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Baby Sleep Guide

the editors of Parenting magazine

Ask a mom of a newborn about her child's sleep and she'll likely look at you through bleary eyes and mutter, "What sleep?" The fact is, it's perfectly normal for babies to have erratic sleep patterns  -- some rest for little more than an hour at a time! But all of them need as much sleep as they can get in order to develop properly. Read on to learn about sleep training, avoiding a "flat head," whether you should co-sleep, how to protect your child against sudden infant death syndrome (SIDS), and more  -- so your baby (and you) can get more zzz's.

Setting a sleep schedule, especially once your child is at least 6 months old, is a good way to make sure she's getting enough rest. Make naptimes and bedtimes as consistent as possible, and build in a cushion of time beforehand to help her unwind  -- show her a book, rock her, or give her a warm bath before bed.

How Much Sleep do Babies Need?
The number of hours of rest a baby needs varies with age. Here's what doctors recommend:

Age: 1 week
Day Sleep: 8 hours
Night Sleep: 8 1/2 hours
Total: 16 1/2 hours

Age: 1 month
Day Sleep: 7 hours
Night Sleep: 8 1/2 hours
Total: 15 1/2 hours

Age: 3 months
Day Sleep: 5 hours
Night Sleep: 10 hours
Total: 15 hours

Age: 6 months
Day Sleep: 3 1/4 hours
Night Sleep: 11 hours
Total: 14 1/4 hours

Age: 9 months
Day Sleep: 3 hours
Night Sleep: 11 hours
Total: 14 hours

Age: 12 months
Day Sleep: 2 1/4 hours
Night Sleep: 11 1/2 hours
Total: 13 3/4 hours

Baby Sleep Soothers
Can't get your baby to sleep through the night? Try these:

Swaddle
Being wrapped tightly helps newborns feel secure. To swaddle your baby:

  • Fold down one corner of a square receiving blanket  -- lightweight cotton flannel works best  -- and place your baby in the middle, her head above the fold.
  • Pull the left side of the blanket snugly across her body, making sure her right arm is across her chest or by her side.
  • Bring the bottom of the blanket up over her feet, tucking the tip under the fold right below her neck.
  • Place her free arm against her side; fold the other end of the blanket over her body.

Massage
Babies and toddlers who are massaged for 15 minutes before bedtime fall asleep sooner and are more likely to sleep through the night than those who are rocked to sleep, according to studies from the University of Miami's Touch Research Institute.

Let her suck her thumb
Or give her a pacifier after she's a month old. It's her way of soothing herself  -- which is key to helping her learn to fall asleep on her own  -- and studies show it may be protective against SIDS.

Provide loveys
Transitional objects like a teddy bear or blankie help make bedtime less lonely for babies. The AAP doesn't recommend that babies sleep with loveys in the crib until they're 1, so remove them after she's asleep. But if your baby rolls over regularly (usually at around 5 months old), she's capable of moving away from a suffocation hazard, so there's less risk of SIDS. A small, crib-size blanket is also fine for a baby 6 months and older, who can push it off or crawl from under it.

Get-to-Sleep Strategies
The best sleep arrangement for your baby depends on many factors. Here's how to find the right baby sleep routine for your family:

The Independent-Baby Approach
How it works: Establish a bedtime routine  -- including a bath or massage, for example -- that lets your baby know bedtime is near. After soothing him, put him down while he's drowsy but still awake, to help him learn to fall asleep on his own. By 6 weeks of age, a longer sleep period (about four hours) will emerge at night.
Best if... Both you and your baby are take-charge types who prefer order and predictability -- for instance, if he immediately knew how to latch on and smiled at exactly 6 weeks. With these "easy" babies, bedtime may be effortless compared to what other moms go through.

The He'll-Get-it-When-He's-Ready Approach
How it works: This is the polar opposite of the independent-baby approach. If your baby prefers rocking, you rock. If he prefers sucking, you nurse or rely on a stash of pacifiers. Not many sleep experts will endorse this laissez-faire approach to bedtime. Yet many parents follow it.
Best if... You're a very patient person. You see no need to nudge your baby into a routine before he's ready.

