Your Most Common Sleep Questions Answered!

by William Sears, M.d.

Your Most Common Sleep Questions Answered!

With eight kids, my wife, Martha, and I have seen our share of sleepless nights. And we’ve learned that, though we may like them to, our parenting responsibilities don’t end when the sun goes down. Helping our babies develop a healthy attitude toward sleep at night is just as important as reading to them or encouraging them to babble during the day. Three a.m. feedings and tripping over toys in the dark are no fun, I know, but while those middle-of-the-night moments you share with your baby won’t last long, the message of your love and availability will.

Here are some ideas from the Sears’ family home to help you find the nighttime parenting style that is right for your baby and you.

A Restful State

Why does my baby wake up at night? I have friends whose babies sleep straight through.

Babies have shorter periods of deep slumber than adults and spend much of the night in a state of light sleep from which they can be easily awakened. Also, infants’ tiny stomachs don’t allow them to go much longer than three hours without eating, which is why yours wakes up for nighttime feedings. So take comfort in the fact that your baby is not sleeping through the night  — it’s all part of being normal.

At what age will my newborn begin to sleep soundly through the night?

By the time they are 3 months old, many babies may begin to sleep for a four- to six-hour stretch at night. And between 4 and 6 months, the majority will start to sleep from around midnight until dawn. (And they’ll often sleep for a little longer after an early-morning feeding.) But the age at which babies sleep through the night varies tremendously, so have patience.

I can never predict when my baby will fall asleep or wake up. Is there a way to get her on a schedule?

A schedule is a great idea; it will help your baby’s sleep patterns become more predictable. Start by establishing a consistent bedtime and some routines around it so that your baby will learn when it occurs. Try a soothing massage, a warm bath, a feeding, or a lullaby. Soon, she will associate the ritual with the sleep that is expected to follow.

Remember that the rituals and sleeping arrangements that worked for your baby when she was 3 months old may not work for her when she is 9 months old, and that what works for an older sibling may not work for your next child. There’s no “right” or “wrong” when it comes to your baby’s sleep schedule  — whatever gets everyone the best night’s sleep is the one that’s right.

Should I feed my 3-month-old baby solids to help him sleep through the night?

Your son’s tiny stomach can only hold so much food, so no matter what you feed him, he will still wake up for more in about three hours. It’s best to wait to start solids until your baby is 6 months old, when his tummy and his digestive system can handle more substantial food. And because he doesn’t need to be fed quite so often, he’ll sleep for longer periods of time. In the meantime, a great sleepytime snack is breast milk, which may calm and soothe him.

More Restful Tips

What’s the quickest way to get my 9-month-old back to sleep when she wakes up at night?

Some babies will resettle with a simple pat and a lullaby, while others may need to be picked up and rocked. If your daughter needs these extra comforts every so often, give them to her. But by this age, you should be teaching her how to go back to sleep on her own. When you feel her getting drowsy, put her back down in her crib so she can drift off by herself. Soon, she’ll self-soothe, and you’ll both get through the night with no trouble.

I’m nursing. Is it safe for my baby to sleep in my bed?

While the best place for a baby is his own crib, with a few precautions, sharing a bed with your infant can be safe. We’ve found that it’s comforting for a baby, and it’s certainly convenient for mom, too: You’ll both rouse for quick feeds during the night, but if you’re right there next to each other, neither of you need to fully awaken. Here are a few safety precautions:

  • Do not share a bed if you are taking any sedative medications or if you drank alcohol.
  • Place your baby to sleep on her back on a firm, flat mattress.
  • Do not use a waterbed, sheepskin, or featherbed.
  • Remove all pillows, comforters, other soft bedding, and fluffy items from the crib.
  • Do not overbundle your baby. Your body heat will keep him warm.
  • If you use a bed frame, the mattress should fit snugly with no space between the two.
  • It’s best that relatives other than the child’s mother not sleep next to a baby under 2  — they aren’t as accustomed to the baby’s presence, making them more likely to accidentally roll over onto the child.

An alternative to sharing the family bed is to use a co-sleeper, a criblike infant bed that attaches to your bed. This arrangement allows both you and your baby to have separate sleeping spaces, yet keeps you within arm’s reach of each other.

At 4 months of age, my baby was sleeping through the night, but now, two months later, he’s waking up again. What do you think is going on?

I’ve heard this tale from many parents when they bring their baby in for the 6-month checkup. Sleep routines start to get thrown off around this age for some of the following reasons:

  • Teething may have started even before teeth are visible.
  • A major developmental change, such as moving from sitting to crawling, can wake a baby up at night. He may try to crawl, bang into the side of the crib, and get upset.
  • Between 6 and 12 months of age, many babies experience separation anxiety, or the fear of being left alone, making them more anxious when you put them down at night.

Here are some general tips to keep your baby comfortable all night long:

  • If your baby is too cold or too hot, he’ll wake up, so dress him appropriately for bed. The ideal room temperature for babies is 70°F.
  • Along these lines, be careful when you dress your infant in new, unwashed clothes. He may be sensitive to synthetic fabrics or chemicals. Cotton sleepwear is less irritating.
  • Nasal congestion due to dust or mold allergy will interfere with sleep. Keep the nursery allergen-free by removing fuzzy toys that can collect lint and dust and keeping smokers outside.
My 9-month-old just won’t go down for a nap during the day. What can I do?

Try two Sears-family strategies. Consistency, as with bedtime, works wonders for naptime. Pick two times of day when you and your baby are most tired and stick to them. Movement works, too: Put your baby in a sling or stroller and walk around the house. You’ll lull your little one right off to dreamland.

When to Call the Doctor

Though waking in the middle of the night is a rite of a passage for all babies and their parents, you don’t want to miss any underlying medical reasons that could be causing your baby’s distressed sleep. Call your doctor if your child has:

  • sudden colicky-type abdominal pains, indicated by anxious crying, an arched back, red face, and clenched fists;
  • not slept well since birth;
  • inconsolable crying;
  • or if your intuition tells you something is wrong.

Call your doctor and explain what’s going on. He may discover one of the following common conditions:

  • Gastroesophageal reflux disease (GERD) When your baby lies flat, irritating stomach acids are regurgitated into the esophagus, causing heartburn-like pain. Treatment is available.
  • Food allergies If your baby is restless most of the night and is generally gassy, an allergy to cow’s-milk-based formula or to cow’s milk obtained through breastfeeding might be the culprit. You may need to change formulas or alter your own diet slightly.