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Baby Sleep Patterns

Paediatrician and Baby Channel Medical expert comes into the studio to discuss baby sleep patterns.

Mon, 8 Apr 2013|

-One of the things new parents crave most is a good night sleep, for themselves and their baby. But settling a baby into a good sleeping routine isn't always easy. Dr. Su Laurent is a Consultant Pediatrician at Barnet Hospital in Hertfordshire and the Baby Channel's medical advisor. Thanks very much for coming in today, Su. -Hi. -Su, how much sleep do babies need? -Well, the sleep that babies need to begin with, first of all, is very variable, but usually, they are going to sleep about 18 out of 24 hours to begin with, and that sleep gradually will reduce over the first year of life. -And how much-- how do you basically get your baby into a good sleep pattern? It's the kind of question that all parents want to know. -This is the fifty million dollar question, isn't it? And this is so important to begin with. And I must say that although I say this to parents all the time, I'm the worst example. I have got three kids and I didn't get any of them into very good sleep patterns to begin with. And I had to put them all through sleep programs eventually to get them to sleep through the night. But this is-- this is the essence of trying to get your child into a good sleep pattern, and that is encouraging them or training them to be able to go to sleep from a position where they are still awake. In other words, a natural tendency is we breast or we bottle feed our baby, we then very, very, very, very, gently put them down like that, and then we tip-toe away and make sure that they are very, very quiet. -Maybe if they are waking up, it's a nightmare, isn't it? -Exactly. You're picking up again and then you rock them up, then you kind of put them down again. And then what we're training our babies to do is to need us in order to go to sleep. But if on the other hand, we feed them, we get a little sleep. For example at night, when they are a few weeks old, we'll get them into a routine, where you might give them a buff first and read them a little story, and then give them a little feed and then put them down while they're still awake but sleepy, and then say, night, night. And go out of the room, hopefully you'll train them to realize it's actually okay to go to sleep with mommy or daddy not in the room, and therefore, when I wake up in the middle of the night and I realize I am on my own, or there's mommy and daddy near me in the bed, but I don't actually need them to pick me up and cuddle me and put me back down to sleep again. That is good sleep training. -So, for many parents who, you know, want to try this kind of routine because, you know, the baby is up at times at night and day,-- -Yes. -how long does this sort of program take realistically? -Okay. Well, the question is when you're going to start this little program. Most parents will do whatever feels natural for the first three to six months of their baby's life. In other words, they'll feed them, they'll put them down, and they'll try to get them into a good sleep program, but if they don't, that's fine, and then they will be hoping that by about six months or so the baby naturally sleeps through the night and everything is hunky-dory. But for those where they don't sleep through the night, where they want to try and encourage a good sleep pattern, that's where you're going to want to try a really sort of intensive program to train your baby that it's okay to go to sleep at night by themselves. And so what you will want to do is to really aim to get to start off by getting them to go to sleep by themselves at the beginning of the evening, and if they won't do that, what you're going to do is perhaps stay with them, but not keep picking them up, just say, "It's okay, mommy is here, or daddy is here, go back to sleep, you go to sleep," and just talk to them and then leave them and then ease yourself out of the room. And then you might want to go back five minutes later and say, "It's okay, it's time to go to bed now." Just very quietly, but don't actually go and pick them up or rock them or give them anything to feed. And then withdraw yourself, and then you can wait a little bit longer if you dare. And if they're still crying, go back and settle them again, but just by talking to them. And that is what we call the checking system, which means it's okay for you because you know they're okay. And you feel it's okay for them to know that you're there as well. But again, don't pick them up. Just leave them. -A lot easier said than done. -A lot easier said than done. -Talking from experience in my baby. Well, then my husband is worse. -It's really hard. Well, men are often worse. -He must be straight in there, picking him up, rocking him to sleep and-- -Well, I see a baby's cry is made to get you to react; that's what it's all about because it's the baby's survival. And they cry to make you react, and they cry to make you feed them, they cry to make you pick them up and cuddle them because they love comfort, they crave comfort. They cry to make you change, but it got really messing up. Usually babies can tolerate a sort of messing up for quite a long time. But they'll cry if they're really uncomfortable. They'll cry if they are too hot, or they are too cold. It's there for a reason. But if you know actually as a parent know that your baby is crying not because there is any form of discomfort, because they just want to cuddle, that's the point which you have to recognize that it's actually