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Common Baby Sleep Issues

Common Baby Sleep Issues

We are all familiar with the term, “Sleeping like a baby.”  In fact, when you read the sentence now, what image comes to mind?  Most likely it is one of a serene looking baby, contently asleep in her crib.  All is peaceful, all is calm.

Now compare that to an overtired four-month-old baby who is waking constantly throughout the night, or worse yet, a screaming 10-month-old who refuses to even lie down in her crib.  Hey-welcome to parenthood! 

Why do so many babies have sleep problems?  While some infant sleep issues are related to developmental leaps and will pass as quickly as they started, others are a bit trickier, and understanding what might be causing the problem can often help you find the solution. We’ll explore some of the most common baby sleep problems below, along with some helpful tips that will hopefully let everyone in the house get a little more shut eye. If you’d like to join us to learn more about dealing with baby sleep issues, we’d love to help – Learn more here

1) Poor timing for  sleep: An overtired or not tired enough baby will be hard to put down. If your baby goes down for a nap or at bedtime overtired, then she will have a much harder time falling asleep. Overtiredness causes your baby’s body to produce cortisol, a hormone that stimulates arousal (almost like caffeine). Therefore, the more overtired your baby is, the harder it is for her to fall and/or stay asleep. In addition, if you try to put your baby down for bed too soon, she may legitimately not be sleepy enough!

    Finding the right sleep time for both naps and bedtime is key to your baby falling asleep easily. So, what is a good span of awake time between sleeps?  For babies 4-6 months of age, try to put them down for a nap or for bedtime after they’ve been awake for approximately 1.5 to 2.5 hours.  For babies 6-9 months of age, a 2-3-hour awake window usually works well, and a 2.5-4-hour awake window is a good estimate for babies 9 months to a year.

    While you want to have the above-mentioned time frames in mind, you always need to remain a bit flexible, and also look for the signs of sleepiness!

    Signs of sleepiness:  Many new parents will wait until their baby is acting fussy, squirming, or possibly even in meltdown mode before they try to get their little one to sleep.  I get it.  The thought is if they are tired enough, they will fall asleep!  After all, they can’t stay awake forever!  But the “magic time” for sleep is before your baby is in overtired mode. It’s when your baby is most likely going to give into sleep easily-without all the screaming first.  Every baby is unique and can display different signs, but here are some of the most common sleepy signs we encounter:

    • For newborn babies, parents often report that they get red eyebrows and/or red eyelids.
    • As your baby gets a bit older, look for a glazed-over look in his eyes. Often referred to as “the drunken sailor.”
    • Notice if your baby starts staring off or turning away from you when you talk to her. This is not an insult! I have had parents say they feel rejected when they are trying to engage in play with their baby, but the baby wants nothing to do with it.  This is often the sign of a tired baby who is ready for her nap!
    • Look for a reduction in activity. Your baby was very busy exploring the new toy that grandma got him, but now he seems to have lost interest in it as well as the other toys around him. By the way, often the best toys are not toys at all. Think measuring cups, a whisk, a water bottle, a feather duster, etc.
    • Yawning. I promise you, you’re not boring your baby. She is getting sleepy.

    Length of nap: If you find that your baby wants to sleep all day, and is waking up a lot at night, then you may want to try to limit naps to no longer than two hour stretches at a time. In addition, if your baby sleeps a lot during the day, it is also possible he might miss a feed, and then need to make it up during the night.  One super long nap in the morning may throw off the afternoon nap leading to an overtired baby at night. Consistency with nap times can help baby organize daytime and nighttime more easily.

    I will give you an example from a mommy in one of my parenting classes.  Her baby was 10 months old and always took a 2-hour nap in the morning.  There is nothing unusual about this.  However, she was finding that he was consistently refusing his afternoon nap and therefore was very overtired and super cranky by bedtime.  This made it hard for him to go and stay asleep.  I suggested limiting his morning nap to 1.5 hours instead of 2.  Just that small tweak did the trick.  Waking her 10-month-old baby after a 1.5-hour morning nap, allowed him to take a good 1-hour nap in the afternoon, and go down easily at bedtime!  Remember every baby is different!  What worked for this baby might not work for yours, but the point is not to be afraid to explore the length of the nap and see if either lengthening or shortening it solves your sleep problem!

    2. Physical discomfort: I know this one may seem obvious, but it’s important to keep in mind that your baby will have a hard time sleeping if he or she is physically uncomfortable. This may be due to teething or gas pain, reflux, constipation, or discomfort from a cold or fever. It may be that the room temperature is making her too hot or too cold, or that your baby is hungry. To help assure your baby is not hungry throughout the night:

    • Try to make sure your baby isn’t distracted and gets full feedings during the day. Before a baby is at least six months of age, he or she will most likely need to feed during the night, but the more calories your baby gets during the day, the less calories he or she will need during the night. For example, a postpartum night doula told me she noticed that when the baby she worked with took only one ounce of milk at bedtime, he often woke up an hour later for a feed, but when he took three ounces at bedtime, he almost always took a longer stretch (around three hours) before he needed a nighttime feed.
    • For a baby that is four months old, you may want to try a dream feed between 10pm-12am until the baby is at least six months old. To do a dream feed, put your baby down to bed on a full stomach at bedtime (7pm-8:30pm). Then before you go to sleep (10pm-12am), gently wake your baby for a feeding.  Use minimum arousal.  Drowsily wake, feed, burp, change diaper, and then put your baby back to sleep. Sometimes it is not necessary to burp and change your baby’s diaper, you can simply feed your baby and put him back to sleep. This way, your baby's longest stretch of sleep will be during the time that you are also sleeping. This allows mommy and daddy to get a nice stretch of sleep themselves which is important for the entire family’s well-being!

