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Tips for Healthy Sleep in Infancy by Dr. Dominica Donnal

Tips for Healthy Sleep in Infancy
 
One of the biggest challenges facing new parents is the sleep deprivation that comes along with countless nighttime feedings, pre-dawn awakenings, and hours spent rocking your baby to sleep.  This is normal and expected in the first months of life; however, by 6 months of age, most healthy babies should be able to fall asleep on their own and stay asleep through the night.  Let’s break down the first year and talk about what you can expect from your baby at each age and what you can do to help your baby become a great sleeper. 
 
 
Zero to Two Months
 
What should I expect from my baby?
 
You can expect your baby to sleep 14 – 18 hours total per day.  Your baby needs to eat frequently and is not yet neurologically mature enough to fall asleep on his own.
 
What can I do?
 
Don’t worry about establishing a sleep schedule or good sleep habits yet - it’s too early!  Focus on feeding your baby when he is hungry, and do whatever is necessary to help him fall asleep, including rocking, bouncing, singing, feeding, and providing a pacifier.
 
 
Two to Four Months
 
What should I expect from my baby?
 
You can expect your baby to sleep 12 to 14 hours with 3 – 4 naps per day.  Most healthy, full-term babies should be able to sleep 6 hours without needing to feed by 4 months of age.  You may notice that your baby is beginning to develop a more regular sleep pattern and is becoming more aware of his environment.
 
 
 What can I do?
 
The most important thing to do at this age is to establish a sleep routine! The goal of your sleep routine is to teach your child to fall asleep, and stay asleep, on his own.
 
 
How do I establish a sleep routine?
 
1. Pick a few enjoyable activities that you will be able to do every evening with your child.
 
2. The key to the routine is consistency - it should include the same activities and occur at the same time every day.
 
3. The latter part of the routine should take place in the room where your child will be sleeping.
 
For example, this is the routine we do with my one-year-old son: At 7:30 p.m. he has a bath. After the bath we dress him in his PJs, read Goodnight Moon, and give him his milk. After his milk we brush his teeth, sing a song, and put him down in his crib by 8 p.m.
 
 
Why is it so important for my baby to learn how to fall asleep on his own?
 
We all go through several sleep cycles each night. At the end of each cycle, there is a brief partial awakening. A baby who knows how to fall asleep on his own will easily move on to the next sleep cycle after this brief awakening. A baby who is accustomed to falling asleep while feeding, for example, does not know how to fall asleep on his own, and he will wake up fully at the end of the cycle, expecting to be fed in order to fall back asleep.
 
 
 
Four to Six Months
 
What should I expect from my baby?
 
You can expect your baby to sleep 11 – 14 hours with 2 naps per day.  A healthy, full-term baby should be able to sleep 9 hours without needing to eat at 5 months of age, and 12 hours at 6 months.  Furthermore, most babies develop the ability to self-soothe (calm themselves) at this age. This means that your baby is now developmentally mature enough to fall asleep on his own.
 
What can I do?
 
Continue your sleep routine.  Remember to keep nap and bedtimes the same every day and to begin the sleep routine before your baby gets overtired.
 
 
Six to Twelve Months
 
What should I expect from my baby?
 
You can expect your baby to sleep 11 to 14 hours with two naps per day.  By this age, your baby should be sleeping through the night and falling asleep on his own.
 
What can I do?
 
If your baby is waking at night or not falling asleep on his own, 6 months is a reasonable age to start sleep training. 
 
How do I sleep train my baby?
 
Sleep training refers to a variety of behavioral methods that are meant to address sleep problems.  There are several different approaches.  One that has been proven to be effective and work fairly quickly is the “cry it out” method.  With this method, you place your child in his crib at bedtime while he is still awake and allow him to fall asleep on his own.  If he cries, there are two options: progressive waiting or rapid extinction.
 
With progressive waiting, you periodically enter the room to check on your child if they are crying, but wait a longer and longer amount of time before doing so. For example, wait 5 minutes initially, then 10 minutes, then 15 minutes, etc. Your time in the room should be very brief.  In contrast, with the rapid extinction approach, you do not enter the room to check on your child even if they are crying, unless of course you are concerned that they are hurt or sick.
 
The key to sleep training is consistency.  It is very difficult to listen to your child cry, but when done correctly, these approaches work quickly; after a few difficult nights, your baby will be falling asleep on his own and sleeping thought the night.  Do not feel guilty about letting your child cry – remember that teaching your baby how to sleep on his own is an important part of raising a healthy, well-rested child.
 
Ask us about developing healthy sleep habits for your baby at his next physical.  You can also take a look at Dr. Canapari’s blog at drcraigcanapari.com for great sleep advice for children of all ages!
 
Dominica Donnal, M.D., F.A.A.P.
Pediatric Associates of Greater Salem
84 Highland Avenue,
Salem, MA 01970
(978) 745-3050
Posted: 1/29/2015 12:07:12 PM by Kim Gendron | with 0 comments
Filed under: infancy, napping, patterns, routines, schedule, sleep


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