Sleep Schedules and Sleep Training for Babies
THE FIRST MONTH OF LIFE
The first month of life is generally a crap-shoot when it comes to your baby’s sleep. The first 2 hours of life a baby is often alert and awake. Then for the next 24 hours or so, they are very sleepy and almost impossible to wake and feed. After that, it’s pretty much hit and miss for the next month or so. Most babies will lose weight the first few days of life and our advice is always to wake them to feed at least every 3-4 hours until they have re-attained their birth weight. Typically at about 1-2 weeks of life babies start to cluster feed. And of course, they generally begin to do that in the middle of the night. If your baby does this—feed him! This time generally involves a big growth spurt and so babies need to feed more often. After about a week of this, a baby will move that period of cluster-feeding to the late afternoon or early evening hours and soon after that they often begin to sleep at least 5-6 hours (hopefully longer) during the night. If your baby doesn’t develop this schedule on his own by about a month of age, you might try to wake him to feed every two hours during the day, get him 8-10 feeds during the day and often he will sleep longer at night. This is not true for every baby however and there are certainly some children who don’t sleep all night for several months.
FOUR TO SIX MONTHS OF LIFE
Most babies at this age are sleeping at least 6-8 hours at night and having at least 2 naps. Many parents whose babies are NOT sleeping want to know if they should start cereal. This is occasionally worth trying and depends largely on your baby’s development and growth rate. Talk to your pediatrician about whether this might be helpful for your baby. Cereal is generally not recommended before 4-6 months as it has been shown to contribute to childhood obesity.
SIX TO NINE MONTHS OF LIFE
Some babies who were previously sleeping all night begin to wake again at this stage. Check with your pediatrician if your child is doing this – it can be a sign they need more calories, or that they have an ear infection, etc. Often, however, babies at this stage are doing two new developmental things. They are developing Circadian rhythms–a pattern of sleep-wake cycles that generally each last about 90 minutes and during which she goes through all the sleep stages including REM sleep and then returns to a more wakeful state. Adults do this too, however we generally just roll over and go back to sleep. Babies at this age are also developing OBJECT PERMANENCE—“do Mommy and Daddy still exist when I can’t see them?” So—they wake up and try to find out. At this stage, SLEEP TRAINING is appropriate. Prior to this stage if a baby is left alone to cry for an extended period they may feel abandoned which could potentially lead to future insecurities. But once a baby reaches this stage she is capable of understanding that her parents do still exist even if they aren’t in the same room. When a baby begins to do this, and when you are ready to do some sleep training, here are some instructions:
- First of all, pick a day or a weekend when you don’t have to get up too early. You may be in for a couple of loooooong nights. Let your baby have a doll, teddy bear, or “lovey” in her crib to help her comfort herself. When your baby wakes up and cries, go in to comfort her—pat her on the back, sing her a song, offer some words of encouragement, or even play her a mobile– something brief– and then leave the room, EVEN IF SHE IS STILL CRYING.
- Go back and repeat step one in 5 minutes and continue to do so every 5 minutes for 2 or 3 times.
- Now—space your visits to every 10 minutes. Continue to go into her room and offer some brief comfort every 10 minutes for 2 or 3 times.
- Now—space your visits to every 15 minutes. Continue to enter your child’s room and offer brief comfort every 15 minutes FOR AS LONG AS IT TAKES. THIS IS THE HARD PART—that first night, it may take TWO HOURS! However, most babies will soon understand his parent is close by and available and he will eventually self-soothe and go to sleep. Good news!—the second night generally only takes about half as long as the first night and by the third night your baby will have learned to comfort herself and go back to sleep on her own.Some important caveats to this sleep training method. When you enter your child’s room, DO NOT STAY LONGER THAN ONE MINUTE; DO NOT PICK HER UP; AND DO NOT FEED HER. Even after she has cried for TWO HOURS, do not pick her up and feed her. If you do, you have just given her positive reinforcement for crying all that time and she will conclude that “if I cry for two hours, Mommy will come feed me—therefore I should cry for two hours EVERY NIGHT.” So…..once you decide to try some sleep training, stick with it. It may be a tough couple of nights but most often it is totally worth it! Sleep training is definitely something you want to tackle BEFORE your child is able to climb out of her crib. Once your baby is capable of getting out of her bed and coming into your bed to join you, many parents are stuck with a toddler sleeping with them for months or years.
There are, of course some children who do not respond to sleep training after even 3 or 4 nights. For those kids—talk to your pediatrician, there may be some other strategies that may be helpful.