Baby sleep

Newborn sleep tips from Dr. Marc Weissbluth

Get sleep survival tips in this Q&A with Healthy Sleep Habits, Happy Child author, doctor and preeminent sleep guru, Marc Weissbluth

By The Mark News
Newborn sleep tips from Dr. Marc Weissbluth

As every parent of a newborn knows (or soon finds out), in the first year of a baby's life, one of the hardest things to deal with is sleep deprivation. A lack of sleep makes every other challenge of child rearing even more challenging. Get sleep survival tips in this Q&A with Healthy Sleep Habits, Happy Child author, doctor and preeminent sleep guru, Marc Weissbluth.
What kind of sleep should parents be hoping for when they get home with their new baby?
In the newborn period, parents’ goal is to encourage the child to learn self-soothing skills – starting on the day they come home from the hospital. They should put the child down while he or she is drowsy but awake, and keep the intervals of wakefulness brief so the child doesn't become overtired. (If the child becomes overtired, it interferes with his or her ability to learn self-soothing skills.) Those intervals of wakefulness might be 30, 60, or 90 minutes for a newborn.
It’s important to start immediately: practicing encouraging sleep in the drowsy but awake period, keeping brief intervals of wakefulness, and getting Dad on board. That phrase – “getting Dad on board” – refers to anyone but the mother. So sometimes the father, sister, nanny, or grandparent should put the baby down to sleep after soothing, so the baby is more able to learn self-soothing independent of mother feeding. 

What signs of baby fatigue are most often missed by first-time parents?
The subtle signs are: the child might be a little less engaged in the environment, his or her eyes might be less sparkling, the child might be socially less smiley, or he or she might be less focused on mom and dad, but maybe looking through them. The child’s body movements might also be slower. So the child appears to be somewhat quieter. If the child is actually fussy, or slightly irritable, then he or she has passed from being tired to overtired, and you say to yourself, “Whoops, I blew it. I should have started all of this10 minutes earlier.”

And what if the baby is already fussy (and thus overtired)? How can the parent calm the child when that's the case? 
It depends on the degree of over-tiredness, and the age of the child. For a mild situation, the parents might just have to accept that they'll need to put forth more soothing to get the child to sleep, or that, once asleep, the child might not sleep very long. Or it may be that the child is so overtired that he or she won't fall asleep. In that case, you have to skip to the next sleeping period and try again.

Also, it's important to know when to let the child cry. Every mother of twins knows low-level crying happens all the time, because you can't clone a mom. When she's tending to one twin, the other child might be crying a bit, but she can't get to it in time and, in the meantime, the other infant has fallen asleep. That mother will develop the confidence to know that low-level crying, which you might call whimpering or moaning or just a little bit of fussiness, can be safely ignored. 

If you had to break down the first year into distinct sleep phases, what would they be? 
At six weeks of age, night sleep develops – longer night sleep with earlier bedtimes. At three to four months of age, naps begin to become more regular around mid-morning (9 a.m. or so) and midday (12 to 2 p.m. or so). These are not exact times, but guidelines. These naps are brief, but they get longer at six to nine months of age, so that, by six months of age, the duration of each nap – the mid-morning nap and the midday nap – is one to two hours. And there may or may not be a third nap. If there's a third nap, it disappears by nine months of age.

Is it ever too late for parents to start sleep training?
It's never too late, but the timing and the way you start it depends on your child's age. If the child is substantially past six weeks of age, but not yet substantially past four months of age, you focus on night sleep, because the night-sleep rhythm is used as an aid to help the child fall asleep. If the child is substantially past four months of age, you focus on day sleep and night sleep because you will be using the day sleep as an aid, too, to help the child fall asleep.
That might mean putting the child down drowsy but awake, it might mean getting other people involved, and it might mean tolerating some crying. However, you should not assume that there will always be crying, because I've done many sleep consultations and occasionally the family will move the child to an earlier bedtime. If the child falls asleep at this earlier bedtime, there is more net night sleep, and that causes the child to wake up better rested, so he or she begins to nap better … and all of these improvements come about without any crying. So there may or may not be crying. 

Have you had any parents doubt the wisdom of the early bedtime?
Of course. They're very skeptical that it will work. It's counterintuitive, but it does help many children. Once you see it, you believe it. And it's so obvious. But first-time parents are more skeptical, and I understand that.

What about parents who come home late from work at night and want to see their children but can't because of the early bedtime? 
There are two ways to look at it. Here’s one example: Let’s say a child needs a bedtime, biologically speaking, and his or her circadian rhythm is approximately 6:30 or 7:30 p.m. – pretend that's the case. And because of commute times, the mother comes home from work around 9 p.m., and the child is sleep deprived because the child is kept up too late. But the mother adjusts her schedule and can come home at 8 p.m. That's the best she can do. Perhaps the child is still going to bed a little too late, but the reality is that 8 p.m. is better than 9 p.m.
We do the best we can in the real world to try to have the child go to bed as early as he or she needs to. Nothing's perfect. Having said that, if the child can be put to bed early, the child should be put to bed early, and sometimes parents might have to make the decision to do so even if it means that they don’t get to see their child at night because of their work schedules, but they spend morning time with their baby and it's warm, loving, friendly playing time, or time spent together as they feed the baby.

There's no 11th commandment that says you have to put your baby to bed at night. But it's important to have a well-rested family. And the benefits are enormous. There are parents who accept this and understand it and, as a result, will put their baby to bed when the child is getting drowsy. But the consequence is that they might not see the child at night Monday through Friday.

Content provided by The Mark News.

This article was originally published on Nov 30, 2011

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