Sleep (or lack of) and babies is a major issue for new parents and an incredibly booming business. Any web search will yield hundreds of articles and books offering advice on “sleep training “ and how to help baby sleep better through the night. While there are many opinions and sources out there, it is important to note the recommendations of the American Academy of Pediatrics.
A recent guide by the AAP gives professional recommendations on how parents can help baby develop healthy sleep habits during different stages of infancy.
Newborn stage - Introduce: At this stage, baby needs 16-18 hours of sleep and may prefer to be awake during the peaceful nighttime hours rather than the more chaotic daytime ones. According to the AAP, parents need to slowly introduce gentle stimulation during the day to increase daytime wakefulness.
Two months-Reinforce: At two months, most babies are staying awake for longer daytime periods but often have difficulty transitioning to sleep. The AAP reports that “these babies are already over stimulated, and that a brief period of under stimulation (swaddling, quiet, dark room) may allow the child to settle to sleep after a little fussing.” Most young babies at this stage still require nighttime feeding, but the AAP recommends learning your child’s cues. There is a difference between a baby that wakes up hungry and a baby that is lightly fussing and may self soothe back to sleep in a few minutes.
Four months-Reinforce: Four months is often the age pediatricians deem healthy babies can start sleeping longer stretches at night, but it is also around the time babies start to develop separation anxiety. The AAP does not recommend feeding children as “an effort to quiet their crying,” and states “if they are fed in an effort to quiet their crying, changes are they will soon come to expect this response whenever they wake up in the night.” The fourth month visit is a vital time for families to discuss sleep concerns with their pediatrician and develop a bedtime rituals for baby, i.e. songs, stories, bath, and transitional objects
Six Months through Nine Months: Continue to Reinforce: The AAP warns that if sleep behaviors are not positively reinforced by this time, the behaviors will become habits, and may lead to added stress for the family. Parents should continue to fortify nighttime rituals and make sure baby is well fed, rested, and stimulated during the day.
Before meeting with a pediatrician, parents with questions about infant sleep should assess their child’s bedtime routine, sleep environment, response to waking, and determine their current sleep cycles. A pediatrician or other professional can work with a family to help establish an age-appropriate, consistent bedtime routine and to encourage baby, when it’s suitable and parents are comfortable with it, to console himself.
Parents need to remember that the real work in getting baby to sleep independently occurs before bedtime and does not mean a standoff between a parent and child. Baby needs to consistently be fed properly, allowed stimulating activities, and have a calming nighttime routine. In accordance with the AAP, the daily routine is much more important than any “sleep training” method, because when it is time for bed, baby will feel secure and receptive to sleep.