Sleep Training and Babies

Hylton I Lightman, MD, DCH (SA), FAAP

Getting babies to sleep through the night is one of the questions most often addressed to pediatricians.

For some parents, it’s a nonissue. For others, it’s a barrage of negative emotions.

Here are 9 points for babies up to 12 months of age based on my 30+ years as a pediatrician, father and grandfather.

Make sleep a priority. Why should you be concerned about your baby’s sleep? All human brains – including yours and your baby’s – run on sleep. The American Academy of Pediatrics (AAP) has linked babies’ frequent night waking to many things, including postpartum depression in Moms to future obesity and behavior problems in kids. Children who don’t get enough consolidated REM sleep have shorter attention spans, so they don’t learn as well. These babies also release more of the stress hormone cortisol, setting them up for frequent night waking and stunted naps.

Let’s define “sleeping through the night” according to scientific terms. When physicians speak about sleeping through the night, they mean that the baby sleeps 5-8 hours straight by the time he’s 6 months old. Please ignore the “But my baby is sleeping 12 hours straight” comments. I highly doubt that’s the case as babies typically don’t drop a night feed until they’re between 5 to 12 months of age.

Make sure your baby is ready for sleep training. Speak to your pediatrician to discuss issues you or your child might have that will affect sleep. If your baby, for example, has colic or acid reflux, their sleep will be disturbed. Likewise, sleep will be impacted if there were complications with the birth. Your pediatrician should guide you for how often your baby should be sleeping or eating during a 24- hour period. Eating solids is an important foundation to sleeping longer stretches.

Make sure your baby has the 5 signs of self-soothing:

1) sucking on hands and fingers

2) bringing hands to midline

3) burrowing into a parent’s armpit to turn off stimulation

4) developing a whiny, self-soothing cry

5) rolling on his side or tummy

Once these milestones are met, sleep training becomes an option.

Also, is your spouse on board? Sleep training successfully is a team effort.

Log your baby’s sleep. A log will help you notice patterns. It’s hard to remember how many times your baby woke up last night, let alone recall what happened last week. Track his sleeping patterns – both day and night – over one week. Then you’ll have objective information to start figuring out a bedtime. You might notice, “Oh, he’s always fussy at 7 p.m. — that’s probably when I should be putting him down, and I’m missing the window.” A log will also let you see that your baby may not have cried during the night for as long as you thought. Five minutes of fussing can feel like 50 minutes when it’s 2 a.m. Download a free sleep log template to download!

Create a routine. 15 minutes is all you need to create a quiet, soothing time filled with Krias Shema, lullabies and other quiet singing, reading books, and cuddling to reassure your baby that you love him. Keep anything stimulating (i.e., an iPad or television) out of the picture. If your baby is over 6 months old, you may give him a blanket or stuffed animal.

Pick a start time. Yes, there’s no time like the present but let’s be smart about this. It will take several nights and possibly up to 2 weeks. Make sure your calendar is clear so you can focus on the process. Some parents choose a Thursday night and then use the weekend for follow up. No one has yet told me they used vacation days for this purpose.

Create the right environment. The crib should be a completely flat surface with a tightly fitted sheet. No bumpers or toys please in the crib. Make sure the room is cool (no more than 70 degrees) and dark. You might want to install room darkening shades. A nightlight is a good idea.

Put them baby in the crib DROWSY BUT STILL AWAKE. Run through your routine – Krias Shema, lullabies, stories, etc. Then when you baby is drowsy, put him in the crib before he’s fully asleep. Expect some tears, especially if he’s accustomed to going to sleep in your arms. Wait outside the room in increments of 5, 10, 15 and 20 minutes before going back, talking reassuredly to him without patting him on the back or picking him up. You may give him the pacifier. Note: This step may have to be repeated several times.

Be consistent. Regression is normal even when you think you’re over the hump of sleep training. Accept it and be consistent in getting your baby back on track to sleeping longer stretches at night. Has travelling or Yom Tov wreaked havoc with your baby’s sleeping? Is your baby teething? These can cause sleep interruptions. Stay calm and just get back on track right away.

Good habits begun when your baby is little will lay the foundation for other good habits.

Don’t listen to everyone else – Follow your own G-d given intuition. Every child is unique.

Sleep well