Helping Babies to Settle

This is a couple of edited excerpts from the chapter on “Sleep” from my new book “Your Cherished Baby” published by Pan Macmillan and released on the 1st August 2014.

Read on……

IIt is important to understand that babies up to the age of about six months have almost no ‘working memory’. That means that they can’t really ‘learn’ anything at this early age. ‘Controlled crying’, that is, leaving a baby to cry for gradually increasing periods of time, is stressful to the baby (and the parents) and is a complete waste of time and tears.

There is a world of difference between the newborn under 3 months and older infants. At this age the problems are not so much ‘sleep’ problems but that of general crying and fussiness.

In the first weeks babies sleep pattern is mostly dictated by their stomachs. When they’re hungry they wake, when they are satisfied, they sleep.

There is good scientific evidence to suggest that in the early months, prompt attention to distress leads to less frequent waking and disruptive crying patterns later on.

So, always check that your baby is not hungry. Remember that some babies require another feed within an hour of the last one. Studies have shown that the stomach may empty within 30 to 40 minutes following a breastfeed. Don’t worry if he falls asleep on the breast. This is not an important issue until one gets nearer 6 months of age.

If he does not fall asleep spontaneously following his feed, all you should do is keep him calm and keep him close. Babies cannot be taught how to sleep. The human newborn baby emerges in a relatively immature state, so he will respond to an environment that reminds him of the womb. That is:

1)    He’s snugly contained (but not so tight it interferes with his breathing) with rounded back and contained, flexed limbs. In the womb all the limbs are flexed, elbows, hips and knees and that posture is comforting.

2)    He is surrounded by rhythmic noise (the primary noise within the womb is that of mother’s heartbeat).

3)    Within the amniotic fluid, he was immersed in the taste and smell of mother and her diet. He loves lying skin to skin with his mother, with as much skin crammed against her as possible.

4)    It is also very low key and boring within the womb. The inside of the uterus is like a float chamber, visually very unexciting. The environment is quiet, meditative, and calm.

If you can reproduce this environment it is likely your baby will sleep.

 

Prevention of Sleep Problems: 3 – 6 months

About three quarters of babies start to sleep more during the night than the day as they head towards three months of age. On average between 3 and 5 months infants are sleeping for about 10 hours at night, with the longest sleep being between 6 and 7 hours and 75% of babies at this age have at least a 5 hour stretch.

If you have a baby who can’t manage this, as she heads beyond 3 months (depending on the individual) there is good evidence to suggest that a gentle programme to encourage her to prolong sleep will pay dividends. I emphasise that this is a ‘no cry’ preventive program. It is not designed to ‘teach’ the baby to sleep – and they are still too young to learn, but it will help establish for herself the ‘normal’ structure of sleep that most babies exhibit at this age.

The concept is to gently disassociate the act of waking, with the reward of feeding which becomes a conditioned reflex.  If, whenever we wake, we are fed, we will tend to wake more often. By avoiding reinforcing this wake/feed behaviour, and by reinforcing quietness, we will decrease the tendency to wake.

Thus:

1)             Make the first feed of the day in a brightly lit room to switch on the day/night diurnal hormone rhythm in the baby’s body.

2)             Make the difference between day feeds and night feeds to be as obvious as possible. Also cluster activities such as playing, changing and feeding into discrete episodes during the day, interspersed with periods of calm, and hopefully naps. During the night however the environment should remain dark, quiet and unstimulating.

3)             If she lets you, introduce placing the baby into the cot before she falls asleep. But if she insists on falling asleep on the breast, let her at least for the first few months. The cot should be in the same place every night. From 3 months, if possible, bedtime should be at approximately the same time, with the use of the same routines, songs and words.

4)             When the baby re-wakens in the night, don’t delay going to her but delay the start of the feed for a short while. So change her nappy, give her a cuddle, walk with her, all in a calm, dark environment. Then feed her.

This programme should be introduced gradually, with stops and starts over a number of weeks. I emphasise, it does not involve leaving the baby to cry. It is merely to allow her to practice her own settling abilities and to make sure you don’t reinforce a cry/reward reflex.

As mentioned above, by the age of three months about 75% of babies have spontaneously initiated a good day/night sleep difference. Studies show that utilising the above four step regime will improve most of the other 25%. It is not that they are learning something (because, as I said, they are still too young to learn very much at all). What the program does is establish the innate structure of behaviour that is present in every baby at this age, which helps them to regulate their sleep patterns.