You are home from the hospital with your baby. For months you’ve contemplated what combination of characteristics she might have—your husband’s eyes, your own intellect? Never once did you imagine that you would have a baby who didn't sleep.
Instead of sleeping, this baby lies in her crib and screams bloody murder. If and when she occasionally falls asleep, she seems to wake only an hour or two later—just as you are starting to feel human again. It’s a situation that is upping your blood pressure, your stress hormones and your guilt. It’s stressing your peace of mind, your marriage and your relationship with baby, too.
You are so very exhausted that you can smell it.
All you need is a good night’s sleep. It will put your problems into perspective and remind you that this little goo bag is worth all the trouble. And it may even renew your interest in that man (formerly known as Loverboy) who still seems to share your house.
Taryn Chlebowski, M.D., a board-certified pediatric and internal medicine doctor for more than 14 years, has seen it all when it comes to baby sleep issues. She assures us that most of these problems are the result of sleep practices that confuse, rather than reinforce, good sleeping habits for baby. (Sigh.)
Baby Sleep Basics
For starters, Chlebowski wants to establish three basic facts on which to build our understanding of babies and sleep.
1. Sleeping is a new skill being learned.
"I think it’s important for parents to know that falling and staying asleep are developmental skills that can be learned and practiced,” says Chlebowski. As with any new skill, babies may experience frustration, expressed as crying, until they master this skill.
2. Everyone else is having the same problem.
Because sleep is so important to the health and well-being of a family, it is a topic that Chlebowski often addresses as a pediatrician. “I think it can help parents to know that they are not the only ones suffering,” says Chlebowski. “It’s a common problem—and one that most families find their way through.”
So that mom down the street who has already lost all of her baby weight and seems to have the perfect baby, too? It's probably not so different for her behind closed doors.
3. Consider sleep training at six months.
“This surprises some parents who are nowhere near a seven- to eight-hour stretch by that time,” says Chlebowski. Some parents don’t know when to start sleep training. She suggests promoting self-soothing skills in newborns by placing them in a sleeping area when they are drowsy but still awake.
At six months of age, parents may consider trying sleep training. If they are looking for a recommendation, Chlebowksi suggests that they consider a bedtime approach described by Richard Ferber, M.D., in "Solve Your Child’s Sleep Problems" (originally published in 1985; updated in 2006). “It’s a method of sleep training commonly called Ferberization,” says Chlebowski.
Aha, Ferberization! You may have heard 'Ferberization' spat out at Moms Meetups as if it were a dirty word. It has the reputation of just letting your baby cry, which feels mean for many new moms. But the Ferber method is more sophisticated than that.
“The premise of the Ferber method is that babies will learn to soothe themselves,” says Chlebowski. “It involves letting babies try to get to sleep on their own, assuming they are healthy, fed, burped and have a clean diaper.”
How Ferberization Works
Parents put baby into the crib when she is drowsy, but not quite asleep, and return to the room at set intervals to provide reassurance with soothing talk and pats on the back rather than holding or feeding their baby.
“It is important to make any nighttime visits brief and boring,” says Chlebowski. She recommends trying the Ferber method first upon the initial bedtime (rather than a middle-of-the-night waking) so that you can know that your infant’s needs have been met.
Chlebowski has seen parents apply the Ferber method with success in her own practice. “In most cases,” says Chlebowski, “the good news is that a few nights of fussing and frustration can translate into years of painless bedtimes. Once your infant learns to self-soothe, other nighttime awakenings usually quickly diminish.”
A Different Perspective
Aditi Grandy is a certified nurse midwife at the Midwives Clinic at Northwest Outpatient Medical Center who has worked with women and families for more than 20 years. She has a different perspective.
“Babies were just inside their mother,” says Grandy. “The baby still sees itself as one with the mother. Baby wants to be near the mother and wants to be held.” She tells her patients that babies have only one means of communication—the cry. “Babies cry to have their needs met,” says Grandy.
Grandy suggests that there is a dissonance between what new parents would like their life to be like and what it actually is. This creates a tension that informs their feelings about their baby’s sleeping habits.
“The new parents are thinking, ‘I should be able to do all these things and baby is getting in the way,’” says Grandy. “If instead, parents are able to let go of their expectations and meet reality straight on, they will be much happier.”
Grandy also has a couple of practical suggestions for improving parental sleep. The first—known as co-sleeping—comes from the parenting model known as Attachment Parenting.
“Co-sleeping or having the baby in the room can really help,” she explains. “You can scoop the baby up when they start making those ‘getting hungry sounds’ such as whimpers or sucking on their hands or tongue so baby doesn’t need to ramp up to full cry mode to get your attention. This makes it easier on mother and baby both.”
Grandy also recommends that new moms be strategic about their own sleep. "I always tell moms, ‘Sleep when your baby sleeps. Let the dishes and the laundry go and take care of yourself first. Anytime an opportunity for sleep presents itself, take it.’”
Wow, almost polar opposite advice. Welcome to parenting! So what’s the take-home message here when even the experts disagree?
The Bottom Line
Babies younger than four to six months do need to be fed and changed during the night, so parents need to maximize their own sleep by going to bed early and napping when baby naps. All babies will eventually learn to sleep through the night, either gradually on their own or with the firm guidance of their parents. The most important thing is to decide what is most important for your family and then, be consistent. Babies (and children) respond well to consistency and routine.
The Good News
You may be relieved to know that though there is little research on the long-term effects of sleep training, the research that does exist is reassuring. It shows that five years down the road, there is absolutely no difference between those babies who were sleep-trained and those who weren’t.
Phew. You may choose your approach to your baby’s sleep with a clear conscience. One day, whether you use a sleep training method or just wing it, you and your partner will get enough sleep that you remember why you wanted a baby in the first place. And you and Loverboy might just get around to making another.