    3. Outside distractions:  Is there an outside noise that is bothering your baby? Perhaps the television in the next room is on too loudly, the room is too light, or baby smells something (good or bad). Blackout curtains for babies four months and up often help babies to sleep longer at naptime and in the morning. The dark room environment helps the baby’s body produce melatonin; a hormone that helps regulate sleep.  The darkness also helps to limit other distractions in the room.   Don’t worry, babies are not afraid of the dark!  That fear does not usually creep in until the toddler years when your little one might request a nightlight. In general, you want to make sure that you have a constant room environment, and there is nothing in baby’s room making it difficult for her to fall or stay asleep.  I once had a momma whose baby was consistently waking up at 4am.  She had tried everything to no avail.  Finally, I suggested that she go into her baby’s nursery a little before 4am to see if there was any change in the baby’s room environment.  Sure enough, every morning at 4am her next-door neighbor left for work.  As he pulled out of his driveway, his outside lights automatically went on waking up this momma’s baby whose bedroom window was located next to her neighbor’s driveway!  The lights only stayed on for a short period, so by the time she had gone in to check on her baby, the lights were off again.  Now that she knew what the issue was, she ordered blackout curtains for the baby’s room, and the problem was solved!

    4. No transition to sleep: Many babies fall asleep much easier when they have a transition from being awake to going to sleep. It is sometimes hard for a baby, who is playing and socializing with you one minute, to be put down for a nap or bed the next.  This is why winding down and having a sleep routine are so important!  A sleep routine helps your baby to get into a relaxed state, psychologically and physiologically preparing him for sleep.  For example, perhaps as you change your baby into his pajamas, you give him a little body massage and play a couple of minutes of relaxing lullaby music. Next you and your baby say good night to the room.  “Good night moon, good night room, good night kitty cat, good night mommy, good night daddy, etc. As you turn off the lights, you put on some white noise, place your baby in his crib, and say, “I love you. Night-night.”

      One note here. I have found that many parents will read their babies books as part of their bedtime routine. While reading to your baby is a wonderful engaging activity and helps encourage speech and language development, I often find that for a baby, it can be too stimulating as part of their bedtime routine. Don’t get me wrong. I love reading books to babies, but I prefer them as a daytime activity that babies can really enjoy and engage in.  Once your baby is a more developed toddler, then reading a bedtime story where the two of you can cuddle up together is pure heaven!  Of course, there are always exceptions to this rule, and if you feel that your baby tolerates the bedtime story well, by all means, enjoy the ritual.  If, however, you see signs of overstimulation after reading a bedtime story, incorporate it as a daytime activity and reintroduce it at nighttime when your little one is a bit older.

      5. Negative sleep associations: Although sleep cycles in babies are not quite the same as adults, all human beings will have periods during their sleep cycle when they awaken. They will also have periods where they are not likely to wake up (during deep sleep) and periods where they are more susceptible to waking up (during light sleep). So if you think back to before you had your baby, when you went to bed at 11pm and slept straight through until 7am the next morning (the glory days), you actually did wake up several times during the night as part of your sleep cycle, but you may not have realized that you had awoken, or you may remember briefly waking and re-adjusting your pillow, or changing position, but then going right back to sleep. We all tend to wake up briefly after an episode of dreaming, and at that moment we are sensitive to anything amiss in our environment.

        Babies sometimes cannot return to sleep quickly after these normal arousals because something seems “wrong” to them—their environment has changed. All people, but especially babies and children, learn to connect certain conditions with falling asleep. When they wake periodically during the night, they check to make sure those conditions are still present. If they are, they tend to fall back to sleep easily.  Everything that was there when they first fell asleep is still there.  But often with babies, this is not the case. The environment that baby fell asleep in has now changed. Negative sleep associations are things that your baby has associated with falling asleep, that disappear once your baby is put down to sleep. It is not uncommon for a baby to fall asleep in one room, in mommy’s arms, being rocked, while taking in warm milk, only to awaken later and find himself in a different room environment, in a crib instead of mommy’s arms, without being rocked, and without milk.  Imagine that you fall asleep in your bedroom, in your bed with your pillow and blanket, and then a few hours later, you wake up on the couch with no pillow or blanket. What would happen?  Would you go right back to sleep?  Most likely you would not. You would go back into your bedroom, lie back down in your bed with your pillow and blanket, and then you would be able to fall back to sleep.

        This is one of the key reasons why sleep science proposes that you put your baby down to sleep awake.  This way when your baby falls asleep, and then wakes up again during the night (which we now understand your baby will wake up several times) he is in the same place, and the objects that he used to help him fall asleep, his “sleep associations,” are still there with him. This way, your baby may be able to use those sleep associations to easily put himself back to sleep.  Sleep associations that remain present throughout your baby’s sleep period are often referred to as positive sleep associations.  Examples of these include: a white noise sound machine, a lovie, a swaddle or sleep sack, a consistent room environment, baby sucking his fingers, etc.

        Please remember that every baby is unique and comes into this world with his or her own temperament and personality.  What might work for one baby, might not work for another.  This list is meant as a tool to help you to problem-solve your baby’s sleep problem.  It is not meant as a “must do” list that if you don’t incorporate you will never get a good night’s sleep again.  Take what works for you and leave the rest alone.  Just a thought-perhaps when we are referencing someone who is getting a good night’s rest, instead of saying they are “Sleeping like a baby,” we should say they are “Sleeping like a new parent who snuck off to a hotel for one night while someone else stayed home with the baby!”

        Jill Campbell, Psy.D., Parent & Me Curriculum Director