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March/April 2008

Getting up at night with a new baby can be pretty exciting at first! You get to have a visit with your precious little bundle. And, it can be very satisfying to attend to your baby’s needs and see that your actions (feeding, changing, cuddling) leave your little one feeling content. However, after a few months of getting woken up every two or three hours, the novelty certainly wears off. New moms walk around feeling like they are in a fog. And, even the most caring, attentive moms can start to feel resentful toward their little ones when they hear that middle of the night wail. So, what’s a new mom to do…not only to attend to her own needs, but also to help her little one sleep through the night?

Sleep 101 for Babies

There are some excellent books available on infant sleep. Check out our Resources page to see my favorites. For moms who are too sleep-deprived to read these books, here are a couple of quick tips!

Routine, routine, routine: Are you a person that used to fly by the seat of her pants before having kids? Was “Whatever” your favorite word? Now is the time to change! Babies thrive on routine and according to sleep experts, it is never too early to start:

	By about six weeks of age, new babies should start to have a bedtime. Sleep experts recommend that babies go to sleep between 7 and 8:30 PM – even if they wake up just an hour or two later to eat. The idea is to start teaching babies that there is a difference between daytime (when babies take brief naps…often wherever they happen to be when they get tired) and nighttime (when babies should be sleeping for longer stretches, typically in a crib).
	By about six weeks, parents should also establish some sort of nighttime routine. This routine signals the beginning of nighttime. You can establish any nighttime routine that you like. Just remember that whatever you decide on will be repeated every night -- perhaps for years to come. And, remember that you will also use your routine (perhaps in an abridged form) before every nap (again for years to come). SO, before you concoct an hour-long routine that requires a PhD in some super-complex scientific field to follow, please reconsider. Figure out a routine that is brief and simple. Here’s a great example for little babies – nurse/bottle feed, change into jammies, read stories, put baby in crib and turn on some nice music.
	Put Your Baby to Sleep Awake: You might wonder why nurse/bottle feed came first in the suggested nighttime routine just provided. Many parents use feeding (or rocking, or driving around the block!) as a means of lulling their babies to sleep. By the end of that last evening feeding or the end of a long cuddle/rock, parents delicately transfer their sleeping babes to their beds and voilá! Not a peep out of the little guy for several hours to come! Sounds great, right? Wrong! The problem here is that babies (and in fact all people) wake up 2-6 times per night. If babies are put to bed asleep, they do not learn how to put themselves to sleep. So, when they have natural awakenings at night, they will again need your help (via feeding, or rocking, or driving around the block or whatever you’ve been doing) to get back to sleep. This is why it is a good idea to do the last feeding in a bright room (that isn’t necessarily quiet) and then do the calming bedtime routine. By doing things in this order, you will be able to plunk your baby in his bed when he is drowsy but not sleeping.
	Remember that babies cry, and it’s okay: The hardest thing about putting down a drowsy baby is that he will usually cry. You know why? Because babies cry…and that’s okay! Babies might cry to blow off steam. Rather than rushing to the rescue, remind yourself that a few minutes of crying might actually help your little one get to sleep. Decide on a time to go back in and check on the baby – maybe after five minutes of crying for very little babies. Give him a little pat on the back, say a calming phrase, “It’s sleepy time” and leave for another five minutes. Remember that as soon as you DO something to help your baby get to sleep (pop a pacifier in, give him a bottle to suck on, rock him, etc.), you have established a new association between one of your behaviors and sleep. This means that whenever your baby wakes up in the middle of the night, he is going to need that same stimuli to get back to sleep. So, resist the urge to rescue!   When babies get older, they often cry when mom and dad leave the room. This is a time when many parents get into habits like lying on the floor next to the crib till baby falls asleep or bringing baby into bed with them. Sure, this will stop the crying and help your baby to fall asleep. But again, think of the implications. Your baby is not learning to get himself to sleep. As your baby gets older, it will be harder and harder to break the association between you and sleep. This is how I end up with 11 year old kids in my psychology practice who still sleep in their parents’ rooms! The biggest problem for new parents is feeling guilty for letting their little ones cry it out. Try thinking about the situation a little differently. When you allow your baby to get to sleep on his own (even if he cries), you are helping him learn two essential lessons – how to soothe himself to sleep (something he will have to do every night for the rest of his life) and that he can trust his parents. Even though separating can be hard, mom and dad are always there in the morning.
	Have reasonable expectations: People assume that babies should sleep through the night much earlier than they actually do. It is actually not until six months of age that most babies are capable of sleeping through the night. While some babies will sleep through the night earlier than six months, many will not. Rather than becoming resentful of your baby for interrupting your sleep for upwards of half a year, accept it…and savor it. Before you know it, your little one will want to hold his own bottle and will be too busy for cuddles with mom.
	And, stop the battle of the babies: People like to brag that their tiny baby is sleeping through the night. These same people will tell you in a few years that their child plays tennis better than any six year old in the city and then, a few years after that, that their child received full scholarships to “almost every” Ivy League College. Well, guess what? People can stretch the truth! Some people define sleeping through the night as putting their baby to bed at 1 AM and having him sleep until 6 AM. Personally, I couldn’t stay awake till 1 AM with my babies (or by myself) if I drank half the coffee in Kenya! As a psychologist, I can tell you this – when your baby sleeps through the night matters very little. What does matter is teaching your child excellent sleep habits so that he or she knows how to soothe himself to sleep for years to come.

