Let's Talk about Sleep, Baby!

If there's a topic common to all parenting blogs, websites, Facebook pages, and playgroups, it's sleep. Sleep, sleep, sleep. "Does your baby sleep well?" "When did your baby sleep through the night?" "How many times do you feed your baby at night?" "How much sleep are you getting?" "Does your baby sleep in your bed?" Sleep. Always sleep.

Sleep is a necessity, and we feel it when we don't get enough. The whole day is affected by how well we slept the night before, whether or not we have kids. But when our sleep is disrupted because of an external force - the baby - we can become resentful and frustrated, because it feels like something outside of our control. Then the discussions about "sleep training" begin. "How do I get my baby to fall asleep on his own?" "How do I get him to stop waking up at night?" "Is he really hungry at night or just eating out of habit?" "Would a pacifier help? What about a lovey?"

Here's what I know about baby sleep.

1. Sleep patterns are not linear.
We have this idea that babies start out waking every three hours to eat, then decreasing the night wakings over time until they're *poof* sleeping through the night, at which point they will continue to do so. This is really, really not the case. Many full-term, healthy, breastfed newborns will sleep fairly soundly, waking every three to four hours or so to eat, especially when they sleep in close proximity to their mothers. However, at around four months of age, there are some major developmental spurts that cause what we call a "sleep regression." Your baby who was sleeping three to four hours at a time, or even more in some cases, suddenly starts waking every hour or two to eat, fussing, crying, needing to be held or rocked. All the "tricks" you had don't work, and you're exhausted. Things slowly improve, and then, around eight or nine months, it happens again! And again at 13 months. And again at 18 months. While you probably will experience these changes in your baby's sleep habits, you should notice an overall trend, over months and years, toward more acceptable (by adult standards) sleep patterns. Some kids don't sleep through the night until after two years old. Some sleep through the night for a while and then stop. Just because your formerly excellent sleeper is now waking every hour and a half doesn't mean you're doing anything wrong. It just means your baby is growing and experiencing physical and mental growth, learning new skills, erupting teeth, and meeting milestones. And while those years sure seem long when you're in them, one day you will sleep again. I promise.

2. Babies don't need to be taught to sleep on their own.
Sleeping through the night is not a skill that needs to be taught; it's a developmental stage that will be reached when the baby is ready. You have not fallen into some great trap if you don't "teach" your baby to sleep through the night by six months, or a year, or two years. You are not doing your baby a disservice by feeding or comforting him when he wakes at night. You are not reinforcing "bad" habits by shushing, patting, rocking, nursing, feeding, offering a pacifier, or bringing him to your bed when he wakes up at night. You are not creating a future insomniac by assisting your baby in falling back to sleep. There are some methods that may help your baby sleep in longer stretches or cease to wake you up at night, and these range from slow and gradual night-weaning to "extinction" crying. Some of these methods work some of the time for some babies. You may successfully teach your baby to sleep well at night and then find, a few months on, that he starts waking again at night. You haven't done anything wrong if you do "sleep train" and it wears off, and you haven't done anything wrong if you don't "sleep train." And, just because your baby sleeps through the night doesn't mean there's anything wrong with someone else's baby who doesn't.

3. Some babies do need to eat at night, and some don't.
Many pediatricians and sleep experts, especially the "old school" ones, will tell you that a baby older than six months doesn't need to eat at night, developmentally speaking, and that if your eight-month-old baby is still waking to nurse or takes a bottle at night, it's because you're reinforcing a bad habit and not because the baby is genuinely hungry. While some babies will stop waking to eat by six months of age (my oldest stopped waking for a bottle at about 5 months), others will continue to wake up hungry throughout the night long beyond that arbitrary age. A baby needs a given number of calories in a 24-hour period, and while some will take in enough during the daylight hours to sustain them through the night, others will not. If your baby is eating enthusiastically at those 1:00 and 4:00 a.m. wake-ups, then I think it's safe to say she really is hungry at those times. If she sucks a few times and then falls asleep for three hours, she's probably doing what we call "non-nutritive sucking," meaning she's not taking in much milk but just needed a little help soothing herself back to sleep. Increasing daytime feeds (in frequency and/or quantity) may help to decrease nighttime feeds. Remember that, especially in the early weeks and months, those early morning and middle-of-the-night feeds are essential for your milk supply, as prolactin levels are much higher at night.

4. Do what works for you and your baby.
If your baby sleeps the best cuddled up with you, then let your baby sleep cuddled up with you (assuming you're in a safe cosleeping environment, of course). If your baby sleeps the best swaddled in a bassinet in another room, then put your baby to bed swaddled in a bassinet in another room. If you simply cannot function because of how often your baby wakes at night, try a method to get him to sleep in longer stretches, whether that's crying-it-out or cosleeping or something in between. If you are content with your baby's sleep patterns and you can function during the day with the amount of sleep you're getting, don't let someone else's experience make you think you're doing something wrong by leaving things as they are. If you feel there is a medical reason your baby is not sleeping, consult with a doctor. If you feel that your baby is not getting enough sleep for her, see what you can do to help her sleep better. With sleep, as with all things baby, finding what works for you is going to make your parenting journey that much smoother.