Sleep
Sleep, or lack of it is probably one of the questions Health Visitor Direct are asked most about.
First of all it is important not to have unrealistic expectations from your baby. Many babies will need a feed during the night up to the age of 6 months old. But hopefully, long before this she will have an awareness of day and night, will be in a good bedtime routine and will only be waking for a quick feed and then straight back to sleep.
A newborn baby has no concept of day and night and therefore it’s important to sleep when your baby sleeps. I’m sure your sick of people telling you to do this, but it really is essential, as exhaustion will affect you both physically and emotionally.
- How much sleep does my baby need.
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Adults need varying amounts of sleep and this is also true of babies. Therefore the amounts of sleep stated below are just to give you a rough idea of how much you can expect your baby/child to sleep.
A baby aged 0-3 months usually sleeps 16-18 hours over 24 hours, waking at regular intervals for feeds throughout the day and night.
By 3-6 months a baby can go longer between feeds and will be sleeping for longer periods at night. The average amount of sleep needed is 14-15 hours.
At 6-12 months a baby should be able to sleep through the night, possibly up to 12 hours at a time, as well as daytime sleeps.
There is then a gradual reduction in the amount of sleep a child needs.
- Prevention is better than cure.
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It is much easier to prevent sleep problems, by putting in good sleep routines, than trying to solve them at a later date.
During the early weeks, just start by making day and nights very different. At night keep the lights low, try not to talk to her and if you have to, do so in a low calm voice and keep it to a minimum. When feeding at night, as soon as she has finished, put her down while she’s still awake and don’t even change her nappy unless she has passed a stool or is very wet. The opposite of course is true in the day. Make daytime feeds and alert periods full of singing and chatter, and lots of eye contact and stimulation.
- Put baby down awake.
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It’s important for your baby to learn to go to sleep by herself. If she only ever falls asleep during a feed, being cuddled or with a dummy, she will always need you to get back to sleep, even when she longer needs a feed in the night. She doesn’t have to be wide awake, she can be drowsy, but she does need to be aware that she is being put down and is to go to sleep by herself.
Some babies need a comforter, so introduce a soft toy, which she can become attached to and it can become an aid for sleep. It can take a while for your baby to become attached to it, but if you put it near her when you are comforting her and when you put her to sleep, she’ll eventually become attached to it. It doesn’t have to be anything expensive; some babies become attached to their muslin cloths. - Bedtime routines.
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A bedtime routing is very important, as your baby will learn that this is the run up to bedtime. At a similar time each evening, bath/wash your baby, change her into her night clothes, give her last feed in the bedroom with the lights low. Put her into her crib awake and let her fall asleep by herself. If she does cry, wait a short while before going back to her as she may settle herself. If you need to go back, settle her with as little fuss as possible and then leave again. Repeat this as many times as necessary.
In the early weeks, this routine may be as you’re going to bed, as newborns can be very wakeful during the evening, but you can bring it earlier as your baby is more wakeful during the day and ready to sleep during the evening.Hopefully by following the above advice you can prevent sleep problems. If your baby does have sleep problems then read the sections below.
- Sleep problems
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A sleep problem is only a problem if it is causing difficulties for you, your family or your child. For example some parents are happy for their children to stay up with them in the evening and as long as they are happy with this and the children don’t get over tired in the day, then it’s not a problem.
- Night Waking
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When babies/children go through the light sleep stage of sleep, they can easily wake. This is quite common, but your child needs to learn to go back to sleep by herself.
First try to find out if there is a problem, which is causing your baby to wake. A baby over the age of 6 months should not need a feed during the night, so if she appears hungry, it could be because she is not getting enough food during the day. If this is so, then maybe introduce a supper e.g. cereal. Or, is she just asking for a feed because she doesn’t know how to go back to sleep without a feed? Check for other reasons for waking, for example, too hot or cold, or in older children, afraid of the dark- sometimes a night light can do the trick.
Follow the tips below to help nighttime waking.
- Don’t go to her immediately. Wait a few minutes to see if she will settle herself.
- Do not offer her a milk feed (unless she is under 6 months) this will only encourage her to wake up and she’s not learning to go to sleep by herself.
- Don’t take her into your bed or downstairs – you’re rewarding her for waking up if you do this.
- Settle her down, give her the attachment toy and then leave the room.
- If she cries, leave her for a short period to see if she settles herself, and then go back to her, settle her and then leave the room again.
- Continue doing this until she eventually settles.
To start with, you may be getting less sleep and it’s very tempting to give in and let her a feed or take her into your bed, as you know this will make her sleep. However, whilst nice things continue to happen at night e.g. a feed, then your child will continue waking. Stick to your guns. It will be tough, but eventually your child will learn to go back to sleep without disturbing you.
- Late bedtimes/refusing to go to bed.
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If this is happening, go back to concentrating on the bedtime routine, as described earlier. If your child currently does not go to sleep until very late, it will be difficult for her to suddenly be able to sleep during the early evening. It’s probably worth bringing the bedtime earlier by 20 minutes at a time, so she gradually gets used to it.
Complete the bedtime routine, tuck her in, give her the attachment toy and leave the room. Next follow the same tips as for nighttime waking.
For an older child you can introduce a reward system. This will give her a big incentive to sleep through the night or go to bed on time. A sticker chart is always useful.
When discussing sleep with parents, many will say they’ve tried everything and nothing works. However, improvements will not happen overnight, so consistency and perseverance are important, as it may take a couple of weeks for your child to respond, but stick with it and you will see results.
All children are individuals and therefore the tips above are not set in stone and can be tweaked to suit your child, so if you would like a more personalised plan or have any specific questions regarding sleep, please post a question on the Ask Our Health Visitor page.
Anyway, good luck with it, because we know it’s easier said than done.
The Charity Health Visitor Direct