Sleep 101 for Mommies

Taking care of yourself is not selfish: New moms are guilty of the martyr syndrome – “Don’t worry about me…my priority right now is the baby”. Well, guess what? If you are a sleep deprived mess, you are going to be an irritable, clumsy, indecisive, scatter-brained, sad, and nervous mother. Yikes. New moms – you must take care of yourself. Here are some quick tips for how to do so:

	Nap when the baby naps – even if it is just for half an hour a day.
	Hire a babysitter so that you can take a nap. Even an hour, a couple of times a week will make a difference. Pool together the money you are used to spend on lattés or manicures each month and spend it on babysitters instead.
	Share the responsibility of nighttime feedings. This works even for moms who breastfeed – pump earlier in the day so that someone else can get up for one of the nighttime feedings. Even having someone share the responsibility of nighttime feedings a few nights each week (like on the weekends) can make a huge difference.
	And, on the subject of lattés, watch your caffeine intake. Although it is tempting to drink a ton of coffee to battle sleep deprivation, it might result in you not being able to sleep when you have the rare opportunity to do so. It can also add to the nervousness that many new moms are already trying to cope with.
	Establish a new bedtime for yourself. When you have very little kids, it is probably not a good idea to stay up for Letterman or Leno anymore. Remember, if you go to sleep at 8:30, you might be able to catch your favorite shows later when you get up to feed your baby – only you will have a few hours of sleep under your belt already!
	Get rid of the guilt: It is okay to not rush in to check on your baby every time she utters a peep. It is okay to turn the baby monitor off if it is interfering in your sleep – if you can hear crying without the monitor, there is no reason to listen to every other breath, burp, and grunt your loud little one makes throughout the night. And, it is okay to push aside other tasks for the time being, like cleaning every closet in your house (yes, this is on my to-do list right now!). Whenever you put your own sleep first (and feel guilty about it), remind yourself that a more well-rested mom is a calmer mom and a calmer mom is a better mom!
	Have reasonable expectations: A trap that new moms fall into is expecting that they can accomplish in a day what they used to accomplish prior to having kids. Unfortunately, this goal is an impossible one to achieve. And, when moms are engaging in the futile task of trying to do so, it often comes at the price of sleep. Rather than trying to accomplish ten non-baby-related tasks over the course of a day, try to accomplish ONE. Write one thank-you note, clean up one room in your house, make one phone call. Spend the rest of your non-baby-related time tending to your own needs, like sleeping or having a conversation with your spouse.

