Perinatal Neonatal

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Safety Sleeping

0 to 3 months

Newborns sleep a lot – typically up to 16 to 17 hours a day. But most babies don't stay asleep for more than two to four hours at a time, day or night, during the first few weeks of life. The result? Lots of sleep for your baby and a very irregular – and tiring – schedule for you. Your job is to respond to your newborn's cues, so you'll probably be up several times during the night to change, feed, and comfort him.

What's going on

Baby sleep cycles are far shorter than those of adults, and babies spend more time in rapid eye movement (REM) sleep, which is thought to be necessary for the extraordinary development happening in their brain. REM sleep is lighter than non-REM sleep, and more easily disrupted.

All this unpredictability is a necessary phase for your baby and it doesn't last long – though it may seem like an eternity when you're sleep-deprived.

What's next

At 6 to 8 weeks of age, most babies begin to sleep for shorter periods during the day and longer periods at night, though most continue to wake up to feed during the night. They also have shorter periods of REM sleep, and longer periods of deep, non-REM sleep.

Somewhere between 4 and 6 months, experts say, most babies are capable of sleeping for a stretch of 8 to 12 hours through the night. Some infants sleep for a long stretch at night as early as 6 weeks, but many babies don't reach that milestone until they're 5 or 6 months old and some continue to wake up at night into toddlerhood. You can help your baby get there sooner, if that's your goal, by teaching him good sleep habits from the start.

How to establish good baby sleep habits

Here are some tips for helping your baby settle down to sleep:

Learn the signs that mean he's tired.

For the first six to eight weeks, most babies aren't able to stay up much longer than two hours at a time. If you wait longer than that to put your baby down, he may be overtired and have trouble falling asleep.

Watch your baby for signs that he's tired. Is he rubbing his eyes, pulling on his ear, or being more fussy than normal? If you spot these or any other signs of sleepiness, try putting him down to sleep. You'll soon develop a sixth sense about your baby's daily rhythms and patterns, and you'll know instinctively when he's ready for a nap.

Begin to teach him the difference between day and night.

Some infants are night owls (something you may have gotten a hint of during pregnancy) and will be wide awake just when you want to hit the hay. For the first few days you won't be able to do much about this. But once your baby is about 2 weeks old, you can start teaching him to distinguish night from day.

When he's alert and awake during the day, interact with him as much as you can, keep the house and his room light and bright, and don't worry about minimizing regular daytime noises like the phone, music, or dishwasher. If he tends to sleep through feedings, wake him up.

At night, don't play with him when he wakes up. Keep the lights and noise level low, and don't spend too much time talking to him. Before long he should begin to figure out that nighttime is for sleeping.

Consider starting a bedtime routine.

It's never too early to start trying to follow a bedtime routine. It can be something as simple as getting your baby changed for bed, singing a lullaby, and giving him a kiss goodnight.

Give him a chance to fall asleep on his own.

By the time he's 6 to 8 weeks old, you can start giving your baby a chance to fall asleep on his own. How? Put him down when he's sleepy but still awake, suggests Jodi Mindell, associate director of the Sleep Disorders Center at Children's Hospital of Philadelphia and author of Sleeping Through the Night.

Mindell advises against rocking or nursing your baby to sleep, even at this young age. "Parents think that what they do this early doesn't have an effect," she says, "but it does. Babies are learning their sleep habits. If you rock your child to sleep every night for the first eight weeks, why would he expect anything different later on?"

Not everyone agrees with this strategy, however. Some parents choose to rock or nurse their babies to sleep because they believe it's normal and natural, because they enjoy it and their baby is thriving and sleeping well, or simply because nothing else seems to work. These parents expect to get up with their baby several times during the night to help him get back to sleep.

3 to 6 months:

Typical sleep at this age

At 3 months, most babies sleep a total of 15 hours a day, including nighttime sleep and naps.

Sleep training opportunity

Typically, by age 4 months or so, babies have started to develop more of a regular sleep/wake pattern and have dropped most of their night feedings.

This doesn't mean you should suddenly impose a rigid sleep program on your 4- or 5-month-old. In fact, your baby may already have developed sleep patterns that fit in well with your family life. But if you'd like to help your baby sleep longer at a stretch and keep more regular hours, now might be a good time to try some type of sleep training.

