If you are expecting and want to have a healthy start for your baby or if you have a newborn and want to help your baby sleep, this is for you!
Understanding Baby's Sleep
After departing from your nice, warm uterus, your baby suddenly needs to do many things by himself. He needs to breath, eat, eliminate, control body temperature and etc. Regulating and maintaining homeostasis is a huge job for him to accomplish during the first few months after birth. Sleep/arousal is one of these big tasks.
You would like to see your little one to sleep and be awake in more predictable patterns, sleep for longer stretches, have a smoother transition between sleep and being awake, being awake for feeding, enjoying time with you, learning the world, and eventually more consolidated night time sleep. His sleep and arousal can be divided into six states characterized by observable evidence such as breathing, eye movement, and body movement. The big changes in states is that full-term babies spend 50% of their sleep for active sleep at birth and it reduces to 25% by 6 months. Studies have suggested that this change correlates to rapid brain development. Moreover, they have shorter sleep cycles (60 minutes) when compared to adults (90 minutes) which equates to more vulnerable moments for arousal.
Sleep/arousal is organized based on the circadian rhythm and homeostatic processes. Circadian rhythm incorporates cues from the external environment to regulate timing. So, sunlight in the morning, and darkness at night are cues to activate circadian rhythm. Sleep pressure in the homeostatic process is relieved by sleep. Let's imagine a spring toy – When you wake up, you are constantly tightening the spring and once you fall asleep, the spring is released. Your baby's sleep gradually is organized by these two bodily processes.
If your baby is premature or medically fragile, they need more support from you to organize their sleep and arousal due to the immaturity of central nervous system and lack of typical habituation* due to hospitalization.
*Habituation: The world of sensory stimuli can be overwhelming for your baby. If your baby is exposed to a familiar environment, he will learn how to react less to those repeated sensory inputs, consequently lessening their arousals. This is called habituation.
Why is your baby's sleep important?
There are several reasons of which, studies have confirmed
- Physical health (growth & development, obesity, immune system)
- Brain development and function (brain metabolism, memory consolidation, learning)
- Awake time performance and safety
- Emotional well-being
- Your baby's sleep = whole family's well-being
- Sleep issues can become chronic
Supporting your baby's sleep
First and foremost, is creating a safe environment to prevent sudden infant death (SID). Here are general guidelines of safe to sleep (campaign) created by the U.S. Department of Health and Human Services.
The needs for each baby is as unique as those for the family. The ways of supporting your baby's needs largely depending on who your child is and what situation he is in. The following suggestions are not made as solutions but should help guide you in finding ways to meet your little one's unique needs by observing and understanding his sleep and arousal.
OBSERVATION & RECORD
Sleep/arousal states should not be looked at as isolated but interdependent. Therefore, your observation should be done in 24-hour time-frames.
How's his sleep/arousal patterns? You can look into this while relating it to the six states.
What about his sleep cycles?
What changes have been made that have made your baby more or less sleep/calm/alert/irritable (e.g., your voice, mood, pace, how to play with, feed, change him, hold, move, bundle him, efforts to calm him down, etc.)?
What sensory inputs made him more or less sleep/calm/alert/irritable (e.g., lights, sound, new blanket, visitors, weather, etc.)?
FOLLOW YOUR CHILD'S LEAD & SUPPORT HIM TO DEVELOP MORE HABITUATION.
Now, you are aware of your child's sleep patterns and what help his sleep and attention while he is awake. It's time to create the best daily routine for him. It cannot be a rigid schedule, since his needs can change from time to time. However, it is good to have some predictable patterns/flows which can help him react less to sensory stimuli when he is tired (habituation).
YOUR SLEEP IS IMPORTANT, TOO!
Studies have confirmed that parental sleep deprivation due to their babies' sleep issues can cause depression, poor sleep quality, fatigue, physical health issues and can also, increase potential accidents (e.g., micro sleep while driving). This tremendously impacts the relationship between you and your baby since you are prone to having less patience and making less than ideal parenting decisions in order to meet his needs, including his sleep needs. This two can become an endless chain effect. Therefore, your attempt to addressing your own sleep should coincide with one another. The best way to approach this is lifestyle changes. Food intakes (e.g., caffeine), usage of electronics, exercise, relaxation techniques, etc. should be looked at as compounding factors.
As your child become bigger and stronger, his needs will change. Therefore, your observation and readjusting your support should be a constant focus. It is also important to keep in mind that it is common to have sleep disturbances during the first few years of life. However, it is also important to seek medical help if your baby's sleep issues become out of control or chronic.
Sleep is important for your baby's growth and development as well as the well-being of your whole family!
