Sleep in the First Year of Life: Helping your baby develop healthy sleep hygiene


One of the biggest struggles parents have is getting their baby to sleep through the night and establishing routines that lead to healthy sleep. In the first year of life sleep patterns change so often that it is hard to get into a consistent rhythm or routine. Learning how to be a good sleeper, is like learning any other skill; it takes times and practice. Understanding some basic tenants about babies’ sleep can help parents gain control and nurture healthy sleep habits for their baby.

1. Can I be of any assistance?
From the first few weeks of life a baby needs their parents help in some fashion to fall asleep. Whether it’s a swaddle, a hand on the chest, rocking/swaying or a combination, all babies need some assistance. In order to determine what your baby needs from you start with a small intervention (i.e. hand on chest or swaddle) and move up the hierarchy to more stimulating interventions (i.e. music or rocking). Once you know what your baby needs from you it will become that much easier to execute.

2. Wake-Sleep Cycles
Newborn sleep patterns are very different than those after the first three months of life. Newborns typically sleep for an average of 14 hours over a 24-hour period and their wake-sleep cycles are driven by hunger. In your babies’ third month of life, he will begin to sleep longer stretches in the evening and this will continue to increase until about 8-9 months when he should be sleeping 10-12 hours at night.

3. Night Wakings
It is important to note that all babies wake on average four times per night. Addressing these night wakings looks different for each family and requires a different strategy depending on your infant’s age and needs. As mentioned above, night wakings in the first three months of life are primarily driven by hunger and should be handled by providing your baby with breast or bottle. As your baby gets older and is eating more during the day breaking the association between night wakings and feeding is important. Helping older infants settle when they awake during the night may require giving them a pacifier or rocking them back to sleep.

4. Routine, Routine, Routine
It is never too early to begin a night time routine. This can include a few things (i.e. bath, story, music, bottle/breastfeeding) and should be executed in the same order every night. When the routine begins, this will alert your baby that night time and sleep are coming and their systems will begin to “power down.” Once you have established a routine, remember that consistency is key.

5. It’s time for some self-soothing
One of the most crucial pieces to nurturing healthy sleep is helping your baby learn how to self-sooth and put themselves to sleep. Beginning at around 5 months parents can put their child to bed drowsy, but not asleep. Once you have completed the night time routine, place your baby down awake. When your baby cries out and needs support remember to start with a less invasive intervention to help them settle. Once settled, continue to support you’re baby in falling asleep on their own. Falling asleep on your own is a skill that takes time to develop, so be consistent and patient.

6. Challenges Await
Situations and events in a baby’s life can lead to or worsen sleep difficulties. Separations or even exciting milestones being reached can cause disruptions in sleep. At around 4 months of age all infants go through a sleep regression which represents a shift in your infant’s sleep patterns. Unlike later sleep regressions, the 4 month regression causes permanent change in the way your baby sleeps. It is important to reevaluate the strategies you have been using to support your infant in falling asleep during this time. Overall, sleep regressions can be difficult to manage. Be patient and consistent. Stick to the routine you have established and your child will get back on track to good sleep hygiene.

Dr. Erica Samson-Pepose


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