The All-Together-Now Approach
How it works: A co-sleeper or bassinet next to your bed is safest, but many parents sleep with their baby right in their own bed. Co-sleeping can work as long as you remember that the baby's bedtime is before yours (so don't keep him up until you turn in) and that you'll have less room and will have to be careful not to roll over on him. Also, to keep him safe from SIDS, you'll need to put him down on his back; keep him away from comforters and pillows; make sure he doesn't get wedged against the wall; avoid water beds; maintain a smoke-free environment; and never use alcohol, drugs, or any medication that might make you unaware of your baby's presence and more likely to roll over on him.
Best if... Parenting for you is like one great big bear hug, with lots of holding, rocking, and breastfeeding. Most babies would love this close connection, except perhaps a very active child, who might feel penned in.

The Long-Goodbye Approach
How it works: You're going to very slowly decondition your baby from using you as a sleep crutch. Begin by putting him to bed in his crib, while you sit on a chair next to him. If he fusses, pat his back or head to soothe him, but don't pick him up. Leave the room after he's asleep; repeat if he wakes during the night. Do this for the next three days during naps and bedtime. Then move your chair about halfway across the room and soothe him verbally only. Every three days, move farther away until you're in the hall. Typically by day 14, he's fine on his own.
Best if... You can't bear the thought of hearing your baby cry for hours on end, but you want him to learn how to fall asleep on his own  -- soon. You may also have found that your baby's temperament isn't the easiest: He may be shy and clingy, sensitive and easily overstimulated, or high-energy and intense.

The Get-with-the-Program Approach
How it works: This strategy  -- known as "Ferberizing" because it was popularized by Richard Ferber, M.D., in his book Solve Your Child's Sleep Problems -- is best used after 4 months (you should always respond quickly to newborns) and before 8 months so your baby hasn't fallen into hard-to-break habits. Begin by putting him down when he's drowsy but still awake. If he cries, console him by talking softly and rubbing his back. Leave the room for a brief period  -- about five minutes at first  -- then return to console him if he's still upset. Don't take him out of the crib, though. Repeat this pattern until your baby falls asleep, and again if he wakes during the night. Each consecutive night, lengthen the time you let him fuss by a few more minutes, until it's no longer necessary  -- which, depending on your baby's temperament, may be a few days or a few weeks.
Best if... You don't mind hearing your baby cry because you know it'll get him into a good sleep routine in the long run. Plus, your baby's not the type to get more and more worked up the longer he cries.

Baby Sleep Safety Precautions

  • Put your baby to sleep on his back, even if he was born premature.
  • Use a crib or bassinet in your bedroom or a co-sleeper that attaches to the side of your bed until your baby is 6 months old. He's safer there than in his own bedroom, according to the American Academy of Pediatrics (AAP).
  • Avoid having your baby sleep in your bed. Research from the Saint Louis University School of Medicine found that babies under 8 months old who slept in adult beds rather than cribs were 40 times more likely to suffocate or become entrapped between the wall and the mattress.
  • Steer clear of loose bedding, pillows, or stuffed toys in the crib.
  • Don't overbundle your baby, overheat the room where he sleeps (the AAP recommends keeping the temperature around 65 degrees Fahrenheit), or smoke in the house. All of these have been shown to increase the risk of SIDS.
  • Never let your baby sleep on a sofa.
  • Be vigilant about how your child's caregiver puts your baby to sleep. More than 20 percent of babies in daycare centers are still put to sleep on their tummies.

Avoiding a "Flat Head"
Flat spots on the head (also called plagiocephaly) can develop when your baby continually rests in the same position. To keep this from happening:

  • Vary your baby's sleep position. Most babies prefer to face the action in the room, so periodically change the direction in which you lay your child down in the crib (so that her head is where her feet usually are). That way, she'll rest on different sides of her head.
  • Provide plenty of tummy time. Let your child lie on her stomach when she's awake, and encourage her to look up. She may not like it at first, but a few minutes of tummy time each day is fine for a start. It strengthens her upper-body muscles so she can move her head around when she's lying down.
  • Limit time spent in infant seats. Keeping your child in a position where her head rests the same way against any surface can cause a flat head. So don't leave her for extended periods in infant seats, swings, carriers, or strollers. Vary her position throughout the day, and give her plenty of upright "cuddle time."

If your pediatrician discovers any flattening of the head, she may recommend adjustments or exercises to strengthen your child's neck muscles. With these changes, most flattening improves within two to three months. If it doesn't, a specialist can determine whether further treatment, such as a "skull-molding" helmet, is necessary.

Nap Know-How
To help your child get his rest during the day, use the same strategies you use at night: Provide a pre-nap cue like reading a book or offering a favorite stuffed animal, always put him where he usually sleeps to nap, and try as much as possible to stick to regular naptimes.

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