Skills for sleep

Skills for sleep: Guiding your baby's ship of dreams

Corrine Langill, RN, BScN

Manager, Health Promotion and Injury Prevention 

Children's Hospital of Eastern Ontario

Why can some babies settle easily to sleep with little fuss, while others need lots of help from parents and caregivers?  According to Dr. Hilary Myron, a baby's temperament and ability to soothe herself is key.  Dr. Myron specializes in behavioural sleep issues in her work at the Montfort's Community Pediatrics Clinic and CHEO's Sleep Clinic.  Dr. Myron says it's normal for very young babies to need a parent or caregiver to comfort them while they fall asleep.   But there are many things parents can do right from the start to help babies learn 'sleep skills'.  Dr. Myron recommends that parents and caregivers develop a comforting sleep routine with their baby from the first day at home. This means 20-30 minutes of quiet, soothing activities in the place where the baby will sleep.  For example, you might give your baby a bedtime feeding, change her diaper, read a story, cuddle, and sing lullabies.  A consistent, comforting routine will make it easier for your baby to settle at bedtime.

During the first few weeks of life, babies sleep a lot and often fall asleep during feeding.  But as they become more wakeful, try to remove this link between feeding and sleep.  After feeding, change your baby's diaper, then put your baby to bed in a dark room while he is drowsy, but still awake.  When babies fall asleep while being fed, or held, they learn to link sleep with feeding or having you there.  When they wake up during the night, as we all do, you're not there.  Because they don't know how to settle back to sleep without you, they cry out.

By the time most healthy, growing babies are 6 months old, they should be able to sleep for 6-7 hours at night without needing to be fed. If your baby is waking up during the night more than you would expect, first check with your doctor to make sure there is no medical reason for this.  If your baby is healthy, and if night time waking is a problem for you, you may decide to look for ways to help your baby sleep through the night.  Night time waking can be exhausting and very stressful for parents.  Fatigue can make it difficult for parents to function during the day, and it can also contribute to depression in parents.

There are many ways to help your baby develop the skills needed to fall asleep.  The methods you choose really depend on your baby and your own comfort level.  Parent need to make a plan that suits their family's needs.  Dr. Myron suggests that parents try to find the best way to break the link their child has made between sleep and a parent being there (or being fed, or anything else the baby can't 'replicate' in the middle of the night).  And while many parents find it hard to listen to their baby cry, it is OK for a baby to cry a little before settling to sleep. 

For example, after a comforting bedtime routine, parents might:

  • Remove one nighttime feeding, and do other things to soothe their baby when she wakes during the night.
  • Lay baby down, leave the room for a few minutes, then return until the baby falls asleep.  Each night, parents stay outside the room for a little longer.
  • Pick their baby up when he cries, comforting him for a moment, then put him back to bed awake.  They continue this until the baby falls asleep in his crib.  Each night, parents increase the time in between 'pick ups'.

Parents will usually see a big improvement in 5-7 days.  Research studies have found that sleep strategies are not harmful, and do not get in the way of healthy bonding with parents.

Even so, some parents still worry that such approaches can be harmful to the attachment process.   Dr. Katherine Matheson, a child psychiatrist at CHEO, isn't concerned about parents using the methods described here.  There is no research to suggest that such strategies do any harm.  She says it's important to remember that secure attachment develops when a caregiver is attuned to the baby's cues, and able to comfort the baby when she's distressed.  Healthy attachment it important, because it gives babies the security they need to explore their world, knowing their caregiver is there for them when they need it.  When using a sleep strategy for a week to help their baby develop sleep skills, parents just respond differently to their child's crying.  And they may wait slightly longer before responding if they feel their baby is not hungry, but needs help falling asleep (especially if the baby is 6+ months).  This allows the baby to learn and practice self-soothing skills so she can learn to fall back to sleep on her own.  But they still respond to their baby's cues, and comfort her crying after a short period of time.

Sleep comes easy to some babies.  Other babies need more help settling to sleep.  Parents can choose from a number of options to help their baby, guided by their family's needs, values and comfort level.  Like anything in parenting, there isn't one approach that fits everyone.   But parents who decide to use a 'sleep training' strategy can do so without worrying that they are harming their child.

Did you know?

  • Everyone wakes up briefly after a sleep cycle (each one is 90-100 minutes long), and falls back to sleep again.  We just don't remember waking.
  • Babies under 3 months of age, have very short sleep cycles of about 50 minutes.
  • Regular naps during the day (following a baby's own pattern) helps babies get better quality sleep at night.
  • For the first 6 months of life, your baby should sleep in a crib, cradle or bassinet next to a parent's bed.  Sleeping with your baby in a bed, sofa or chair increases the risk of Sudden Infant Death (SIDS ) and suffocation.

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