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BABY'S 1ST YEAR

Rude Awakenings

When the New Arrival Won't Sleep at Night, What's a Worn-Out Parent to Do?

October 05, 1998|SHARI ROAN | TIMES HEALTH WRITER

For many adults, the first big test of parenting comes about four months after having a baby. Call it the first semester exam.

That's when most pediatricians and textbooks suggest that baby should be sleeping "through the night," that being an ill-defined concept of six to eight hours of uninterrupted sleep sometime between 10 p.m. and 6 a.m.

If baby is cooperating, good for you; you lucked out this time, perhaps without even having to study.

If baby is still waking--and you feel that is a problem--it may be time to hit the parenting textbooks.

Many parents do just that. Sleep deprivation is the pop quiz of parenting. Parents wonder whether the dark circles under their eyes will ever fade. Arguments over whose turn it is to get up with the baby replace earlier forms of marital communication. A full night's sleep is akin to acing the SATs.

"For many parents, it's the biggest problem," says Dr. William Sears, a Capistrano Beach pediatrician and author of several parenting books. "Parents need to think about what their goal is regarding sleep. To me, the main goal is to create a healthy sleep attitude so children grow up learning that sleep is a pleasant state to enter. This is a long-term investment."

A good sleeping pattern is not just for the parents' benefit. Hormones related to growth are released at night. And, like adults, children simply learn better during the day after having adequate sleep.

But this is where the consensus about babies and sleep habits ends. There is no right or wrong way to get a baby to go to bed passively and sleep through the night. For a minority of parents, how much and when the baby sleeps isn't even an issue.

The majority of parents, however, usually need to come to grips with baby's sleep patterns. And that requires some research on various philosophies and, perhaps, some experimentation to find what works best for you and your baby.

"I think, a lot of times, that we approach babies with the intent of trying to make things as easy as possible for the parents instead of trying to help the child grow into their individual strengths," notes Dr. Rachelle Tyler, a professor of pediatrics at UCLA.

The American Academy of Pediatrics is a good place to look for guidance because the organization takes something of a middle road on the matter, while some other popular methods are more dogmatic.

According to the academy's literature--which many pediatricians adhere to--there is a wide range of "normal" sleep behavior in babies under 1 year old. And, the academy notes, babies' patterns change. Sometimes an infant will sleep well for a few months, then will start waking.

Working Toward the All-Nighter

In general, however, newborns will sleep off and on around the clock because they do not yet differentiate between night and day and because they need to be fed every two to four hours. This is called an ultradian sleep cycle, meaning it is less than 24 hours.

But, around 3 to 4 months, according to the academy, babies should naturally settle into a circadian rhythm, which means their sleep-wake pattern will follow a 24-hour pattern. At this age, they can usually skip a feeding, such as the 2 a.m. one.

At 4 months of age, studies show, about one-third of babies will sleep through the night on their own.

By 4 to 7 months, baby should be able to go eight hours without feeding, and during this period, parents can play a role in promoting uninterrupted sleep, experts say. For example, the pediatric academy does not follow any particular method, but suggests such things as not bothering to screen out light and noise during baby's daytime naps and not letting baby nap for long periods.

At night, the academy suggests, minimize play and interaction. Keep lights low when feeding. Don't talk or turn on the TV. And put baby in her crib when she's sleepy but is still awake so that she can learn to put herself to sleep.

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It sounds pretty simple. Too often, however, such mild advice doesn't cut it, and parents turn to more strategic methods.

For instance, the 1985 bestseller "Solve Your Child's Sleep Problems" (Simon & Schuster), by Dr. Richard Ferber, is still recommended for parents whose babies have developed troublesome sleep habits.

Like Dr. Benjamin Spock before him, Ferber says that by 5 to 6 months, babies who cry at bedtime or when awakening in the middle of the night should be allowed to cry, giving them a chance to learn to put themselves back to sleep.

After five minutes of crying, a parent can go in for a couple of minutes to reassure him, pat him, talk to him but not pick him up.

This process is repeated each night lengthening the interval that the baby cries to 10 and then 15 minutes. Parents are advised to return to the baby's room every 15 minutes for reassurance until he falls asleep. After a few nights of this, Ferber says, baby will adapt to the routine without crying.

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