Healthy Sleep Defined

Ever wonder what the pillars of healthy sleep are? This article will provide you with that information so that you can make sure you have the foundations in place to get your little one the sleep he/she needs!

  1. Nutrition: Appropriate nutrition is fundamental to solid sleep especially during the early stages of a baby’s life. The AAP recommends breastfeeding as breastmilk solely meets the baby’s exact nutritional needs. However, in working with their pediatrician, families can find the perfect formula for their little one. Whether it be breastmilk or formula, the most important thing to establish is a consistent feeding schedule to ensure that a baby is getting as much nutrition as possible during the day to prevent unnecessary wakings overnight. Without daytime intake schedules, babies (especially younger ones) will wake up needing calories overnight. This may include cluster feeds and/or dreamfeeds. Furthermore, many pediatricians will recommend starting solids as young as four months. This change can also affect sleep as there is the potential for introducing allergens, inflammatory foods, processed food or other items that may affect digestion and therefore sleep. Sleep is completely dependent on how, when and what nutritional needs are met. 
  2. Sleep Environment: An environment conducive to sleep is also critical to sleepy hygiene. The perfect sleep environment is completely dark with, quite frankly, zero light. One should not be able to see their hand in front of their face once the lights are off. Temperatures should be set between 68-72 degrees and white noise should be utilized throughout all sleep times. From 0-6 months of age, a baby’s crib should not have anything in it other than the mattress and a snug, fitted sheet. After six months, bumpers are permitted but no other loose items should be in there. The crib settings should be lowered as the baby grows and is able to sit, stand or climb. 
  3. Bedtime Routine: A consistent bedtime routine is absolutely crucial to sleep! It does not have to be elaborate or detailed but must allow time for the baby or child to unwind and prepare their bodies’ for sleep. A warm bath approximately 45 minutes to an hour prior to lights out has been shown to calm baby’s central nervous systems which is conducive to sleep. Not all babies can be bathed nightly (skin concerns) in which case a warm washcloth to wipe the baby down can replace the bath. This can be followed by a ‘baby massage’ with baby safe lotion or oil, nighttime diaper, pjs and swaddle or sleep sack. As appropriate, offer a bottle/breastmilk in the room, outside of the crib, with the lights on. Next can be a short book or song, snuggle and then placing the baby down drowsy but awake. Nap routines can be similar but shortened (no bath or change of clothes).
  4. Morning Wake Ups: Creating a morning routine is just as important as bedtime/nap routines. The wake up time should be consistent daily. I often recommend making the wake up a very big deal. Use lots of enthusiasm to greet your baby (“good morning sweet boy! What a great job you did last night!!!). Opening blinds to let natural sunlight in is also important. Immediately change your baby’s diaper, clothes and offer a feed. Then continue on with your daily schedule!
  5. Emotional Needs Met: The final component of healthy sleep is meeting babies’ emotional needs. A baby’s sense of security, belonging and self all begins with a positive, intentional relationship with his caregivers. Spending quality time interacting with a baby allows him to safely explore the world using his senses. Babies truly need love and support to become emotionally stable. Taking the time to show your child loving emotions, connect with him/her, smile, laugh and love throughout the day meets a need that will foster healthy sleep overnight.

Understanding and Dealing with Sleep Regressions

“Sleep regressions” are some of the most dreaded and frustrating times for parents, especially for those who have historically had great sleepers. Your once wonderful sleeper is now up multiple times throughout the night, fighting naps, irritable and clingy.  Good news! These developmental regressions do not have to be so daunting and overwhelming. Understanding when and why they occur is, in and of itself, a stress reliever. The information here will equip you with the knowledge and tools you need to help your baby through these times. Sleep regressions generally occur at 4 months, 6 months, 9 months, 12 months, 18 months and at 24 months. Let’s dive in and explore why these occur and discuss how we, as parents, can handle them!

4 Month Sleep Regression

This is the first of the six sleep regressions and can be one of the hardest for families. Your baby may all of a sudden be waking up more frequently throughout the night and/or taking very short naps. It is discouraging to say the least but, here is why this is happening. At 4 months old, your baby has grown out of the newborn stage becoming much more aware of his/her surroundings making that beloved newborn “I can sleep in the middle of a concert” sort of sleep, a thing of the past. Your baby is quickly developing sleep cycles that correspond to what we, as adults, have. For example, taking longer to fall asleep or being overstimulated making sleep difficult. 

Babies continually undergo incredible physical and mental developmental milestones. The first of which, you guessed it, occurs around 4 months. Babies develop object permanence which means they now understand that when something disappears, it is not gone forever. You leaving the room becomes difficult for babies because they KNOW you are out there and want you to come back. Most are not very happy with this new discovery making them more clingy. Additionally, this is the age that many babies begin to roll onto their belly but may not yet be able to roll back which is also scary for a baby. Think about it, you are laying there looking up at the ceiling and your surroundings and all of a sudden, you are staring down at your crubsheet, can not see things you were able to seconds ago and you can not move back! All of these changes in your baby can interrupt sleep but, do not fear, this is a short period of time (usually 2-6 weeks). If the difficulty sleeping lasts longer than this, you may have some bad habits to break! Now is the time to really establish bedtime routines if you have not already. They provide your baby with predictability and an understanding of what comes next. If your baby is already sleep trained, fall back onto the method you have used in the past during this phase. If you baby is not sleep trained, contact me and let’s get to it! 