better than everybody to get your baby into a good sleep pattern than for you to be frazzled and worn out the next day and feel baby to be frazzled and worn out the next day. -I suppose one of the tips is the skill and the confidence in knowing the different cries, isn't it, with your baby? -Yes, yes. And I think with the first baby, it's actually quite difficult. I mean, I will so think that I couldn't tell my baby's cry from another baby's cry with my first. You can always say. -It's true. -You can always tell your own baby, don't they? And I often found, you couldn't. I thought is that mine? You know, you don't-- you have a crowd of friends around, and everyone will go, whose is that? -Yeah, it's very true. -But after a while, you do kind of recognize sort of a hunger cry. You do kind of know that sort of times a day when they sort of start to really be hungry, and you feed them and then they settle and that's fine. And you do recognize a painful cry. And after a while, you think that's a whimpery, I-want-to-be-picked-up kind of a cry. And that's really the time at which you have to say, "Okay, do I want my baby to sleep through the night?" I mean, this is a crucial question. Because many parents I see say, "I don't mind getting up three times at night to my baby. That's absolutely fine. That fits in with me, my family, it's not a problem. My husband and I share it. I don't want my baby at any point ever to cry and not feel that we're there." And in that case, I'd say that's fine. That suits you and that suits your family and that's absolutely fine. But if you reach the point where you say, "No, actually, I really would like a good night sleep from now onwards and I think my baby be better off, or by now my toddler will be better off for the good night sleep," then you need to think about how you're going to do it. -I think I must be a very intolerant person. By eight weeks, I was hearing my mom saying help, how do I lead to sleep through the night? -Yes. -Because I couldn't-- You know-- it was in my head and he had no sleep pattern day or night, and I think one of the tips that she gave me, which we would be interested to see what you think, was obviously the hardest thing is walking out when your baby is crying. But what I would do is wait until he actually stopped crying. So I wouldn't pick him up, but I would just kind of soothe him or, you know, stroke his back so that he's gonna stop crying, and then when he stopped crying, then I'd walk out the room, because apparently, psychologically, it's very different. If your, you know, baby is calm when the parent-- -For you. Yes. Exactly. -than when he is crying. -Yes. -Now most of the time, you know, I walk out. Within 30 seconds he's crying again-- -Yes. -and then I'll leave him a few minutes before going back. But there just seems to be quite different from when I just went in, left him crying, to going in, getting him to calm down, and then going out. It seemed to break the cycle of the escalation of the crying he sort of makes. -Yes, yes. And it also sort of makes you feel better as well, I think. It makes you feel that he can settle quite quickly, and you were very successful, weren't you? -A fluke! Fortunately, it took three nights-- -Yes. -and then he's now sleeping through the nights. -So that's from eight weeks? -From eight weeks, yeah. -And that's because you meant business. I mean, you went in with a plan, didn't you? You decided he was going to sleep through the night and you were going to make it happen. And you began to continue doing your program until it happened. I think this is the real essence of it all, is to decide, and once you've decided, both parents, if there are two parents, both parents have to decide that they're going to do this together. You can't have one saying I want to do this and the other one not, because the one who doesn't want to do it will crack inevitably, inevitably, and usually, in my experience, it's actually the bloke who cracks first. So you need to both decide, and actually, if you have left it long time until you've got sort of a really screaming toddler, you may need to warn your neighbors as well that you're going to do this. -Right. -I often say that parents, particularly if you live in a block of flats with thin walls, I say to parents when they say, "What happens if my neighbors hear my baby crying, well they be worried?" And I say, "Well, actually it is worth popping in and saying, "Look, I hope you don't mind, but I'm gonna try for the next few nights to get my baby to sleep through the night and that might mean a bit of crying." And usually, that makes everybody feel a bit more relaxed. -Yes, this is true, because it's the first thing you think of, isn't it? Once you know that the baby-- -Yes. -is fine and happy. You know, they carry on crying. If you're with the baby, it's gonna be thinking. -Exactly, exactly. -I'm a bad mom. -Then you have to decide who is going to be the person that does it. And it may be that one parent acknowledges that they just can't do it. They can't be the one to just pop in and say everything is okay, and then withdraw, undo it. And it may be that parent shouldn't even be in the house for the first night. You should just be one, or maybe the parents need to support each other through the whole thing and do it together. But you need to decide, and it's much, much easier doing it if your baby is in a different room. If you're doing it when your baby is in the same room as you, then it's very difficult to just lie there in bed listening to all the cries and do nothing. It's much easier if