Chapter 2: My Baby Doesn’t Sleep

Chapter 2:

MY BABY DOESN’T SLEEP

Baby Won't SleepThis subject really hits home. My children were horrible sleepers and, during their first few months, my wife and I spent our days like zombies, fantasizing about how wonderful a night’s sleep would be. As a young physician, I had received no training in infant sleep problems and I desperately tried any method suggested to help our baby (and therefore us) to sleep. Nothing worked, not antihistamines, extra feedings, long rides in the car, recorded sounds or even earplugs for the parents.

Based on the unending flow of advice about this subject, one would think that all babies should be easily trained to sleep. The truth of the matter is that, short of general anesthesia, infants can’t be coerced to sleep through the night until their brain matures. Depending on genetics, this sleep timetable is variable and no amount of manipulation will alter the timing. Therefore, suggestions that babies should be fed more, kept awake during nap times, or have their formulas changed will not result in happier parents or sleepier infants. Some “solutions” can, in fact, result in sleep interference.

Where in the world did you hear?

 Babies should have a full tummy in order to sleep. Most babies wake up because they’re hungry and they need an extra good feeding to hold them through the night.

 Sound Advice

It’s a widely held belief that babies sleep poorly because of hunger. Unless the baby is calorie deprived and losing weight, nothing could be further from the truth. Giving babies extra feedings or early solids may cause cramps and bloating and, as a result, poor sleep. These fed-to-sleep babies are often overweight, not starving at all. Surprisingly, infants who cry a lot and sleep poorly will show improvement when intervals between feedings are lengthened. Most full term babies require a feeding every three to four hours, preferably four, since it takes that long for the stomach to fully empty after the last feeding. Parents shouldn’t let themselves be fooled by the vigorous sucking of a crying baby. Sucking is a reflex and even a baby who is filled to the brim with milk, ready to “explode,” may exhibit frantic sucking when offered a nipple. There may be a short interval of peace after an extra feeding, but then the crying resumes with greater intensity than earlier.

The Conclusion

Resist those suggestions to give extra feedings at bedtime. This “remedy” will not improve sleep for anyone, but it may result in an overweight, distressed, cranky baby.

Where in the world did you hear?

Babies who are cranky and don’t sleep usually have gas. The only way to get some relief is to change the formula.

Sound Advice

It’s part of our culture to assume that “gas” is an evil condition causing pain and misery. This conviction is based on myth, not on any fact. All healthy humans produce gas in their large intestine. Bacteria residing in the normal colon produce gas through fermentation. Gas is a part of life and the passage of flatus is a normal, painless bodily function. If the baby is healthy, gaining weight and has normal bowel movements, the passage of gas while crying is normal, caused by the forceful contraction of abdominal muscles. It does not cause pain and it does not interfere with sleep. Crying merely increases the passage of gas, therefore babies who cry a lot tend to pass more gas. The reverse is not true. Unless the baby has an allergic condition, suffers from persistent diarrhea or passes hard, formed stools, changing his diet will not help him sleep

The Conclusion

Don’t start playing “change the formula” just because your baby passes gas. You might be removing an excellent source of nutrition and end up substituting something which is less than ideal for your baby. Always discuss the problem first with your pediatrician before making any changes.

Where in the world did you hear?

Babies sleep better at night if they’re tired. Try to keep the baby awake late in the day, even if he seems to want a nap.

Sound Advice

Withholding sleep during the daylight hours is an exercise in futility. Interrupting an infant’s sleep rhythm generally does nothing but increase irritability. There is no harm in waking a sleeping baby but this maneuver will rarely achieve better nighttime sleep. Is there anything an exhausted parent can do? A recent study has shown that exposing the baby to sunlight during the early afternoon seems to result in better sleep patterns at night. When compared with babies who were kept in dull lighting all day, infants who were exposed to more daytime light had significantly better night sleep. Most babies, regardless of light exposure, begin to sleep through the night by three months. A stubborn minority, to the dismay of the family, continues to wake throughout the night even past the fourth month. Parents shouldn’t despair; there is a successful technique that can be employed once the infant is more than four months. The method, called “non¬intervention,” is based on a study of three groups of non-sleeping infants. Group one parents consoled the baby upon each night awakening; group two parents waited for increasingly long intervals before going in to the crying baby; group three parents allowed the baby to cry, even for several hours “non-intervention.” After only a few nights, most of the “non-intervention” infants had learned to fall asleep without assistance, usually by the second or third night. The “contract” learned by the baby is “if it’s dark and I am in my crib, I go to sleep.” If the infant wakes when the sun rises, even as early as 6 A.M., then the parent must acknowledge the “contract” and go to the baby. This method is very successful, but some parents, unable to stand by while the baby cries, will simply try one of the other methods and wait a little longer for peaceful nights. It should be stressed that all babies should be put into their cribs at bedtime while still awake. The baby must always associate the crib as the “instrument” of sleep, not mommy’s arms, and not the infant seat. If mommy always cuddles the baby to help him fall asleep, he will never fall back asleep alone, expecting (and demanding) that same treatment before he nods off again,

The Conclusion

The good news is that, by six months, almost all babies are sleeping through the night no matter what technique is used. If an infant is still waking after this age, it behooves the parents to have a discussion with their Pediatrician to discuss sleep and the general health of the baby. Often, a small change in routine will result in success.

Have any questions? Please contact Dr. Mesibov

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