The complexities of baby sleep

This was only going to be a quick blog, but once I got writing the more things that impact sleep came to mind. So sorry for the long blog, but hope it is helpful and helps to show why no two babies and children will follow the same routines, or what works for friends babies don’t for you.

Most parent's biggest questions are about their baby's sleep, feeding, and general routines. How do I get them to sleep for longer at night? When do they need to nap in the day? How long should they feed for? How often do they need to feed? How long, how much do they need? Can they feed to sleep? etc etc……….

No two babies are the same, what will work for one may not work for another. Just as you and I are different and have different likes and dislikes so do babies, and most complicated of all what worked yesterday, or even in the mornings won't necessarily work in the afternoon or the following day. This leads parents to microanalysis everything they did or didn’t do, as to why their baby slept or didn’t sleep. It is always parents doubting themselves and blaming themselves for why the baby only slept 20 minutes instead of 45 when in reality it is just normally one of those things. Having 5 minutes less on the left boob, or singing twinkle twinkle little star 3 times instead of 4, or waking them 5 minutes earlier from the last nap because you had an appointment to make. These are all things that really won't make a big difference to long-term sleep habits. Big routine differences will, however, missing the goodnight song altogether, or skipping the whole nap or feed will affect their sleep.

When looking at sleep, the first thing we need to look at is sleep in a 24-hour period. Is your baby getting enough, too much, or too little for their age? The National Sleep Foundation has a useful graph of how much sleep is recommended.

As you can see it varies a lot throughout all the different age groups. It also varies a lot within each age group, what is appropriate for an infant between 4 months and 11 months varies by 8 hours! That’s a huge amount of variation of normal within a 24-hour period. This is why you can’t compare your baby to the next in your baby group, and why the sleep plan they bought off the internet may work for them but won't for you, or won't for them but will for you!

Within our 24-hour sleep need, comes our circadian rhythm, we all have one. Babies don't have a circadian rhythm like you or I. Babies don't start to produce melatonin (the sleepy hormone) until about 6 weeks. This can take until they are about 6 months to mature, so a lot before then is good sleep habits and prompts for sleep.

Newborns only have two different sleep cycles, active sleep and quiet sleep. Their sleep cycles are about 40-50 minutes long. So when you see your baby starting to stir, they could just be in an active sleep cycle, also called REM (rapid eye movement). This is very apt as you can often see their eyes moving, rolling back, and twitching.

You can let them be, and watch and wait and see if they can transition into a quiet sleep cycle. Sometimes this can take 10 minutes or so, as long as your baby is just snuffling around and settling themself then this is good for them to practice. If your baby becomes upset then of course go and comfort them. You could try and put a hand on their tummy and see if this is enough to settle them, or pat them gently and see if this helps. Sometimes this will work and others not, it will depend on how much they have slept, when their next feed is due, or their general temperament that day.

Baby's sleep cycles become more mature like ours by about 4 months when they start to develop four sleep cycles. With the development of sleep cycles, the way they fall asleep changes too. As a newborn they fall into REM / active sleep first, then the deeper non-REM sleep cycles.

By about four months babies start to develop a circadian rhythm and more mature sleep cycles, they develop four stages of sleep that they have to cycle through. Instead of falling into active sleep/REM sleep first, they fall into non-REM sleep first. Therefore having their deeper sleep at the beginning of the sleep cycle rather than at the end, the same as we do. This can be tricky for some babies to get used to. The active feeling of falling asleep, the falling sensation you sometimes get can be unsettling and cause wakings and needing help to fall asleep. This is part of the reason for the 4 month sleep regression, or development leap that people talk about. Children have to cycle through these sleep cycles throughout the night. They become more aware when waking into REM sleep and this is the time if they have been used to being rocked, cuddled, fed, etc to sleep, they will wake and need the same actions to get back to sleep.

To help baby's circadian rhythm to establish and mature, expose them to daylight between 7 am-7 pm. This doesn't mean all day every day, but a morning walk whilst they sleep in the buggy benefits them, or outside play for older children. Also for you to get out, get some fresh air, sunlight and a bit of exercise. Even if you only manage 5 minutes it is still beneficial to you both.

Have day as day time, don’t reduce the noise and light too much, then in the evenings reduce the light and noise to give wind down time. Overnight make sure night is night, no screens, lights kept to a minimum so you can only just see, and no loud stimulating talking. Keep things quiet and boring so babies very quickly learn that nothing exciting is going to happen, it's not stimulating, so they wake, feed, wind, and go straight back to sleep/bed.

To help establish the circadian rhythm start and finish the day at the same time every day. This is important, even over the weekends, holidays, and even days when you have been up half the night. This is key in helping to establish circadian rhythms, try and keep it to within half an hour of the same time waking every morning. I find 7 am -7 pm are the best timings, as babies tend to be earlier wakers. So if you make it 9-9 then they still tend to wake at 7 and they are losing two hours of sleep before you start the day. 6-6 is just too early to go to bed for most people, so 7-7 or 8-8 tend to work well, even with 8-8 babies will probably tend to wake earlier. Once you find a time that's good for you, make sure you stick to it every day, even on weekends, even if you have had a bad night. This helps so much getting baby's circadian rhythm into sync, and getting them used to day and night.

