Why then have you heard that you should not let your child fall asleep during soothing or feeding? The theory is that your child is learning self-soothing skills, and that she would not learn these if you do not do this. Consider two scenarios. First, you keep the intervals of wakefulness brief, only one to two hours, and you watch for signs of drowsiness (see page 63). At the drowsy time, you soothe and/or feed your baby and she now may be more drowsy and entering the sleep zone, but she is not completely asleep at the end of the soothing and/or feeding. Now she is able to continue to self-soothe herself to deep slumber. This is easy because she was not overtired, and 80 percent of babies (common fussiness/crying) can handle this well.
Second, you allow your child to stay up too long and he becomes overtired. He has passed through the drowsy zone and is entering the fatigue zone. Now, when you soothe and/or feed your baby, you discover that he will not be easily placed in his crib or stay asleep unless he is already in a deep sleep at the end of the soothing and/or feeding. Soothing himself to sleep is difficult because he was overtired, and 20 percent of babies (extreme fussiness/colic) are often this way during the first few months anyway. The problem is not your failure to “put him to sleep when drowsy but awake,” rather, the problem is allowing your baby to become overtired or being unlucky and having an extremely fussy/colicky baby.
This translates into the observation that when parents are successful with the sleep strategy of “put your baby to sleep when drowsy but awake,” there are fewer sleep problems, and when parents do not (or cannot) do this, there are more sleep problems. The truth is, the success of this strategy is dependent on having a well-rested child to start with. If you innocently let your child get overtired or if you have an extremely fussy/colicky baby, this sleep strategy is not going to work well.
WARNING!
The first week of life is like a honeymoon. Newborns “sleep like a baby.”
For all babies: It will become more and more difficult to soothe and sleep the baby in the evening hours at six weeks of age, counting from the due date.
For 80 percent of babies: They settle down at night a few weeks later.
For 20 percent of babies: It will become more and more difficult to soothe and sleep the baby all the time starting at several days of age, counting from the due date. These babies settle down at night at three to four months of age.
When your baby becomes more and more difficult to soothe and sleep, he appears to be more completely out of your control and your life will not be easy.
SLEEP TRAINING DOES NOT EQUAL CRY IT OUT
Sleep training involves several general principles to use the natural development of sleep/wake rhythms as an aid to help your child learn to sleep.
Respect your baby's need to sleep.
Start early to plan for or anticipate for when your baby will need to sleep, similar to anticipating when your baby will need to feed.
Maintain brief intervals of wakefulness, this is the one-to two-hour window.
Learn to recognize drowsy cues (see page 63), though they may be absent in 20 percent of extremely fussy/ colicky babies. Drowsy cues or sleepy signs signal that your baby is becoming sleepy; this is when you should begin your soothing efforts.
When you put your baby down or lie down with him, he may be drowsy and awake or in a deep sleep. Either way works if you have good timing.
Develop a bedtime routine.
Matching the time when you soothe your baby to sleep to the time when he naturally needs to sleep is the key. For 80 percent of common fussy babies, perfect timing produces no crying.
During the first several weeks, many babies fall asleep while feeding or sucking to soothe even if not hungry. This is natural. It is not necessary to deliberately wake your baby before you put him down to sleep or lie down with him in your bed. Later, your older baby may or may not momentarily and partially awaken as you remove your breast or bottle before falling asleep. Do not force him to a wakeful state before attempting to sleep him.
Weeks Two to Four: More Fussiness
All babies are a little hard to “read” during these first few weeks. Most activities such as feeding, changing diapers, and soothing to sleep occur at irregular times. Do not expect a scheduled baby, because the baby's needs for food, cuddling, and sleeping occur erratically and unpredictably. When your baby needs to be fed, feed him; when he needs to have his diaper changed, change him; and when he needs to sleep, allow him to sleep.
What do I mean by “allow him to sleep”? Try to provide a calm, quiet place for your baby if he sleeps better this way. Many babies are very portable at this age and seem to sleep well anywhere. You're lucky if your baby is like this, and you're even luckier if he is one of the few who have long night sleep periods. Most newborns don't sleep for long periods at night.
Studies have shown that for babies a few weeks old, the longest single sleep period may be only three to four hours, and it can occur at any time during the day or night. This is day/night confusion. Extremely fussy/colicky babies may not even have single sleep periods that are this long; premature babies may have longer sleep periods.
Parenting strategies such as changes in the amount of light or noise don't appear to greatly influence babies’ sleep patterns now. In fact, specific styles or methods of burping, changing, or feeding do not seem to really affect the baby. Try not to think of doing things to or for the baby. Instead, take time to enjoy doing things with your baby. Do the things that give you both pleasure: holding, cuddling, talking and listening, walking, bathing, and sleeping together. This active love is sufficient stimulation for now; you don't have to worry about buying the right toy to stimulate your baby.