Bayer, J. K., Hiscock, H., Hampton, A., & Wake, M. (2007). Sleep problems in young infants and maternal mental and physical health. Journal of Pediatrics and Child Health, 43, 66–73.
Browne, J. V. & Talmi, A. (2015). BABIES and PreSTEPS Manual and materials.
Ficca, G., Fagioli, I., Giganti, G., & Salzarulo, P. (1999). Spontaneous awakenings from sleep in the first year of life. Early Human Development, 55, 219–22
Galland, B. C., Taylor, B. J., Elder, D. E., & Herbison, P. (2012). Normal sleep patterns in infants and children: A systematic review of observational studies. Sleep Medicine Reviews, 16, 213-22.
Gomez, R. L., Newman-Smith, K. C., Breslin, J. H., Bootzin, R. R. (2011). Learning, Memory, and Sleep in Children. Sleep Medicine Clinics, 6, 45–57. doi: 10.1016/j.jsmc.2010.12.00
Goodlin-Jones, B.L., Burnham, M.M., Gaylor, E.E., & Anders, T. (2001). Night waking, sleep-wake organization, and self-soothing in the first year of life. Journal of Developmental and Behavioral Pediatrics, 22(4), 226-233.
Halbower, A. C., & Marcus, C. L. (2003). Sleep disorders in children. Current Opinion in Pulmonary Medicine,9, 471-476.
Hall, W. A. (2015). Taking Young Children's Sleep Seriously: From Research to Practice. IDSC Summer Institute, UBC.
Hall, W.A., Saunders, R. A., Clauson, M., Carty, E. M., Janssen, P. A. (2006). Effects of an intervention aimed at night waking and signaling in 6- to 12-month-old infants. Behavioral Sleep Medicine, 4(4), 242-261.
Hall, W.A., Scher, A., Zaidman-Zait, A., Espezel, H., & Warnock, F. (2012). A community-based study of sleep and behavior problems in 12- to 36-month-old children. Child: Health, Care, and Development, 38(3), 379-389. doi:10.1111/j/1365-2214.2011.01252.
upbach, A., Gomez, R. L., Bootzin, R. R., & Nadel, L. (2009). Nap dependent learning in infants. Developmental Science 12(6),1007–1012. doi: 10.1111/j.1467-7687.2009.00837.x
Jenni, O., & O’Connor, B. B. (2005). Children’s Sleep: An interplay between culture and biology. Pediatrics, 115 (1), 204216.
Martin, J., Hiscock, H., Hardy, P., Davey, B., & Wake, M. (2007). Adverse associations of infant and child sleep problems and parent health: An Australian population study. Pediatrics, 119 (5), 947-955.
Mastin, L. (2013). How sleep works. Sleep-awake homeostasis. http://www.howsleepworks.com/how_homeostasis.html
Mindell, J. A., Meltzer, L. J., Carskadon, M. A., & Chervin, R. D. (2009). Developmental aspects of sleep hygiene: Findings from the 2004 National Sleep Foundation Sleep in America Poll. Sleep Medicine, 10, 771-779.
Nall, R. (2015). What are the benefits of sunlight?. Healthline. http://www.healthline.com/health/depression/benefits-sunlight
Pattinson, C.L., Staton, S. L., Smith, S. S., Sinclair, D. M., & Thorpe, K. J. (2014). Emotional Climate and Behavioral Management during Sleep Time in Early Childhood Education Settings. Early Childhood Research Quarterly, 29, 660-668.
Shriver, E.K. (2014). What Does a Safe Sleep Environment Look Like?. National Institute of Child Health & Human Development: Safe to Sleep Campaign . https://www.nichd.nih.gov/sts/about/environment/Pages/look.aspx
Touchette, E. Petit, D. Pacquet, J., Boivin, M. Japel, C., Tremblay, R.E., & Montplaisir, J.Y. (2005). Factors associated with fragmented sleep at night across early childhood. Archives of Pediatric and Adolescent Medicine, 159, 242-249.
University Washington. (2016). What is sleep and why do we do it?. http://faculty.washington.edu/
Weiss, S. K. (2006). Better sleep for your baby and child: A parent’s step-by-step guide to healthy sleep habits. Hospital for Sick Children: Toronto, Ontario.
Weissbluth, M. (1995). Naps in children 6 months – 7 years. Sleep, 18(2), 82-87.
Whittingham, K., & Douglas, P. (2014). Optimizing parent-infant sleep from birth to 6 months: a new paradigm: A new paradigm in infant sleep. Infant Mental Health Journal, 35(6), 614-623. doi:10.1002/imhj.21455