Sleeping Through the Night

Early Setup for Sleeping Through the Night

Over the many years that I have played with thousands of children in my practice, I have managed to pick up on a few patterns. I noticed that many infants were starting to sleep all through the night by around two months of age. What they all seemed to have in common was their weight, not age. Many infants between 10 and 12 pounds are starting to sleep through the night. Both breast fed and bottle fed babies tend to do this. Bottle fed babies tend to sleep through the night sooner than breast fed babies. None of this has anything to do with normal/abnormal, good/bad, nice/not, etc. If a baby shows a tendency toward a convenient pattern for the parent, I want to enhance that behavior for your convenience. There’s nothing wrong with setting things up to be easier, as opposed to harder, when the end result is the same. 

I have gotten a bit wary of the “scientific” approach to normal activities. You don’t need a whole slew of studies about the gyroscope, the physics of wind resistance, transmissions and gear ratios, properties of titanium or composite frames to learn to ride a bicycle. If you are Lance Armstrong, those issues may well be important, but to apply his type of training and technology to your kid riding his bike is plain silly. To apply precise scientific rules to breast feeding, sleeping, eating, etc. is to misunderstand normal reality. I think that if some of these prolific lab rats spent more time in the real world with people like you, they would make different recommendations. I have little quarrel with the research, that is often very important, but the application to real life is sometimes strange.

Unquestionably, the best way to set up patterns of behavior is to start early and build on an existing pattern. It is also unquestionably more difficult to retrain an undesirable behavior after it has been established a long time. If you could help your baby sleep through the night by 2-3 months of age, wouldn’t that be great? 

I don’t need to explain the advantages of a good night’s sleep for both adults and children. What I will do is explain the methods I have successfully recommended in my practice for nearly 3 decades. They work! 

This plan applies to all healthy, term or near term, babies who are between 10-12 pounds. There is a wrinkle for breast fed moms that I’ll explain in a moment. It is important to start right around this weight because if we go far beyond 10-12 pounds, it will be more difficult to help the baby sleep all night. 

Set a predictable bedtime. We all function better on a routine. The actual time is unimportant, but most of us like 8-9PM as a convenient time. Once you have the time more or less set up (this is not a flight schedule) make sure there is a period of quiet time leading up the bedtime. 30-60 minutes is reasonable. This is a good time for a bath, cuddling in a warm towel, feeding, lullaby, etc. leading up to going to bed. It is hard to fall asleep if you’re all cranked up, excited and stimulated. Babies sleep best through the night if they enter the bedtime period calm and anticipating falling asleep. That is not likely to happen if you’re tickling and roughhousing till 9PM then realize it’s bedtime, and try to put a baby down. So, it is important to set the stage to make sleepy time more likely.

Make sure you eliminate the common traps that usually interfere with good sleeping patterns. There are 4 common problems that prevent sound sleeping habits. One or more of them may apply to your situation.

1). Over bundling. Many babies are put to sleep in flannel onesies then covered with a thermal blanket. None of us sleep well when we’re hot. Remember those July nights when you tossed and turned? We all sleep better in a cooler room. Do not overdress.

2). Sleeping in the same room with parents. In and of itself, there is nothing wrong with proximity, but as long as the babies sense the presence of a parent nearby, they will be encouraged to continue trying to get their attention. Most of us, unquestionably, sleep better with more privacy. I am aware of a new study that suggests that there is a small reduction in SIDS in those babies that are in the same room with the parents. This is only one study that looked back over past histories, but nothing has ever suggested that there is a real connection to any location. We do know that monitoring babies does not prevent SIDS. Much more information is needed before making accurate recommendations on the topic of SIDS.

3). Continuing to respond because it’s “feeding time” and because  we don’t want to wake, dad, the other kids, neighbors, dogs, cats,  or before things get more out of hand, etc. Once a child shows they can sleep 6 hours at a stretch, there is no reason to think that they need to go to a shorter time period later in life. At the point that the child weighs 10-12 pounds, you can view it as a common expectation to sleep 8-10 hours at a stretch. Allowing the baby to cry 2-3 minutes at 2 months of age is OK. There are two points I want to make here.

You should respond to your young infant when he or she is really making a fuss that help is needed. 2-3 minutes of crying is a perfectly reasonable time frame. They certainly cry that much during the day by the time you get ready, wash your hands and get to the baby. By responding immediately (to keep it from getting worse for you, dad, dog, or neighbors) you will often be the one to initiate the event. Many of these babies are actually asleep, or half sleeping, and they rarely take a full feeding.
Responding very quickly prevents the baby from learning what they need to learn to put themselves back to sleep. If you are poorly skilled at typing in my office, I can get it done faster (in the short run) by pushing you aside, but you’ll never be able to take over your responsibility (in the long run) because I don’t give you an appropriate opportunity to learn what you need to learn. 

4). Responding with a food treat. We quickly learn that the fastest way to but a baby back to sleep at night is to feed them. That is unquestionably the best game plan for tonight. Sadly, it is also the worst plan for next month. Think of it this way. The baby is engaging in a behavior you do not wish to encourage and maintain, yet we give the baby a food treat and cuddling. Any chance that the baby will stop waking if he or she continues to get a food treat? How about between slim and none? All the studies done on this topic clearly show that the only driving factor for nighttime feedings is the continuation of feedings. The child learns the routine: I holler, I eat. Even if they are not “hungry” they will still eat when offered.

There is one other important point I need to make. In a breast feeding situation at about 2 months of age, many moms are likely to get rather engorged by morning. You should feed your baby once during the middle of the night, rather than enduring the pain of excessive engorgement and/or losing your milk supply. On the other hand, if your baby sleeps 6-8 hours at night and you are not uncomfortable, don’t go back to middle of the night feedings. It is clearly a priority to preserve the breast milk supply. 

Here’s how you do it!
The corrective strategy is to reset the child’s expectations. Simply introduce several steps between the “I holler” and “I eat.” 4-6 steps that are peaceful and calming, such as; talk a few seconds, sing a lullaby, cuddle a bit, check the diaper, change it if necessary, then as the last step offer the feeding. That way you’ll leave the door open for the baby to get the feeding they expected, but they have to work for it a bit and usually in 1-2 weeks they give it up! You’ll be amazed at how much you can put up with when you get a good night’s sleep.

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