Keep in mind that every baby is on a unique developmental schedule. Observe how your child reacts to sleep training, and if she doesn't seem ready, slow down and try again in a few weeks.

Sleeping through the night

At some point between 4 and 6 months, most babies are capable of sleeping through the night. "Through the night" at this age generally means a stretch of 8 to 12 hours. This is an important milestone for you as well as your baby, allowing you to get through a few sleep cycles and feel more rested in the morning.

If your baby isn't yet sleeping 8 hours straight, you're not alone. Many babies still wake up more than once at night for feedings in the 4- to 6-month stage. But by 6 months, if not before, your baby's likely to be ready for night weaning, if that's what you choose.

Waking up again

If your baby already sleeps for long periods at night, enjoy it. But babies who've slept through the night for weeks or months may start to wake up – so don't be surprised if you're suddenly getting up every couple of hours again.

It can be frustrating and puzzling if your baby does this, but she has her reasons. She may be increasingly socially aware and wake up crying for your company. Or she may be working so hard to master new skills, like rolling over or sitting up, that she practices in her sleep and wakes herself up.

How you can establish healthy sleep habits

Here are some tips for helping your baby sleep well at this age:

Establish a set bedtime and regular nap times – and stick to them.

When your baby was a newborn, you knew it was bedtime when you started noticing signs of sleepiness (eye-rubbing, ear-pulling, and so on). Now that she's a little older, you should establish a regular bedtime, as well as consistent nap times, to regulate her sleep patterns.

Some babies naturally nod off by 6 every night. Others still seem wide awake at 8 or later. And of course your household routine will influence her sleep schedule, too.

Choose a reasonable bedtime that suits your family's schedule and stick to it as much as possible. If your baby seems to want to stay up past bedtime, consider this: Energetic behavior late at night can be a sign that a child is tired.

You can start to plan naps for a specific time every day, too, such as at 9 a.m., noon, and 3 p.m. Or you can just put your baby down about two hours after she last woke up. As long as she's getting enough opportunities to sleep, either approach is fine.

If your baby's having a hard time getting to sleep or staying asleep, whether during naps or at night, try putting her down sooner. Being too tired can make it hard to settle down and get restful sleep.

Begin to develop a bedtime routine.

If you haven't already done so, now's a good time to start a bedtime routine. Your ritual can include any or all of the following: giving your baby a bath, getting her changed for bed, reading a bedtime story or two, singing a lullaby, and giving her a kiss goodnight.

Whatever routine works for your family is fine, as long as you do it in the same order and at the same time every night. Babies thrive on consistency.

Wake your child in the morning to set her daily clock.

It's fine to wake your baby up in the morning if she's sleeping past her usual waking time, to help set her daily clock. Your baby needs to follow a regular sleep/wake pattern and recharge with naps during the day. Waking her up at the same time every morning will help keep her on a predictable sleep schedule.

Encourage your child to fall asleep independently.

All of us, babies and adults alike, wake up several times every night for brief periods (anywhere from a few seconds to a few minutes). As adults, we put ourselves back to sleep each time – and we don't even remember doing it.

The ability to get back to sleep is key when it comes to snoozing through the night. Some babies seem to do this naturally. But if your baby doesn't, it's a skill she'll have to master. One way to get her started is to put her down when she's drowsy but awake.

If your baby needs more help and you think she's ready, you can try a more involved method of sleep training. Your options include various no-cry and cry-it-out techniques. What will work best for you depends on your parenting style, your personal beliefs, and your child's particular needs.

6 to 9 Months

Typical sleep at this age

By age 6 months, most babies sleep a total of 14 hours a day (between nighttime sleep and naps) and are capable of sleeping for long stretches at a time.

Between the ages of 6 and 9 months, many babies consolidate their daytime sleep into several naps, one in the morning, one in the afternoon, and one in the early evening.

Don't be concerned, though, if your baby continues to take more than three naps a day. Keeping consistent times for bedtime and naps will help regulate his sleep patterns.

Ready for sleep training

If your baby hasn't yet settled into a sleep pattern that fits your family life, now might be a good time to try some type of sleep training. Sleep training methods can help your baby go to sleep more easily, sleep for longer periods at night, and keep more regular hours.