Are you stressed out about your baby’s sleep habits? Or about your own? Or, have you found some great solutions to these common problems that you can share with other new moms? Click here to join the free Calm Moms Forum.

A group of researchers in The Netherlands have published a paper reviewing all studies on the effects of swaddling (van Sleuwen et al. (2007). Swaddling: A Systematic Review. Pediatrics, 1097-1006). In the universal quest to get our babies to sleep for longer stretches at night, this article is actually quite interesting!

What is swaddling?
 

	Swaddling is a form of “infant restraint”.
	Swaddling, in various forms, has been used throughout the world for centuries. In North America, swaddling is typically accomplished by tightly wrapping a blanket around a baby.
	Swaddling had fallen out of favor in North America in the 19th and 20th centuries on account of all sorts of unusual theories (e.g., that swaddling led to personality problems in adulthood!). Recently, it has come back into vogue based on the assumption that swaddling has a soothing effect on crying infants.

What did the swaddling study find?
 

Two findings were of particular interest to readers of The Calm Mom.com: Swaddling and Sleep Quality: One of the main findings of this review paper is that swaddling does “stimulate sleep continuity”. As you might have noticed, newborns do not have the best control over their little limbs! The thinking is that swaddling prevents startle responses, thus preventing awakenings, thus increasing the length of time an infant sleeps. Research has shown that babies who sleep on their tummies sleep better than infants who sleep on their backs. This is likely because tummy sleeping holds in the limbs just like a swaddling blanket. However, it is now recommended that babies sleep on their backs to prevent Sudden Infant Death Syndrome (for more information on the Back to Sleep campaign, see http://www.nichd.nih.gov/sids/) . Luckily, swaddling a baby who is sleeping on his back seems to bring his sleep quality in line with a baby who is sleeping on his tummy.   Swaddling and Sudden Infant Death Syndrome (SIDS): This review paper also found that swaddling in back-sleeping babies is associated with a reduction in SIDS. There are a number of possible reasons for this. First, babies who are tightly wrapped in a blanket have less risk of having a blanket, pillow, or toy fall over their mouth and nose – a risk factor for SIDS. Second, as we noted above, a baby who is swaddled on his back sleeps as well as a baby who sleeps unswaddled on his tummy. So, swaddling might reduce a parent’s temptation to put babies to sleep on their tummies – again, a risk factor for SIDS. And finally, swaddling prevents babies from rolling from their backs to their tummies. Babies who are just learning to roll are at particular risk for SIDS because they might roll onto their tummies but not be able to roll back to their backs. Swaddling keeps babies in the safer, back-sleeping position.

How can you learn to swaddle your baby and when should you stop?
 

	There is a great video showing new parents how to swaddle their little ones on the Today’s Parent website: http://www.todaysparent.com/swaddling.
	For particularly uncoordinated parents like me, there are great swaddling blankets available. Check out the SwaddleMe blanket by Kiddopotomus, http://www.kiddopotamus.com/p_swad.php.
	The swaddling article does not provide specific guidelines on when to stop swaddling your little one – although it is implied that you can stop when your baby can very reliably roll from his front to his back (and vice versa). Although you should always put your baby to sleep on his back, it is okay to allow him to sleep on his tummy when he rolls over onto his tummy on his own and when he can reliably return to the back-sleeping position if he needs to.
	From the behavioral psychology perspective, here is another thing to consider. If babies get used to sleeping swaddled, they will have a difficult time sleeping unswaddled! As babies develop, they become quite good at wiggling out of their swaddling (not to mention outgrowing all of their swaddling blankets!). This, in and of itself, can lead to nighttime awakenings. Babies might become agitated if one arm is in the swaddling and one arm is out. Or, they might become agitated if they want to suck on their fingers or hands and can’t find them. As soon as you sense that the swaddling might actually be interfering in your little one’s sleep, you should consider getting rid of it! Prepare yourself for a few rough nights. Your baby is going to have to learn how to fall asleep without that constrained feeling. But, stick with it and within a few nights, your little one should be sleeping superbly again!