A change will occur in all babies during these first few weeks, and you should prepare for it. When your baby is about to fall asleep or is just about to wake up, a sudden single jerk or massive twitch of his entire body may occur. As the drowsy baby drifts into a deeper sleep, the eyes sometimes appear to roll upward. This is normal behavior during sleep/wake transitions. Also, all babies become somewhat more alert, wakeful, and aroused as the brain develops. You may notice restless movements, such as shuddering, quivering, tremulousness, shaking or jerking, twisting or turning, and hiccoughs. There may be moments when your sweet little baby appears impatient, distressed, or agitated for no identifiable reason. This is normal newborn behavior.
During these spells of unexplainable restlessness, the baby may swallow air and become gassy. Often he appears to be in pain. Sometimes he cries and you can't figure out why. The crying baby may be hungry or just fussy. This is confusing to all parents.
All in all, now you may not have the baby you dreamed of having. She cries too much, sleeps too little, and spits up on you whenever you forget to cover your shoulder with a towel. Here are some concrete steps you can take to make it easier for everyone.
Take naps during the day whenever your baby is sleeping
Unplug all phones in the house
Go out, without your baby, for breaks: a walk, a coffee date, a movie
Plan or arrange for a few hours of private time to take care of yourself
Do whatever comes naturally to soothe your baby; don't worry about spoiling her or creating bad habits
Use swings, pacifiers, or anything else that provides rhythmic, rocking motions or sucking
If you find that your baby sleeps well everywhere and whenever she is tired, enjoy your freedom while you can. A time will come when you will be less able to visit friends, shop, or go to exercise classes, because your baby will need a consistent sleep environment.
Q: Why are breast-fed babies fed more often at night than formula-fed babies’?
A: It may be that the breast milk takes less time to digest so the breast-fed baby is hungrier sooner. It may be that the mother who has chosen to breast-feed is more sensitive or attuned to her baby and responds more frequently to the baby's sounds, both hungry sounds and sleep sounds. Maybe the breast-feeding mother is more committed to soot
he or nurture her baby, using her breasts as a pacifier even when her baby is just fussy and not hungry. Perhaps the breast-feeding mother responds more often because her breasts feel uncomfortably full. Or, the mother who is breast-feeding is unsure whether her baby has gotten enough because, unlike the formula-fed baby, she cannot see how much her baby has taken.
Q: I've heard that my newborn should not sleep in the bassinet in my room or in my bed with me, that it will spoil him.
A: Nonsense. For feeding or nursing, it makes it easier for both of you if your newborn is close. When your baby is older, say three or four months, both of you may sleep better if he is not in your room. Anyway, by then the number of night feedings is usually smaller.
Brief awakenings in young infants under four months of age are acceptable to most parents because these usually are thought to be caused by hunger. For the older child, especially if he had been sleeping overnight previously, night wakings are often thought of as a behavioral problem. The truth is that awakening at night or complete arousals are normally occurring events, as discussed in Chapter 2. Problems in the older child may arise when he has difficulty or is unable or unwilling to return to sleep unassisted. The more often these events occur, the longer each separate awakening lasts.
Q: When will my child sleep through the night?
A: Many infants between six weeks and four months will naturally go to sleep late around 9:00 to 11:00 P.M., and sleep several hours without a need to be fed. Some call this “sleeping through the night.” After four months, infants tend to go to sleep earlier, around 6:00 to 8:00 P.M., and some now need to be fed once or twice before they wake up to start the day. After nine months, these night feedings are not needed. Except for breast-fed babies in a family bed, more than two night feedings will begin to create a night waking habit.
Weeks Five to Six: Fussiness/Crying Peaks
At about six weeks of age, or six weeks after the expected date of delivery for preemies, your baby will start to return your social smiles.
If you are lucky and have a calm baby who appears to have regular sleep periods, prepare yourself for changes resulting from your child's increased social maturation. The social smiles herald the onset of increased social awareness, and it may come to pass that your baby will now start to fight sleep in order to enjoy the pleasure of your company. This is natural!
PRACTICAL POINT
Try to meet your baby's needs. If he's hungry, feed him. If he's tired, sleep him.
When your baby appears slightly fidgety, ask yourself two questions. First, when did you last feed her? Second, how long has she been up? Sometimes you need to sleep her and not feed her.
Around the time your baby produces her first social smiles, at about six weeks of age, night sleep becomes more organized, and the longest single sleep period begins to occur with predictability and regularity in the evening hours. This sleep period is now about four to six hours long. (If your baby has extreme fussiness/colic, the longest sleep period might be less than this.) Your baby will also start to settle down more and more. She will become more interested in objects such as mobiles and toys, she'll have more interest in playing games, and her repertoire of emotional expressions will dramatically increase.
Yet many parents find this time particularly frustrating, since many babies reach a peak of fussiness and wakefulness at about six weeks. Even extremely fussy/colicky babies may be at their worst at six weeks of age.
THE SIX-WEEK PEAK
All babies are most fussy, cry the most, and are most wakeful at six weeks of age.
One mother told me, “He's a little excited about all the living going on.”
Here is a vivid description of the six-week peak.
ANTONIO'S SLEEP STORY
Like many couples today, my husband, Arturo, and I got married in our late twenties/early thirties, and waited several years before deciding the time was right for starting a family. We felt that although our spontaneous, independent lifestyle would change, we were ready for the challenge of having a baby. Our friends with kids all told us that our lives would change, but it was impossible for us to imagine just how different our lives would be after our baby was born!
