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Ask Dr. Sue
HELPING YOUR BABY SLEEP THROUGH THE NIGHT
Dear Dr. Sue,
My husband and I are expecting our first baby. I
have several friends who have babies who are terrible
sleepers, and I’d like to avoid that, if possible!
What can I do to end up with a good sleeper?
Expecting Parents
Dear Mom,
A good night’s sleep is a worthy goal, but it is
important to be clear about the age at which you expect
your baby to be “a good sleeper.” If you plan to
breastfeed (and I hope you do), you can expect to be
feeding your new baby several times during the night for
a number of weeks, and at least once during the night up
to about four months of age. Beginning at four
months, more and more babies are developmentally ready
to have a long sleep during the night. (You may or
may not call this “sleeping through the night:” it
will probably be less long than you were used to before
children, but longer than you were used to with a
newborn in the house!
There are certainly some things you can do to help your
baby be the best sleeper he can be, as well as some
things that you may hear suggested that are not helpful.
Helpful ideas:
1. The MOST important thing is to teach your baby to
fall asleep on his own. This is something you can
work toward from an early age, simply by noticing when
your baby is drowsy and trying to get him into his
bassinet or crib before he falls asleep. If you
enjoy rocking or breastfeeding your baby to sleep, try
to rock or breastfeed him almost to sleep. Note:
if your baby is already used to being rocked into a deep
sleep, he may wake up as soon as you lay him in his bed.
If so, try to pat and soothe him in his crib without
taking him out. If he wakes up all the way and
gets frantic, take him out and start over, with the goal
again being to put him down drowsy, but not yet asleep.
2. Introduce a soothing, calm bedtime routine starting
at about four months of age. Start with a warm
bath. Consider adding a massage (massage has been
shown to increase the levels of the sleep hormone,
melatonin). (1) Rock and breastfeed or read to
your baby, watching for signs of sleepiness. Put
him into his crib when you see those signs.
3. Spend as much time as possible cuddling your baby
during the day. If you have a caregiver because
you work outside the home, make sure that she is warm
and nurturing and that she spends a lot of time holding
your baby. (Trust me, he won’t come to prefer her,
he will just be more secure.)
4. Expose your baby to as much natural light in the
early afternoon as possible (or ask your caregiver to do
so). At least one study suggests that such
exposure improves sleep. (2) More research is
necessary, however, because it may be that the babies
who were exposed to more light were also having more
interesting days to tire them out, or there may be
another reason they were better sleepers.
5. Plan to make your baby’s daytime interesting, with
lots of attention, games, music, and book reading.
Definitely take him for walks: they will be good
for both of you. Putting him into a stroller will
work, but a sling or infant carrier that allows contact
with your body while letting him see where he is going
is better. Evening should be a time to wind down.
Even if you haven’t seen your baby all day, don’t use
the evening hours for high-spirited tickling and loud
play. (You can save those for your days off.)
6. Make night-time the opposite from daytime in every
way. When you respond to your baby’s cries, keep
everything quiet and low key. Turn on minimal
lighting. Don’t change his diaper unless it’s
dirty. If your baby is gaining weight adequately
and is full term, don’t feed him. (Talk to your
pediatrician if you’re not sure about this.) Keep
all night-time visits brief and boring, and, no matter
how cute he is, resist the urge to play with him at this
time. If he keeps crying, you can either return to
soothe him every few minutes, gradually stretching out
the time between visits, or sit by his crib and pat him,
but avoid taking him out of his bed unless you feel that
he is sick or hurting.
7. You might put a “transitional object” in his crib.
In developmental terms, a transitional object is
anything that can provide comfort in your absence.
This could be a small toy or even a handkerchief with
your scent on it (perfume or breastmilk). Remember
not to put anything into your baby’s bed that he could
get wrapped around his neck or push his face under—no
pillows or scarves or receiving blankets.
8. Consider a calming noise in his bedroom. This
could be a CD with bedtime music, a tape of your voice
reading soothing bedtime stories, or a radio set to
classical music or even quiet static.
9. Some experts believe that waking the baby up late at
night for one last feeding before you go to sleep will
help him sleep longer. Some babies just can’t be
woken up when they are in a deep sleep, and some experts
don’t feel that this helps, anyway. It’s likely
that it helps for some babies and not for others, so you
could consider giving it a try, if you are still having
trouble after following the guidelines above.
Things that won’t help your baby sleep through the
night:
1. Gaining a certain amount of weight (although if your
baby is premature, his development in sleep may lag
behind his full-term friends).
2. Adding solids. It has been shown repeatedly
that starting cereal early will not help a baby sleep
through the night. Your baby will do this when he
is developmentally ready, assuming you set the stage for
sleep as described above. Having said this,
however, a baby who was previously sleeping great who
begins to wake up several times each night may be
telling you he is not getting enough to eat. Talk
to your pediatrician about when to introduce solid
foods.
3. Decreasing the length or number of his daytime naps,
or putting him to bed later. Our intuition leads
us astray here, since a worn out baby does not equal a
baby who will sleep better. Often the reverse is
true, since an exhausted baby finds it difficult to wind
down and relax.
References:
Ferber, S. et al. Massage Therapy by Mothers Enhances
the Adjustment of Circadian Rhythms to the Nocturnal
Period in Full-Term Infants. The Journal of
Developmental and Behavioral Pediatrics, Dec. 2002
Harrison, Y. The Relationship Between Daytime Exposure
To Light and Night-Time Sleep in 6-12 week old Infants.
J. Sleep Res. 2004 Dec; 13/4:345-52.
 
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