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Sleep Problems in Babies

Sleep problems are common in babies but understanding and knowing how to deal with them enables parents to get a better night’s sleep for themselves, which in turn enables them to provide loving, patient and consistent care for their baby.

There are all sorts of reasons why babies experience sleep difficulties, but knowing something about the different stages of sleep, what to do if your baby wakes up in the night, and how to establish a regular bedtime routine can be helpful.

Stages of sleep

Babies experience five cycles of sleep. Each cycle lasts about 50 to 60 minutes and consists of NREM light and deep sleep, and active REM sleep.
During light sleep, your baby’s muscles relax, her eyelids flutter and she may twitch, grimace and suck intermittently. If you put your baby in her cot at this stage, she may wake up. Try waiting until her fists unfold and her breathing becomes shallow and regular. It is less likely that your baby will wake up once she has entered deep sleep.

After deep sleep, your baby will enter the frenzied period of active REM sleep. She may grimace and fuss, jerk involuntarily and breathe irregularly. The period between the end of REM sleep and the next cycle of NREM sleep is the most vulnerable one. Very young babies will wake up if hungry, too hot, too cold or if they are uncomfortable. If your baby should need a feed or nappy change (most babies will tolerate a wet nappy), it should be kept as low-key as possible.

If your baby wakes up, but is not hungry or uncomfortable, do not pick her up, speak to her, make eye contact, put on music or lights or interact with her in any way or she will expect the same treatment every time she wakes up. Simply place your hand on your baby to comfort her until she settles back to sleep again.

A regular routine

Research shows that a reduction in parent-infant interactions before bedtime can dramatically improve your baby’s sleep. A consistent, predicable and regular bedtime routine is also important because your baby learns to associate certain events and situations with bedtime. However, it may take a week or two for your baby to fall into a regular routine.

⭐ Allow a quiet wind-down period of at least 20 minutes before bedtime.

⭐ Help your baby to relax and unwind in a warm bath. When she gets out, the surrounding cooler air will lower her temperature, which will help trigger the sleep mechanism.

⭐ Put your baby in special clothes that are only used at night.

⭐ Snuggle quietly with your baby or read a story but avoid overstimulating her or she will still be fizzing at bedtime.

⭐ Use key words such as ‘Bedtime’ or ‘Night-night’ to help your baby associate them with sleep.

⭐ Offer your baby a massage but leave a gap of 30 minutes after a feed or bath, and before bedtime.

⭐ Massage your baby’s feet to stimulate the secretion of melatonin (sleep hormone).

Many parents allow their babies to fall asleep at the breast, in their arms or when they are carried in the belief that it is natural to rock or nurse the baby to sleep. In many parts of the world, this is normal practice. Babies who are kept in close contact with their parents throughout the day typically fall asleep at night while breastfeeding or experiencing skin-to-skin contact. They may also be swaddled and rocked to sleep in their cradles or cribs until they enter the period of deep sleep.

Some sleep experts believe that parents should encourage babies to fall asleep independently to avoid night-waking problems, but there is no research evidence to support this theory.

Helpful tips

Some babies whine for a few minutes before settling, but the sound should not make parents feel uncomfortable. It is not unusual for some babies to take 30 minutes to go to sleep. However, babies should not be left to cry themselves to sleep for longer than a few minutes. A comforting hand on her head or tummy will provide reassurance and comfort.

Babies aged 3 to 6 months may sleep five hours or more once a sleep pattern has been established. However, newborns tend to wake up every two hours for a feed. If your baby is teething, unwell, going through a growth spurt or has been recently immunized, she may experience a temporary disturbance in her sleep pattern.

One common misconception about babies is that they need peace and quiet to get to sleep. Babies find everyday sounds very comforting, having been exposed to them constantly in utero. There is nothing worse for parents than having to tiptoe around in complete silence! Babies also sleep better if the room is completely dark.

By Dr. Lin Day

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