Antonio was born two weeks early and without difficulty. I remember thinking several hours after his birth that he was going to be a very easy boy, since my pregnancy and delivery were both routine and relatively easy. Three days after we brought him home, however, I realized that my expectations might have been a little off. Looking back at the notes I took (I kept a spreadsheet with a sleeping/eating schedule and wrote many comments on it about Antonio's habits), Antonio started crying that day at about 8:00 P.M. and didn't stop until 5:30 A.M. After an extremely stressful night of walking Antonio up and down the hallway, rocking him, and doing everything we could think of to soothe him, he finally fell asleep, exhausted, at about 6:00 A.M. It was a terrible feeling for parents who love their baby so much not to be able to soothe or comfort him! My husband and I felt like failures, and we called the doctor the minute the office opened that morning and pleaded for help. Luckily, we found out that part of his crying that night was due to hunger, as my breast milk hadn't come in yet. That was an easy problem to fix!
We remedied his hunger quickly, but he still seemed to cry a lot. Over the next three weeks we started to notice a pattern of crying that started at about 5:00 P.M. and usually lasted for about six hours. In addition to that, Antonio awakened every two hours to be fed (as most babies do) during the night and didn't take daytime naps! During these early weeks the only way Antonio would sleep, night or day, was if either my husband or I held him. Needless to say, both my husband and I were as desperately in need of sleep, as Antonio was! At the time, my husband said that he couldn't understand why our baby cried so much and slept so little when every other baby he knew didn't seem to have these issues. In fact, of all the new parents we met through my prenatal exercise classes (there were fifteen to twenty couples we knew who had babies at the same time), only one other baby seemed to have the same type of behavior. In addition, couples with older babies and toddlers were no help whatsoever, as they all claimed to “forget” whether or not their babies were fussy. I could not believe anyone could ever forget what we were going through. My husband thought we must be doing something wrong, and I was afraid he might be right, although I didn't admit it at the time.
When Antonio was about three weeks old, I brought him to see Dr. Weissbluth. We discussed his sleep patterns (or lack thereof), and he advised me that Antonio's evening fussiness would get worse until he was six weeks old, and then it would start to improve slowly and hopefully end at about twelve weeks. I was quite dismayed to also learn that since Antonio was born two weeks early, I had to count Antonio's age from his original due date, not his birth date. So instead of having only three more rough weeks, we would probably have at least five! That's an eternity when you're sleep-deprived! I really didn't know how we were going to make it through that rough period! At one point I remember counting out the weeks until week six, as I did at least every other day, telling my husband, “We only have three and a half more weeks!” To which my husband replied, “And what if he doesn't get better after that?!” I think the biggest worry we had was that Antonio's fussiness would never end. This being our first child, we weren't 100 percent sure he would ever grow out of this! In the midst of this period, it seemed to us that this would be what our new lives would be like forever—endless nights of holding our crying baby followed by bleary days of holding him so he would sleep. We knew in our minds that he had to get better, but the big question was when.
Then, at about six weeks after Antonio's original due date, I couldn't believe it, but I actually started to notice that his evening fussiness was decreasing! It was almost six weeks to the day, and I was utterly amazed that Dr. Weissbluth's timetable was so accurate. In addition, at the same time, his nighttime sleep started becoming a little longer and he started falling asleep in his crib instead of having to sleep w
ith me! The improvements were small, but at that point I was just ecstatic to have four solid hours of sleep at night! At about ten weeks I called the doctor and received encouraging advice. He suggested that I start putting Antonio to bed earlier at night, as this might help him feel less tired and make him fall asleep more easily. At the time, Antonio was going to bed between 10:00 and 11:00 P.M. SO I moved his bedtime to around 8:00 P.M. for a few nights, and I could not believe how well this worked! I then started putting him in his crib even earlier, as I noticed that he actually became tired at around 6:30 P.M. Antonio is now almost five months old, and he has been sleeping from 6:30 P.M. through the night to about 7:00 A.M. He has been doing this since he was twelve weeks old. He does wake up occasionally at 4:00 or 5:00 A.M. if he's hungry, but for the most part he sleeps extremely well at night, and is even starting to form regular daytime naps! Arturo and I still can't believe that our “colicky” baby is such a great sleeper now. If we had only known this back in week three, we would have been a little less stressed out! I hate to say it, but like most of my friends with older children, I'm forgetting the details of his fussy period, too! Antonio is such a joy to be with, I actually might want to have a second baby. Yikes!
Your baby may irritate and exhaust you. She may give up napping altogether and, to make matters worse, when awake may appear to be grumbling all day. You may feel battered at the end of each day; you may be at your wits’ end. This, too, is natural. Being annoyed with your baby does not make you a “bad” parent. Just understand why you're annoyed. Remember that your baby's immature nervous system lacks inhibitory control. The brain will develop inhibitory capabilities as it matures, but this takes time; things will settle down after six weeks of age.
Healthy Sleep Habits, Happy Child Page 22