Baby

If your baby has mixed up days and nights, turn her upside down — like somersaults — and the sleeping habits will correct themselves. Sound implausible? That’s just one of the many myths about kids and sleep that tired parents may encounter. And while some, like that somersault one, are easily dismissed, others seem to have proven staying power. Read on for the reassuring facts behind some of the more popular sleep fictions.

Newborn babies sleep most of the time.
The amount of time babies sleep varies widely, anywhere from 11 to over 20 hours a day. The majority, however, average between 14 and 18. So why do new parents often find they’re unable to get much sleep at all?

Young babies need to eat often — nursing every two hours isn’t unusual for a breastfed infant — and sleep in short snatches in between. Frequent feeds help sustain the rapid growth of the early months by keeping tiny tummies topped up and providing a steady stream of nutrients. (In fact, if your newborn regularly sleeps more than four hours at a stretch, you should discuss it with your doctor.) If you count on an hour at each awakening to feed, change and play with your baby, it’s not difficult to see where the day goes. “As I learned when I was a new mother, breastfeeding is a full-time job. That’s why I tell new mothers in my practice to nap when the baby naps,” says Burnaby, BC, paediatrician Cheryl Mutch.

At birth, babies don’t differentiate night and day, so their sleep tends to be distributed randomly over any given 24-hour period. Gradually babies begin to lengthen out the time between feeds and the hours they sleep at a stretch. Experts say that by about three months — and remember this is an average, not a hard-and-fast rule — most babies are sleeping at least one five-hour stretch at night.

Most babies sleep through the night by six months.
All babies awaken throughout the night, says James McKenna, an anthropologist and infant sleep researcher at the University of Notre Dame. Whether their parents are aware, though, is another story. “Some babies will simply go back to sleep while others, presumably with different needs and sensitivities, will awaken and signal their need for contact with their parent, which is not necessarily a sign of immaturity, stubbornness or attempts to manipulate.”

Indeed, a 1999 Today’s Parent survey of babies’ sleep habits found that 61 percent of infants older than seven months were waking at night (and presumably waking their parents).

This stat falls well within the normal range, according to McKenna. In fact, he says, nightwaking is “developmentally appropriate” through the first year of life. Sleeping through the night is like learning to walk — all kids get there, but they do it at their own speed.

Nevertheless, it can be tough for parents who deal with a wakeful baby night after night, especially those who prefer that their little ones sleep in separate quarters. That’s why Mutch encourages families to act before nightwaking has everyone at their wits’ end. “Once breastfeeding is well established, around six weeks, I recommend parents try at least once a day putting babies down drowsy — but not asleep — so that they can learn to settle themselves to sleep.”

McKenna reminds parents that sometimes babies will sleep through the night at three months — but not at six months. Teething, illness, new routines or the onset of separation anxiety, typically in the latter half of the first year, can disrupt previously unbroken nights. “There’s so much going on in that first year,” comments Mutch. “Why wouldn’t you expect that to affect a child’s sleep?”

Even in the second year, says psychologist Sarah Landy, who heads infant and child training at Toronto’s Hincks-Dellcrest Institute, kids may suddenly be more wakeful. Toddlers begin to understand that other people have minds of their own and can make decisions for themselves. A toddler might suddenly become aware that his mother could leave during the night, but hasn’t developed the confidence that she’s not going to do that. Even being put to bed in a room with the door shut can make a toddler anxious, says Landy, “and this anxiety can lead to more nightwaking.” Landy recommends parents let kids know morning and night that they’re close by.

Starting solids helps babies sleep through the night.
This particularly persistent bit of wisdom belongs to our mothers’ generation, but recent research might just be enough to put it to bed.

Researchers in Cleveland divided 106 babies into two groups. Half were given a bedtime feeding of cereal beginning at five weeks, the other half beginning at four months. Parents were asked to keep sleep logs for the children. When researchers tallied the results, they found no significant trend toward sleeping longer stretches in either group, and concluded the cereal made no difference in babies’ sleep patterns.