Then there are naps, when to take them, how often, and how long for within that 24-hour period. If your baby has a low sleep need and is getting 10 hours at night, then they may not need long naps in the day and that two-hour sleep over lunch may never happen, or if it does then they may only need 9 hours overnight! Whereas if your baby is going to bed late and waking early, and needing a long morning, lunch, and afternoon nap, and maybe another too, you may be able to tweak the routine and get more sleep at night and a little less in the day.

Babies and children have awake windows too. This is the average time that they can stay awake after their last sleep. Be it nighttime sleep or daytime nap. After this, they tend to get over tired and grumpy, or some children may go hyperactive, making it look like they are wide awake and ready to party whereas, in fact, their body really is needing to rest and sleep.

These are average awake windows for babies and children. As above there will be babies that can be awake longer and babies that need naps sooner, this is just an average and all babies are different. Some will make 1 hour one day and then not the next, that's babies!

To help establish baby's sleep, routines are needed. Babies and children like a routine, rhythm, or pattern to their day. It helps them to understand what happens next when they can’t talk or understand what we are saying yet. Just as when you sit down to feed your baby, it may be the chair, just the actions of putting a bib or muslin under their chin, or you lifting your top and the click of your bra unfastening, or baby seeing their bottle.

They know it's food time and will kick, get excited, or become frustrated that it is not quick enough! This is a rhythm and routine to the day that signalizes food time. It is that simple, it isn’t a long drawn out routine because they will get frustrated, but a couple of cues in the same order at the same time and babies very quickly know what is going to happen.

This is the same for nap and bedtimes, routines don’t need to be long and drawn out. It can be as simple as saying it is nap time/bedtime whilst picking them up and giving them a cuddle. Walking to the room, drawing the curtains / blind, changing their nappy, putting them in a sleeping bag or swaddle and giving them a cuddle and snuggle for a few minutes, quietly, softly sing a little good night song, or say a night night phrase until they are relaxed and sleepy and then putting them in bed to fall asleep.

Knowing about total sleep needs for children throughout the 24-hour period, and awake windows does help parents and carers to be able to look out for tired signs. Then they can try putting their baby down to bed at the best times (and easiest) for them. Not sticking to a strict routine means baby may not be ready for their sleep, or are over-tired as they can’t make the prescribed nap time.

This sounds great, however feels impossible for a lot of parents. But that is the thing with routines/rhythms/patterns you have to do them over and over again for the body and mind to understand what is going to happen and for it to become second nature.

Babies and children won't suddenly go to bed and fall asleep happily because you did a routine for a day or two. That is way too short for them to forget what happened before, understand the new pattern, and to know what to expect from now on.

Babies have been swimming around inside of you for 9 months, they are warm, they don’t feel hungry, they don't have uncomfortable clothes or dirty nappies, and they have had a lovely relaxing soundtrack of your voice and heartbeat. This is their ‘safe space’. So it will take time when they are born to get used to the world and adjust to the new patterns and noises of the world.

For older babies and toddlers, they have had their old normal for many, many months (being fed, cuddled, rocked to sleep, etc). If you are trying to introduce a new normal, this will take time too. You can see results within a few days, but to get routines established they do take time to consolidate, and become part of everyday life. Consistency is key, habits form over doing the same thing over and over again to become second nature. With children you think you have just cracked it, then they get ill and you will have a blip, or there are holidays, friends/family staying, Christmas, etc. Just as you get back on track there will be something that wobbles the routine. This is normal, but getting back into the bedtime routines as soon as possible is key.

Research has proven that consistent bedtime routines are associated with better sleep outcomes, including earlier bedtimes, shorter sleep onset latency, reduced night wakings, and increased sleep duration. Furthermore, there was a dose-dependent relationship, meaning the more they do it the better it becomes! With each, illness, holiday, and change in daily routine. Having a solid consistent bedtime routine, children get back to ‘normal’ quicker each time and with less resistance than the last time you started. It does get easier and stays easier.

Nighttime routines only need to be about 30 minutes long, anything longer babies/children get a bit lost with it, and the wind-down process is not as effective. The same things in the same order will help them wind down and be a prompt that bedtime is near. For example, dim the lights if possible and have the curtains drawn so it is darker and a cue for the body bedtime is coming. Then bath, pajamas, milk, teeth, stories, cuddle and snuggle, then bed.

Babies thrive with routines. The consistency a regular routine provides will ensure your baby feels safe, secure, and loved. As well as being well rested, which in turn helps your baby’s development. Giving babies and children the foundations to develop their own sleep prompts and patterns will become a lifelong tool for good sleeping.

It is not what we do for our children but what they can learn to do for themselves, which will ensure they have good sleep for life.

If you would like any support or have any questions about your baby's sleep, development, routines, or anything baby. Please get in touch, I would love to be able to help.