6 and 9 Month Sleep Regression

Just when you thought things were normalizing again, the 6 and then 9 month regressions come. The two regressions are paired as they both are founded in your baby’s discovery of similar mental and physical skills. And teething comes into play as well. Most children experience their first tooth coming in around 6 months (although some do not get a tooth until much much later) which can be a very painful experience. If you suspect this is the cause of your sleep problems, contact your pediatrician and get clearance for the use of over the counter pain medications. 

Babies go through a major developmental leap at 6 months where they begin to better understand the world around them and how it works. They can make connections between events, specifically the transitions found in sound, light and textures. All of this coincides with babies’ blossoming physical skill of being able to sit independently. Then, around 9 months, this physical progress matures and, before you know it, you find your baby pulling to stand or even ‘cruising’ along furniture. At 9 months, they also have discovered a world of relationships such as the distance between objects which can be very alarming to babies. If a desired object is just out of reach, you will understand just how frustrating this realization of distance can be for your baby.

The acquisition of all these new abilities are both exciting, distracting and upsetting to many babies which in turn, interrupts sleep. You may, once again, find your baby taking short naps, resisting naps and waking up throughout the night. Take ease in the fact that all regressions last only between 2 and 6 weeks (although this may seem like forever to a very tired parent!). Maintain consistency in your baby’s schedule and your approach to their sleep. Offer them lots of love, snuggles and comfort throughout the day as YOU are the only constant they know. However, if the disruption to sleep lasts longer than 6 weeks, it may be time to consolidate naps and make the transition from 3 to 2 naps. On average, this occurs around 7 months old but some babies move to two naps earlier or later than others. If you need help with this transition, I am here to help you!

12 Month Sleep Regression

This is about the time that you realize how much time flies (despite the days feeling long;). And your once little baby is quickly turning into a toddler! With that, comes a ton of physical and mental developmental leaps. At this age your little one begins walking or cruising, climbing, truly engaging with toys and people. Both their vocabulary and cognitive skills are exploding as they begin to communicate with you (some words, gestures or sounds) and can receptively understand language at a much greater capacity.  Right before your very eyes, they are becoming little independent thinkers who have opinions on just about everything INCLUDING sleep. 

And, you guessed it, but at this age it is very common to see some sleep disruption again. This may be in the form of interrupted nighttime sleep, early wake ups, nap refusals or short naps and taking even greater time frames to fall asleep. Your child will most likely still be on two naps but their ability to stay awake for longer periods of time sometimes leads them to believe they do not need one of those. Stick with your routine! Keep offering their naps at the same time while engaging them as much as possible throughout the day, practicing all the new skills they have acquired. Including them in small tasks, offering controlled choices, and talking to them are great ways to help minimize issues. Separation anxiety becomes a real thing at one year old as well. Talking to them and/or lengthening sleepy time routines may help! If sleep continues to be an issue after 6 weeks, look to see if you have developed any old habits or sleep crutches. I am here to help you identify  and work through these.

18 Month Sleep Regression

You have probably noticed that your toddler, this tiny little human, is gaining independence and a personality to match! If you have not already, now is the time to consolidate sleep so your toddler is taking one, long nap, after lunch. He or she may be resisting this nap, waking up throughout it or having difficulty with overnight sleep. Your toddler has control of very little in their everyday lives but they CAN control sleep. This sleep regression is often seen because your little one is expressing his or her independence and controlling one of the very few things they can. To help get through this phase, keep offering controlled choices throughout the day (‘would you like an applesauce or banana?’) which increases their feelings of independence. This too shall pass!

24 Months/2 Year Sleep Regression

You made it! This is, hopefully, the last of the sleep regressions you should see in your growing child! Around 2 years of age, some very big life changes may be coming your and your toddler’s way. He or she may be starting to show interest in using the toilet which means….potty training! Some may be welcoming a baby brother or sister into their home and some toddlers may be transitioning into beds. All of these changes can seriously affect sleep. That and their ever evolving independent and growth of skills! 

Take time to talk to your toddler. He or she can comprehend way more than we often give them credit for. I always recommend using real language (not baby talk) and speaking the truth. In my experience and years in early childhood education, I came to one realization – children (including your little two year old) have a voice that wants to be heard AND they want to know what is really happening in their world. Talk to them….include them and be upfront with them about any changes coming their way. Give them independence in little tasks throughout the day. If sleep continues to be an issue, I am here for you! With my background in education and understanding of child development as well as sleep, we can come up with a plan to get back on track together!