There are other reasons to hold off introducing solids until kids reach the recommended six-month mark. According to Montreal dietitian Louise Lambert-Lagacé, the most nutritious food for young babies is breastmilk or formula. Young babies don’t have the ability to swallow adequately or digest solid foods properly. Plus, some studies indicate that the early introduction of solids can trigger certain food allergies.

All babies can be trained to sleep through the night.
Rrichard Ferber’s book, Solve Your Child’s Sleep Problems, firmly entrenched the sleep-training model into popular parenting culture. It’s based on the belief that parents should intervene to teach young children how to fall asleep and stay asleep on their own. Ferber recommends that after a soothing bedtime routine, parents put their baby to bed awake. If she cries, parents should make brief, reassuring visits (but avoid picking up or feeding the baby) at gradually lengthening intervals until she learns to fall asleep on her own.

Some parents report that the method works, typically inside a week. Others give up, unable to endure long bouts of crying. Then there are parents who say sleep training seems to work initially, but then nightwaking resurfaces. Ferber himself, in a 1999 New Yorker interview, recanted a little, saying that some children are untrainable. They just won’t stop crying.

Some, like my son, cry until they throw up. (This happened about 20 minutes into our first and only night on the program.) Yet many sleep trainers say I needn’t have been deterred. In Sleeping Through the Night, author Jodi Mindell observes that “vomiting is no big deal for infants and toddlers, although it can be quite upsetting for parents. For young children, vomiting can even be fun…don’t worry about it and don’t reinforce it. Be neutral. Change the sheets, clean up the baby as well as you can (preferably without picking him up) and leave the room.”

For many parents, besides being counterintuitive, this advice demands a steely resolve they’re not up to. A visitor to the Todaysparent.com sleep issues forum wrote: “The myth is that babies need to learn to soothe themselves, which translates as, parent during the day, sure, but at night, no way.”

McKenna says the sleep-training model is perhaps the biggest sleep myth of them all. “There’s no good science here. Problems with sleep arise with the separation of parents and kids.” He says that while some nightwaking babies can be conditioned to sleep through the night and self-soothe at a young age, that’s not what nature intended. Babies, he says, were designed to sleep close to their mothers, which facilitates breastfeeding, provides warmth and protection and may reduce the risk of sudden infant death syndrome.

Mutch says she’s reticent to toss Ferber out completely. “My advice is to modify it. If you can’t stand listening to five minutes of crying — which is a long time — start with one minute.” Mutch draws the line at the cold-turkey approach: I don’t think crying it out after six months [of being rocked or nursed to sleep] is fair. Falling asleep on your own is a learned skill. The bottom line is you don’t let your baby scream for two hours.”

Daytime irritability is caused by nightwaking.
No cause-and-effect relationship here, says Landy. Babies can’t keep themselves awake and will sleep wherever they are, whenever they need to. “I would look for other reasons for the irritability.”

While adults or older children might be irritable because of lack of sleep, babies can be fussy for other reasons, like teething, hunger or boredom.

Temperament can also be a factor, says Mutch. For example, a child who is slow to adapt to change may feel anxious about a switch in daycare. He may be more wakeful at night and seem out of sorts during the day while he adjusts to his new circumstances.

If, however, a child is experiencing a lot of anxiety or is awake for long periods of time at night, parents might want to consult with their doctor to rule out any clinical problems.

Keeping a toddler or preschooler nap-free all day will make her fall asleep more easily at night.
Beware of backfire! Landy and Mutch agree that kids who are overtired or stressed out can have more difficulty falling asleep at night.

“There’s a kind of no man’s land you can get into with this one,” says Mutch. If a child naps early in the day, around 11 a.m., he can be miserable by suppertime — or simply fall asleep in his dinner. A nap late in the day can mean you’re both up when the news comes on. Mutch suggests parents aim for an early nap, one that ends well before four in the afternoon, and build in plenty of active play so that kids are tired by bedtime.

As age increases, sleep needs decrease.
Not quite, says Judith Owens, a Rhode Island paediatrician specializing in children’s sleep. There’s a steady decline from birth through to the middle school years. But the amount of sleep kids need tends to level off at this point or even increase slightly, remaining a constant nine hours or so through the early teen years.

