goes back to sleep. Sometimes distraction can be helpful as well. Offer your hand as a toy to play with. Some moms prefer to try these methods before a night feeding b/c often a baby will fall asleep using these methods within a minute or two. If baby does not fall asleep then please consider night feeding, whether for hunger or for comfort.

I. Smells Like Mom - Put something that smells like mom next to your baby if you are laying baby down without you. Then when LO falls into a deeper sleep remove it so as to avoid a sleep hazard.

J. Reduce Your Anxiety - Babies do pick up on their parents' anxiety and will respond accordingly. So when you are starting to feel overwhelmed take a deep breath, drink some water, get a snack, take a shower. Do anything to give you a little pick-me-up.

K. Sleep Begets Sleep - Keep in mind that the more naps your baby will get the better your baby will sleep during the day and at night. An overtired baby is much harder to put down to rest. So offer more naps and an earlier bedtime. If you need to switch a bedtime then please make sure to do it incrementally.

L. Baby Needs Activity - During the day your baby needs activity! So engage your little one in play. Make sure your LO is active.

M. Diet - If your baby is on solid foods or formula you want to consider that you may be offering something that is causing your LO some digestive issues. If poor sleeping started recently try eliminating some foods to see if it helps or with your Pedi's help switching formula. If you are breastfeeding then consider the same for what is in your diet.

N. Comfort - Make sure your baby is comfortable. The first thing you want to check is baby's diaper of course. Check baby's fingers and toes to make sure they are not red and there is no hair wrapped around them. Check for a rash under baby's neck or in baby's armpits or on baby's bum. Check inside baby's ears for redness or ooze. Check baby's mouth for mouth sores, teeth, and thrush. Check baby's clothes to see if they are too tight around the arms and legs or if there is a scratchy tag. If all of these things check out think about the temperature of the room. Is it too hot or too cold? Remember too hot is a risk factor for SIDS an blankets in bed/crib is a risk factor for SIDS.

O. Co-Sleeping - This is one of the tools I suggest strongly. Co-sleeping can greatly affect mom's ability to get some sleep! If you want to know more about it's safety and how to do it safely I highly suggest reading the book "Sleeping with Your Baby". The author is a leading authority on parent baby sleep.

P. Medical Issues - Please keep in mind that your baby may have a medical issue causing sleep loss. There are lots of medical issues that can cause sleep issues and many of them are common such as earache and reflux. One primary reason your Pediatrician asks if your baby is sleeping is to assess if there is a medical sleep issue going on. Sometimes that can get lost when the Pedi also offers parenting advice that is unwanted.

Stay tuned... I will post resources for this information soon.


  1. Good Blog post. I feel it takes a momma hearing advice over and over to actually realize that it is helpful. I can't tell you how many times I have looked up the same questions just to get the same responses. My little girl sleeps well at night and so when she has a night where she wakes up it is hard for me to adjust. I love when she wakes up at 5am when I am getting ready for work because I get a chance to play with her before I go to work. Thanks for the post it is reassuring :-)

    Bellacornwell - BBC

  2. Thanks for the link to the CIO video. My instinct has told me from the time my baby was born that CIO is terrible, but I'm going to share this with the family and friends who think it's ok and are trying to convince me it's ok.