Sleeping Through the Night

One way to tell if your child is waking before getting enough sleep is to look at her behavior during the day. Does she seem more sleepy than usual? Does she return to sleep an hour or two after her early morning rising? Remember, it is rare for an infant or toddler to need less than nine or ten hours of sleep per night. So if your child is waking after less than ten hours of sleep, look for reasons.

If your baby falls asleep while you are nursing him, wake him before putting him in his crib. To succeed at getting your baby to sleep through the night put him in his crib awake so that he puts himself to sleep. Your baby may not like having you wake him and may even cry, but this will last only for a short time. In a few days you will not need to breast-feed at sleep times and can simply put him in his crib awake.

Involve others. If your baby usually falls asleep while breast-feeding, it will be hard for him not to associate sleep with breast-feeding. To counteract this, get someone else involved in putting your baby to sleep and responding to him in the middle of the night. Once your baby begins sleeping through the night you can go back to responding to him. Your baby will have developed other soothing techniques and have other ways to cope with going back to sleep, other than just wanting to nurse. You can ask the baby’s father, a sitter, a friend, or a grandparent to put your baby to sleep and go to him during the night when he wakes for several nights.

Vomiting can be dealt with just like any other behavior. If your baby vomits after crying, don’t worry about it and don’t reinforce it. Be neutral. Change the sheets, clean up the baby as well as you can (preferably without picking him up), and leave the room. One helpful hint is to make your baby’s crib with two sets of sheets (with a liner in between) so that when he vomits, you can quickly and easily take off the top set and leave the bottom set on.

The good news is that each time your baby’s sleep begins to be problematic, if you have a set bedtime routine and put her to bed awake, she will return to sleeping through the night quicker and with less fuss each time.

The hope and belief that most parents have is that they will have to deal with sleep issues only once and that when their baby is sleeping through the night, their worries are over. Unfortunately, this isn’t the case. You will almost certainly have to deal with sleep issues again (see Chapter 9 on obstacles to continued good sleep and solutions to these common problems). A child’s sleep will be disturbed by illness, vacations, and the development of separation anxiety (an aspect of normal development when your child will not want to be apart from you).

Growing out of it. Babies don’t grow out of sleep problems. Studies show that most babies with sleep problems at one year of age will still have sleep problems at four years of age if nothing is done.

Solid foods do not help babies sleep.

Scheduled awakenings. Research has shown that another technique, scheduled awakenings, can also be effective in helping your baby sleep through the night, but it requires a greater commitment of your time. The first step is to keep track of the time that your baby wakes during the night for one week. You will see a pattern in your baby’s awakenings. Once the pattern is clear, figure out what time they typically occur. Betty’s five-month-old son, Jason, woke up three times every night, at about 1:00, 3:15, and 4:35.

The next step is to wake your child fifteen minutes before each of these times. Betty was to wake Jason at 12:45, 3:00, and 4:20. She woke him up and then breast-fed him and soothed him back to sleep. Since Betty was usually asleep at these times, she had to set an alarm to be sure that she woke him in time. During the first week, Jason still woke a few times, usually about 2:00. After six days Jason stopped waking up at other times of the night. Once all other spontaneous awakenings subsided, Betty started cutting back on the number of scheduled times that she woke him. By the second week Betty cut back to waking him only two times per night. By week four Jason was sleeping even better, and she woke him only once per night. And by week five she stopped waking him at all. Six weeks later Jason was still sleeping soundly through the night, and Betty did not have to wake him up at any more scheduled times.

Gradual parent removal. Some parents find the “cold turkey” approach—of completely leaving their child when he is still awake at bedtime—too difficult. An alternative approach is to ease yourself gradually out of your child’s presence. Start with sitting in a chair by your child’s crib or bed. Stay there until he falls asleep. After two nights of this, move your chair a little farther away. Move your chair two feet away for nights three and four, and then five feet away for nights five and six. On the seventh night you should be sitting in the doorway. On night nine, move into the hallway. Within ten days to two weeks your child should be falling asleep on his own.

There is one major drawback to this method, however. In theory it sounds good, but in reality it may be more difficult than it seems. With the basic bedtime method described above, your child has to get used to only one major change at bedtime: the switch from a negative sleep association to a positive one in which he is falling asleep on his own. With the gradual removal of your presence recommended here, your child has to go through a new transition every other night. Just when he gets used to your being only five feet away, you have now moved to the doorway. And just when he gets used to this, you head into the hallway. So this method can just drag out the inevitable and be more upsetting to your child. It is worth a try, however, if leaving altogether is just too hard on you or your baby. This method may also be helpful if you are worried about your child’s hurting himself or jumping out of his crib. You can keep an eye on him while maintaining your distance and teaching your child to fall asleep on his own.