they've got their own room, and you can withdraw and close the door and go out. -Su-- Yes, exactly. So it's definitely easy if they're in a separate room, but for those that their baby is sleeping with them-- -Yes. -actually physically in their bed or even as a toddler, they're still sleeping in their bed, what advice would you give to them? -Well, it's much hard if your baby is in your bed. And in fact, you probably heard recently, there's been quite a lot publicity about not co-sharing, co-sleeping with your baby because of the increased risk of cot death particularly in the newborn babies. And the recommendation is, you should have your baby in the cot right next to your bed for the first three to six months of life. You should pick them up and feed them with you in bed, then you should put them back into their own space, which would make it slightly easier from the point if you're trying to do a sleep program with your baby. But again, if you're trying to get into sleep with you and there in your room, then what you need to do is to put them back down. Once they wake up and they cry, you can just touch them, stroke them, settle them back down again and then leave them, and say, "Go back to sleep." And then you're going to have to go back, get back into your own bed and then just wait while the crying carries on, when it starts up again, and then five minutes later, say, "It's okay, go back to sleep" very quietly and then wait again. Personally, with my third child, I did the short shot shock approach. I didn't do check, check, check, check every five minutes. I did, "You're going to go to sleep now, good night," went out again and then hour-and-a-half later. -An hour-and-a-half? -An hour-and-a-half later with my husband saying, "That's it, that's it, I can't bear this any longer." He went to sleep, didn't wake up again. For a single night after that, that was it. -Oh really? Short shot shock. -One night and that was it. -Now, a lot of people would say, with that kind of approach,-- -Yes. -you know, oh, you're going to psychologically damage, you know, the baby. -The answer is absolutely not, absolutely not. They're in their own environment, they know there is that. They've often got a sort of comfort, my kids all have blankets that they love. And it's important that they're in the kind of environment where they've got familiar things, familiar smells, it might be the bit of music what your child likes, might be something like that that they are familiar with, but whatever it is, they will not be psychologically scarred. And in fact, the fact they have got a happy cheerful mommy and daddy the next day, who is not sleep-deprived, and they've got a-- and they themselves have a good night sleep, it's so, so important. I can't stress that enough. And the parents who say to me, "I just can't leave my child to cry. I'm sorry, whatever you say. I want a method which means that they don't cry." I say, well that's fine, that's absolutely fine, but you may find it takes you a lot longer for your child to sleep through the night, but that's fine. Then when eventually they just say, "I can't bear this any longer, I've got to put them through a sleep program." They then come back and they see me and they say, "I wish I've done that six months ago. -There you go. Right. -I really wish I had done it six months ago." If you leave it to the point where they can climb out of their cot, or climb out of their bed, before you do a sleep program with them because they are still waking up several times at night, you've really lost the game there, because then you've got them coming out into your bed all the time and then you've not only got to try and settle them down in a cot which they can't get out of, but now you've got to get-- you've got to lift them, carry them back, put them back into their bed, and then get back into your bed, and then carry them out again, put them back. -So the problem is a lot greater. -Exactly. -Okay. So, just to summarize for parents watching this and to do pulling their hair out like rubbing their eyes, or falling asleep at work, what are the key messages to help them get their baby or their child to sleep? -The key message is, first of all, if you can from very early on, try and practice getting your child into a good sleep routine, which means that you will leave them to go to sleep on their own, very sleepy, but not quite asleep; that's the first thing. After that, if you've got a child who hasn't naturally got into a good sleep pattern, when they wake up at night, to go to them, to check that they're okay, check that they haven't been sick or whatever that I don't think it's sort of real mettle, to settle them down and then to leave them without feeding them. This is by the time-- by without feeding them, I mean when they've reached the point when they no longer-- -Yes, no need to feed through the night. -need feeds at night without feeding them, to settle them down again. Then if they wake up again, which they almost definitely will, again to settle them down again, to keep checking and to settle them. I do recommend buying a good book. Because if you've got a book in front of you, you do step-by-step what you're being told, that's often extremely helpful. To recognize that you're not going to do your baby any psychological harm by putting him through a sleep program and to rope in all your friends and family to help you with it. I think those are my key messages. -Well, thank you very much for all your help and advice, and if you've got a little one who is trying to get to sleep, hopefully that will help you.