The problem is, it’s more difficult for the average 12-year-old to get the sleep he needs. “Kids going through puberty just aren’t as sleepy early in the evening,” says Owens. Increased hormonal activity and changing circadian rhythms mean a preteen’s optimal sleeping time shifts to between 1 a.m. and 9 a.m. — not conducive to making the school bus.

What can help? Make sure kids get enough exercise, preferably earlier in the day, says Owens, and steer clear of caffeine. A regular bedtime and wake-up time — even on weekends — can help too. “Staying up late and sleeping in two days a week is like travelling from Toronto to Los Angeles on the weekend,” Owens comments. “You’re jet-lagged by Monday morning.”

Owens also recommends a 30-minute unwind time for kids of all ages before it’s time to hit the sack. “We often expect kids to go from 60 miles an hour to a screeching halt. Bedtime routines are there for a reason.” Like darkness or the time on the clock, they signal the body that it’s time to sleep.

Sleepwalkers should never be touched or awakened.
About 15 percent of children sleepwalk at some point, typically between the ages of four and 12. Owens says it usually happens during the deepest sleep state — within two hours of bedtime — and is often an inherited tendency. Kids have no memory of these nocturnal strolls the next morning.

During a sleepwalking episode, explains Mutch, kids may do ordinary things but in a slightly twisted way — for example, peeing in a closet. The best approach, says Mutch, is to gently guide a sleepwalking child back to bed without trying to awaken her, which can startle or scare her.

According to Owens, what’s more dangerous is “the old wives’ tale that sleepwalkers can’t injure themselves.” They can, she says, so parents need to think about safety issues if they have a child who tends to wander at night. Keep outside doors and windows locked — but don’t lock your child in her bedroom — and keep dangerous objects out of reach.

All Night Long

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The next time you fret that you have the only baby who doesn't sleep from dusk to dawn, remember this: "Sleeping through the night" is defined by experts as a five-hour stretch, typically between midnight and 5 a.m.

Snoring

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"Most parents find it cute or funny," says sleep specialist Judith Owens. In fact, children who snore should be seen by their doctor, since it may be a symptom of sleep apnea or another breathing problem.

Sweet Dreams

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No one knows for sure if babies dream, but parents have wondered for centuries why their little ones smile and make faces in their sleep.

The book Mamatoto: A Celebration of Birth gathers some of the more fanciful explanations. In Welsh folklore, a baby’s sleeping smile is from fairies kissing her. Gypsies put sprigs of rosemary in their babies’ beds to sweeten their dreams. And in Tibet, “a dwarfish creature called a rep-thang irritates a slumbering baby, making it frown. But when the rep-thang plays, the baby smiles.”

We do know that babies spend about 50 percent of their slumber in REM or active sleep when waking is more likely and dreams occur. Adults spend only about two hours a night in REM. How can you tell the difference? During REM sleep, your baby’s body and face may twitch or seem to startle. In quiet sleep, your baby is still, his breathing deep and even.

In A Good Night’s Sleep, author Harvey Karp suggests another theory to account for the heart-melting smiles of baby sleep. “Contrary to myth, these grins are not caused by gas; rather, your baby is practising what will soon become his more charming and powerful social tool — his smile.”

Light Sleepers

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Night lights are bad for kids’ eyes. There’s no credible science behind this one, says Toronto optometrist Dennis Bader. Back in 1999, a headline-grabbing study claimed that kids under two who slept with a night light were more likely to develop myopia (short-sightedness) than their peers who slept in a darkened room. Since then, the original researchers have backed away from these findings, saying that their study failed to take into account the fact that myopia tends to be inherited.

Likewise, says paediatrician Cheryl Mutch, kids who sleep with the light on won’t ruin their eyes, but they may have more trouble falling back to sleep if they wake up.

The old admonishment to “Turn on a light or you’ll ruin your eyes!” isn’t true, either. Reading in dim light won’t impair your vision, says Mutch, but all that squinting and straining can give you a headache.

Originally published in Today's Parent, October 2003