Routine and Sleep

Expert / 13 April, 2018 / Dr Tom York

Baby Sleep: How To Set Up A Healthy Infant Sleep Pattern

I wanted to write about sleeping for infants from the perspective of a GP and new dad. How should you safely put your baby to sleep? What equipment do you need? What is normal when it comes to infant sleeping patterns?

Of the four main activities which babies do; feeding, crying, producing waste products and sleeping, the latter is the one you are likely to relish the most. Thankfully human babies (are supposed to) asleep for at least 15 hours per day. Unfortunately, this rarely happens at a convenient time, so new parents must adapt quickly into a cycle of multiple daily naps.

Here’s how to ensure your baby is sleeping healthily, happily and safely.

Safe Sleeping

In the early 90s there was a major shift in baby sleeping advice which has now led to a massive reduction in sudden infant death syndrome (SIDS or cot death). The advice as it stands is:

  • Put your baby on their back for every sleep
  • A firm, flat, waterproof mattress in a cot or Moses basket in the same room as you is best
  • Avoid overcrowding the cot with toys etc and avoid loose or too much bedding
  • Co-sleeping is generally not recommended but should never be done anywhere other than in a bed and never if you smoke, have drunk alcohol or taken sedating medication
  • The jury is still out on swaddling but if you decide to do this, use thin blankets, make sure baby doesn’t get too hot, don’t swaddle too tight and make sure the blanket doesn’t go above the shoulders

baby and sleep

All babies are different and either a cot, bassinet or Moses basket is fine. The recommendation is that babies sleep in the same room as the parents until at least six months old.

Sleep Monitors

Many parents choose to buy a sleep monitor. There’s varying schools of thought on whether you should leave babies alone to cry or not but ignoring a noise so clearly designed by evolution to warrant our attention doesn’t make a great deal of sense to me.

I’m not really a fan of my son starting his life under constant video surveillance in a world where I’m sure he’ll experience plenty of this when he’s older.

There are monitors available which measure your baby’s movements and will give you a video stream of your sleeping child. I might find this useful if I left my baby asleep in the bushes whilst I pop to the shops for a bit, but generally, I’m pretty happy that my child’s sleeping environment is safe and clear from anything which could harm them. I might be being silly but I’m not really a fan of my son starting his life under constant video surveillance in a world where I’m sure he’ll experience plenty of this when he’s older. There’s also no evidence that these monitors help prevent SIDS and may even increase parental anxiety or give false reassurance, so overall I wouldn’t recommend them. The room temperature monitor on the other hand can be quite helpful although you could just use a simple thermometer.

Sleeping Habits

I remember a really useful piece of advice from a parenting course we attended. Newborn babies are used to being in the womb, so replicating this environment once they’re born can help to sooth them. Wombs tend to be warm, dark and compact with only low-pitched noises getting through. Babies are also used to motion, and many pregnant ladies find their babies are far more active when they are stationary than when they are on the go. So, a warm, dark, space with no high-pitched noises and your baby swaddled is an environment they’re used to and will tend to make them feel safe and secure and fall asleep more easily. We find that any kind of motion, be it rocking chair, pram, baby sling, car seat or dancing to the radio all seem to be pretty good ways of sending him to sleep as well.

Habits can sometimes take a few weeks to form so it pays to persevere and endure some short-term struggles for the benefit of long term sanity.

The most important thing is that once asleep, your baby sleeps on their back somewhere safe. But, as our son has grown older, a really important thing for us was that he be able to fall asleep in his own bed. Many parents seem to get stuck in a rut where their child will only fall asleep whilst being held. I don’t know if our success in avoiding this is down to our parenting or just good fortune. I think that often, the problem is that during the early days when you’d be willing to sell a kidney for your child to just fall asleep, you suddenly chance upon a position which seems to work. It works the first time, and then the second, and then you start to think that this is the only way your child will fall asleep. Now you’re in the tricky scenario where you have to consider if you can sustain holding you child whilst standing on one leg in the bath every night for the next six months, or do you try and break the new routine and risk a few tough nights. Habits can sometimes take a few weeks to form so it pays to persevere and endure some short-term struggles for the benefit of long term sanity.

READ MORE: Co-Sleeping: The Facts You Need To Know

From about six weeks old, your baby should start to get the hang of day and night cycles. The best way to encourage this is to make night time feeds quiet and dark and to put baby back in bed shortly after they finish feeding. Day time feeds should be much more active affairs with lots of talking, singing and then burping and playing afterwards. Another way to encourage night time sleeping is to have a routine. Try and get up at about the same time each day, and consider having a night time routine such as, bath-time, followed by a feed, then a story, then bed.

Sleeping can sometimes be a cause for concern for parents, heightened usually by their own sleep deprivation. There’s a wide variety of what’s considered normal but generally, your baby should sleep for longer periods the older they get, although be prepared for periods of regression when your child goes through teething and growth spurts. As long as your baby is developing and growing normally then there’s usually no cause for concern. However, a sudden change in sleeping pattern, e.g. crying all night then sleeping out of exhaustion in the morning, should make you consider seeing a doctor as it may be that there’s an infection or something else causing them pain which can hopefully be treated.

READ MORE: Ellie’s Recommended Five Sleep Essentials For Your Newborn

Ultimately, babies are all different and you’ll find your own ways and methods of helping them sleep. There are many books and guides with conflicting advice claiming to have the magic solution to make babies sleep. As long as the baby is sleeping in a safe environment and mum and dad are staying sane then you’re doing fine. Routine and habits can help but these will change and you just have to roll with the punches of parenthood and look forward to that wonderful first time when your child sleeps all the way though until morning.

By Dr Tom York, NHS-registered GP and private GP at GPDQ – UK’s doctor-on-demand app

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