Sleeping through the night

If your baby now sleeps for nine or ten hours at night, it means he's figured out how to settle back to sleep – a sign that you're raising a good sleeper.

If your baby isn't yet sleeping at least five or six hours straight, you're not alone. Many babies still wake up at night for feedings in the 6- to 9-month stage – though most are ready for night weaning, if that's what you choose. But babies this age don't necessarily wake up because they're hungry.

We all wake up several times every night for brief periods of time. And as adults, we put ourselves back to sleep each time – so quickly we don't even remember it in the morning. If your baby hasn't mastered this skill, he'll wake up and cry during the night even if he's not hungry.

Waking up again

Babies who were great sleepers may suddenly start waking up at night or have difficulty falling asleep between 6 and 12 months of age. Why? Sleep disturbances often go hand-in-hand with reaching major milestones in cognitive and motor development and with separation anxiety.

At 6 to 9 months, your baby may be learning to sit up, crawl, or possibly even cruise or walk – quite a list of achievements! Not surprisingly, he may not want to stop practicing his new skills at bedtime and may get so excited that he'll wake up to try sitting up just one more time.

Separation anxiety could also be the cause of your baby's wake-up calls. Waking up and finding you not there may cause some distress. But he'll probably calm down as soon as you enter the room and greet him.

9 to 12 months

At 9 months, babies typically sleep about 14 hours a day, including a nap several times a day for one to two hours at a time.

Ready for sleep training

If your baby hasn't yet settled into a sleep pattern that fits your family life, now might be a good time to try some type of sleep training. Sleep training methods can help your baby go to sleep more easily, sleep for longer periods at night, and keep more regular hours.

Sleeping through the night

If your baby now sleeps for nine or ten hours at night, it means she's figured out how to settle back to sleep – a sign that you're raising a good sleeper.

If your baby's still waking up at night for feedings, she's probably ready for night weaning, if that's what you choose. But babies this age don't necessarily wake up because they're hungry.

We all wake up several times every night for brief periods of time. And as adults, we put ourselves back to sleep each time – so quickly we don't even remember it in the morning. If your baby hasn't mastered this skill, she'll wake up and cry during the night even if she's not hungry.

Waking up again

Don't be surprised if your sound sleeper suddenly becomes a night owl or has a hard time falling asleep at this age. Why? Sleep disturbances often go hand-in-hand with reaching major milestones in cognitive and motor development and with separation anxiety.

At 9 to 12 months, your baby's likely to be crawling, pulling up, and learning to walk. And because she's refining and expanding on these skills, she may wake up at night to practice or be too excited to fall asleep. If she can't soothe herself back to sleep, she'll end up crying for you.

Separation anxiety could also be the cause of your baby's wake-up calls. Waking up and finding you not there may cause some distress. But she'll probably calm down as soon as you enter the room and greet her.

This is a time to continue working on the techniques you and your baby learned in the first nine months, including:

Stick to a consistent bedtime routine.

We can't say it often enough: You and your baby will both benefit from a nightly bedtime ritual. You can opt for the tried-and-true – giving her a bath, reading her a bedtime story, and tucking her in – or add a quiet game into the mix.

Make sure your baby finds the routine soothing. For example, if she hates taking baths, move them earlier in the day. Or sing songs if she'd rather chew on a book than be read to. Just be sure to follow the same routine every night. Children thrive on consistency and feel more secure when they know what to expect.

Also, start your bedtime routine at a reasonable hour so she's not overtired, which may make it harder for her to get to sleep.

Make sure your baby has a regular schedule.

Bedtime may go more smoothly if you make an effort to keep the rest of your baby's daily schedule consistent, too. If she naps, eats, plays, and gets ready for bed at about the same time every day, she'll be much more likely to fall asleep without a struggle.

Give your child plenty of chances to fall asleep on her own.

If you want your baby to sleep independently, she needs opportunities to practice this important skill. Instead of nursing or rocking her to sleep, let her practice falling asleep on her own by putting her in bed when she's relaxed and drowsy. Otherwise she'll probably cry when she wakes up during the night and need your help to drop off again.

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