PREVENTION OF SLEEP PROBLEMS

Description

Parents want their children to go to bed without resistance and to sleep through the night. They look forward to a time when they can again have 7 or 8 hours of uninterrupted sleep. Newborns, however, have a limit to how many hours they can sleep, often only 4-5 without feeding. By 2 months of age, some 50 percent of infants can sleep through the night. By 4 months, most infants have acquired this capacity. It may not develop, however, unless you have a plan.

Guidelines

Consider the following guidelines if you want to teach your baby that nighttime is a special time for sleeping, that her crib is where she stays at night, and that she can put herself back to sleep. It is far easier to prevent sleep problems before 6 months of age than it is to treat them later.

Newborns

• Place your baby in the crib when he is drowsy but awake. This step is very important. Without it, the other preventive measures will fail. Your baby's last waking memory should be of the crib, not of you or of being fed. He must learn to put himself to sleep without you. Don't expect him to go to sleep as soon as you lay him down. It often takes 20 minutes of restlessness for a baby to go to sleep. If he is crying, rock him and cuddle him. But when he settles down, try to place him in the crib before he falls asleep. Handle naps in the same way. This is how your child will learn to put himself back to sleep after normal awakenings. Don't help your infant when he doesn't need any help. (Note: The sleep position recommended by the American Academy of Pediatrics for healthy infants is on the back or side.)

• Hold your baby for all fussy crying during the first 3 months. All new babies cry some during the day and night. Always respond to a crying baby. Gentle rocking and cuddling seem to help the most. Babies can't be spoiled during the first 3 or 4 months of life. A baby who cries excessively may have colic, and this should be discussed with your provider. But even colicky babies have a few times each day when they are drowsy and not crying. On these occasions, place your child in the crib and let him learn to comfort himself and put himself to sleep.

• Carry your baby for at least 3 hours a day when he isn't crying. This practice will reduce fussy crying.

• Do not let your baby sleep for more than three consecutive hours during the day. Try to awaken him gently and entertain him. In this way, the time when your infant sleeps the longest will occur during the night. (Note: Many newborns can sleep five consecutive hours and you can teach him to take this longer period of sleep at night.)

• Keep daytime feeding intervals to at least 2 hours for newborns. More frequent daytime feedings (such as hourly) lead
to frequent awakenings for small feedings at night. Crying is the only form of communication newborns have. Crying does not always mean your baby is hungry. He may be tired, bored, lonely, or too hot. Hold your baby at these times or put him to bed. Don't let feeding become a pacifier. For every time you nurse your baby, there should be four or five times that you snuggle your baby without nursing. Don't let him get into the bad habit of eating every time you hold him. That's called grazing.

• Make middle-of-the-night feedings brief and boring. You want your baby to think of nighttime as a special time for sleeping. When he awakens at night for feedings, don't turn on the lights, talk to him, or rock him. Feed him quickly and quietly. Provide extra rocking and playtime during the day. This approach will lead to longer periods of sleep at night.

• Don't awaken your infant to change diapers during the night. The exceptions to this rule are diapers soiled with bowel movements or times when you are treating a bad diaper rash. If you must change your child, use as little light as possible (for example, a flashlight), do it quietly, and don't provide any entertainment.

• Don't let your baby sleep in your bed. Once your baby is used to sleeping with you, a move to his own bed will be
extremely difficult. While it's not harmful for your child to sleep with you, you probably won't get a restful night's sleep.
So why not teach your child to prefer his own bed? For the first 2 or 3 months, you can keep your baby in a crib or box next to your bed. The American Academy of Pediatrics also advises against babies sleeping in the parent’s bed to reduce the risk of suffocation.

• Give the last feeding at your bedtime (10 or 11 PM). Try to keep your baby awake for the 2 hours before this last feeding. Going to bed at the same time every night helps your baby develop good sleeping habits.

Two-month-old babies

• Move your baby's crib to a separate room. By 3 months of age, your baby should be sleeping in a separate room. This will help parents who are light sleepers sleep better. Also, your baby may forget that her parents are available if she can't see them when she awakens. If separate rooms are impractical, at least put up a screen or cover the crib railing with a blanket so that your baby cannot see your bed.

• Try to delay middle-of-the-night feedings. By now, your baby should be down to one feeding during the night. Before preparing a bottle, try holding your baby briefly to see if that will satisfy her. If you must feed her, give 1 or 2 ounces less formula than you would during the day. If you are breast-feeding, nurse for less time at night. As your baby gets close to 4 months of age, try nursing on just one side at night. Never awaken your baby at night for a feeding except at your bedtime.