Now lets talk sleep:
The most common questions I receive: Birth to 4 months old
Over the years i have been asked many questions regarding the best practices for helping your newborn sleep. Below are the most common questions I have received about sleep for babies from birth to 4 month old.
• In your room 6 months-1 year AAP
• Crib, Bassinet, Co-sleeper on the side of the bed, not in the bed (Talk to your Peds if you plan to bed share)
• Do not let them sleep in a car seat unless moving in a car.
• New crib
• Nothing in the crib, No bumpers, toys, blankets, stuffed animals
• Nothing on the wall above the crib that can fall into the crib.
• No blind strings
• Room Vegas dark small yellow or red nightlight if needed
• Noise machine
• Room temperature 65-70
• Swaddle, below neck, dress for temp, not to hot or cold, feel cheeks, forehead & back for sweat. Check nose and feet for cold.
• Do not use any sleep devices with sides, or wedges
• Safe sleep ABC’s Alone, on their Back, In a crib or bassinet, no smoking in the house.
• Yes you can start as soon as you bring your baby home.
• Of course you are not going to let them cry, but if you know they are dry, fed, and comfortable you can let them try to self soothe themselves for a min or two.
• Lots of babies will babble to themselves for a bit, or rub their feet together, or jack knife their legs in the air, or suck on their fingers, even sucking a pacifier is self soothing. Let them discover these strategies on their own, and then let them practice them a little. It’s a skill, and skills take time to master.
• This is the hard part esp when they are so little. Try not to rock, feed or cuddle them until they fall sound asleep every time. Let them practice finding ways to do it on their own. That way, when they wake in the night, and they are not hungry, they’ll have the skills they need to settle back down on their own.
• This will not always be possible, as I know the first 4 months parents are in survival mode, and will do whatever they can to get the baby and themselves back to sleep the quickest way possible. I drove around with my son in the car 38 years ago, and I would have driven to China if it meant I got 3 hours of sleep.
• Just practice with them self-soothing, even if it just during the day. Try to feed them and keep them awake 45min-1hour and then lay they down in their bed. If they fuss pick them up make sure they do not have a burp, or dirty diaper, calm them and try to lay them back down drowsy but awake if possible.
• Self-soothing is them putting themselves to sleep without depending on you to do it for them by rocking, bouncing, walking, car rides movement, or feeding to sleep. Whenever they wake up, they will need you to do the same scenario to get them back to sleep, because they do not know how to do it themselves.
• Use the wake window reference guide
• Birth-6 weeks 45min-1hour
• 6-10 weeks 1hour-1 15min
• 11-15 weeks 1.5 hours
• 4-5 months 2 hours
• Every baby is very different, watch for sleep cues
Rubbing their eye’s, yawning, rubbing their ears, staring off
If they are crying we probably missed their window. Look at the time, if you kept them up 11/2 hours then put them down the next day after 1hour and 15min and see how they do. First morning nap is usually very early.
Babies who don’t sleep enough and who stay awake for longer than they can handle end up having a stress response — an increase in adrenaline and cortisol — making it trickier for them to wind down for bed. I say it is like putting them down after drinking a pot of coffee
Sometimes it’s obvious your baby is overtired … and other times the signs are subtle. Here’s what to look for in your little one:
• They have a hard time settling down for sleep.
• They only takes brief catnaps, instead of full-blown naps.
• They don’t get a lot of sleep at night.
• They are very cranky or fussy.
• They are less able to handle frustration or pain.
• They are more prone to meltdowns (in an older baby).
• They fall asleep at random times during the day (in the high chair when eating, for instance, or as soon as they hit the stroller, even if it’s not naptime).
• 6 weeks old, circadian rhythm develops
• Routines at every age help them know what is coming next and fosters a sense a safety and security. Whatever you choose for your routine it should not take more then 1 hour from start to bed if you are giving a bath, 30min if not.
• Nap routine should be a shortened version of nighttime and only last 10min
• Bath or spit and polish. Wash face, neck, hands, and bottom
• Massage
• Pajama’s
• Swaddle or sleep sack
• Close blinds
• Read a page or 2 from a book, increase pages as they grow.
• Turn on noise machine.
• Last feeding before bed
• Try to lay them down drowsy but awake when ever possible.
• You can get them on somewhat of a schedule but it will change everyday at this age. We are looking for them to eat at least every 3 hours during the day and nap them according to their wake windows and sleep cues. These times will change depending on what time they wake up in the morning and from each nap. Depending on how much they eat during the day, will tell you how much they need to eat at night.
• Some babies depending on how much they weigh and how much they eat during the day, may sleep through the night after 4 months from there due date. I have had the most babies sleep through the night when they are taking in at least 30oz during the day and weigh over 14lbs. These usually happen after 4 months but can happen earlier. My grandson was 15pds and slept through the night on his own at 3 months. I would not actively sleep train him at that age, but I would not wake him if he was eating enough during the day, his weight was good and he was doing it himself. If your baby was born early, exp at 36wks, it may take them an extra 4 weeks to meet these goals.
To answer that I am going to explain what are normal sleep stages?
Many of us just think of sleep as an on-or-off situation. You’re either asleep or you’re not. But sleep actually has a number of different stages, and they make up the “sleep cycle,” which we go through several times a night.
Stage 1 is that initial stage we’re all familiar with where you can just feel yourself drifting off, but don’t really feel like you’ve fallen asleep. Anyone who has ever seen their partner nodding off in front of the TV, told them to go to bed, and gotten the canned response of, “I wasn’t sleeping!” knows exactly what this looks like.
Stage 2, which is considered the first “true sleep” stage. This is where people tend to realize, once woken up, that they actually were sleeping. For anyone taking a “power nap,” this is as deep as you want to go, or else you’re going to wake up groggy.
Stage 3 is deep and regenerative. Also known as “slow wave” sleep, this is where the body starts repairing and rejuvenating the immune system, muscles tissue, energy stores, and sparks growth and development.
Stage 4 is REM (rapid eye movement) sleep. This is where the brain starts to kick in and consolidates information and memories from the day before. It’s also the stage where we do most of our dreaming.
• The 4-month regression is also called a progression because babies change from only 2 sleep cycles stage 3(the deep and regenerative sleep) and Stage 4 Rem (Rapid eye movement and dreaming stage) that they spend half their time in each stage, to a 4 stage method of sleep that they will have for the rest of their lives.
• When this change takes place, baby moves from 50% REM sleep to 25% in order to make room for those first two stages. So although REM sleep is light, it’s not as light as these 2 new stages that they’re getting used to, and with more time spent in lighter sleep, there’s more of a chance that baby’s going to wake up.
• The best way to help your baby through this time is to make sure they know how to self soothe. So when they have more wakeups due to lighter sleep, they no how to put themselves back to sleep without your help.
• Make sure your baby is not overtired going to bed and down for naps. If they are overtired, they will have an increase in cortisol and adrenaline. They will have a hard time falling asleep and they will have more wake ups and increased difficulty putting them selves’ back to sleep.
• Why is this so important?
When your baby is in a deep restful healthy sleep is when they have their most growth and development, esp their brain. Also a well rested baby is much more fun.
• Do not listen to other peoples stories of how their babies slept (WE FORGET)
• Every baby is very different, even your own
• Try to avoid sleep prop’s like me driving my son around in the car 38 years ago if at all possible
• Most important be kind to yourself and remember you are in survival mode, as long as the props you use that help you and the baby get more sleep are safe, use them if you have to and we can change them later.