Your Baby and Toddler's Sleep When Sick

There are many guarantees in your child’s life and one of the biggest guarantees is that at some point, your child is going to get sick. The average child under age 2 will come down with an illness 6 times/year. And if your child attends daycare, that number could be doubled. Depending on the severity of the illness, a child’s sleep can really derail when they are feeling under the weather. Many parents struggle to know what to do when their child is sick - do all the rules go out the window? Do we still try to remain consistent? What should we be flexible with and where should we draw a hard line? Enter - this post! While it certainly is impossible to give a concrete game plan for your child when they are ill as it absolutely depends on the severity of the illness, this post is meant to give you a framework to work with so that hopefully you can rebound more easily when your child is back to full-strength. Happy reading!

Why do illnesses impact sleep?

As I always tell families, when dealing with a sick baby or toddler, we have to consider that their psychological needs need to be met as well. We want them to know that if they are unwell, we will be there to help them through it. Trouble arises when we need to introduce certain sleep associations to help them sleep when they aren’t feeling well [rocking, holding, nursing, bottle, etc.] as while these associations may not be inherently ‘bad’, especially when your child is needing support, the expectation of these associations continuing even once they are feeling better can be very high, especially with a toddler. As I’m sure you’ve experienced, it can be very difficult to sleep with a sore throat, cough, fever, ear ache, etc. and children need help managing these symptoms, but the key is that the day your child is better, we need to get back to our normal schedule/routine. Bigger issues arise when we allow the new habits to linger past the healthy point as more often than not, even if we’ve had to bring in all the big guns to help your child sleep, it should only take around 3-5 days to get back on track if we do so in a timely manner. If weeks have gone by since your child was sick and you are still supporting heavily to sleep, a bigger sleep training endeavor may be required.

Which rules should we try to follow?

Just because your child is sick, it does not automatically mean that all rules are out the window. Many children can maintain the same sleep habits when sick [and some even sleep harder/more easily/longer!] so it’s always important to give your child a chance first before we add extra support. Some rules to try and follow include:

• If your child is an independent sleeper, aim to still put them down awake for all sleep times and see if they are able to manage without extra support. Keep reading to find out what to do if this is not the case.

• If your child sleeps in a crib/their own bed, try to keep this consistent [vs. bringing them into your bed - this can be a very difficult association to remove, especially with toddlers!] If you would like to monitor your child more closely, consider making a bed on the floor of their room for yourself.

• If extra support is needed, try to intervene as minimally as possible at first, adding extra help as required. This means still waiting at night during any wakings, trying to comfort them in their crib first before moving to a pick-up if needed, and trying to save extra feeds as a last resort unless dehydration is suspected. Check out the information below for an actionable game plan for bedtime, naps, and the middle of the night!

Which rules are okay to break?

While not all rules go out the window when your kiddo is unwell, there are some rules that we certainly want to break in the spirit of giving your child the best chance possible to ward off their illness. These rules include:

• Waking them at a certain time in the morning [let your child sleep as long as they need!]

• Waking them at a certain time from their naps [let your child sleep as long as they need!]

• Following any sort of schedule [waketimes, by the clock, etc.] When your child looks tired, let them sleep/help them to sleep.

• Worrying about feeding too close to sleep or any sort of feeding schedule through the day - your child needs plenty of rest and plenty of fluids.

How else can we help our babies/toddlers when they are unwell?

• A nightly warm bath [especially helpful if you can run a hot shower first with the door closed to steam up the room for congesion]. If your child has a fever, a lukewarm bath [not cold!] would be ideal.

• Using a humidifier/vaporizer for congestion/cough. My favorite can be found here!

• A massage before bedtime can help with any body aches.

• A nasal aspirator [or ‘snot sucker’ as we like to call it] is worth its weight in gold. I literally do not know how any family can survive without one of these! Definitely one of my most highly recommended baby products.

• Offering medication as needed [especially 30 minutes before bedtime]. Wondering about which to use? Advil/Motrin [ibuprofen] are anti-inflammatories so will be especially helpful for illnesses with inflammation [croup, teething], and for higher fevers. It also lasts longer than its counterpart but should only be used in babies 6+ months of age. Tylenol [acetaminophen] would be the better option for stomach pain/upset and can be used for babies under 6 months. As always, make sure you are using the correct dosage and consulting your pediatrician with any questions or concerns. Parents should not hesitate to contact the pediatrician if a child continues to have a persistent fever.

Managing sleep during illness is never easy, even when a child isn't severely ill. All children have different tolerance levels for illness and some can seem to be impacted by even a minor cold. If all else fails, do what you need to do and don't worry about creating bad habits. And if you are in need of support to help get your healthy child back on track, do not hesitate to reach out!

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Pam Edwards is a Certified Infant & Child Sleep Consultant and founder of Wee Bee Dreaming Pediatric Sleep Consulting, based out of Kamloops, B.C. Healthy sleep is addicting and she has made it her life mission to help families all across the world get the sleep they deserve - a good night's sleep doesn't have to be a dream!

Newborn Sleep 101

I have been sleep consulting now for 4.5 years and have learned so much in that time. The earliest I begin working with families is once baby has reached the 16 week mark which means newborn sleep is a bit of uncharted territory for me! Or it has until recently, as my 3rd baby was born in April 2018 and I have learned so much in 7 short weeks. If you've read my 'about me' section here, you'll know that I struggled majorly with my first-born and sleep. Ignorance was not bliss! With my second, I did a lot of things differently and while it was exponentially better, I couldn't help but think if there are more ways we can help improve sleep in the first few months [or the 'fourth trimester' as some call it]. Thus began my research - I scoured the Internet and the most popular newborn sleep books for the best tips and advice on how to improve sleep in the newborn days. And it has paid off so far! This blog post is meant to outline what I've done differently this time around and what has helped shape baby W into a so-far great sleeper [hello 9 hour stretches of nighttime sleep!] Happy reading!

While I know that a lot of newborn sleep is 'luck of the draw', I also know that trying to cultivate some healthy sleep habits right off the bat is never a bad idea. While true bad habits are not created until a baby is older, oftentimes by setting baby up on the right foot, we can avoid having to do any major sleep training down the road. The key with most newborns is trying your best to avoid the overtired state, which can be tricky as babies at this age are very prone to overtiredness. So what have I found to be the most important keys in the early weeks with newborns? 

Baby dab!

 

Get those days and nights sorted out ASAP

Babies live in perpetual darkness in your tummy which means that when they enter the world, their circadian rhythms are all sorts of messed up. Additionally, most babies are more active at night while you are sleeping and sleep during the day when your movements help lull them to sleep. One your main priorities in the early weeks should be helping baby sort out her days and nights. A few important ways to do that include:

• Waking baby up every 3 hours during the day. Even if it's just for a quick feed and then right back to sleep, making sure baby doesn't sleep through feeds in those early weeks is important as then baby will start to try to make up for the missing intake at nighttime. This also ensures baby doesn't clock too many daytime sleep hours which then = less nighttime sleep hours. As the weeks go by, you may need to even experiment with capping naps closer to the 2-2.5 hour mark [by 6 weeks I was capping baby W's naps at 2 hours and that has helped us get some nice long stretches at night].

• Nap in the light, nights in the dark. Until you are certain baby has their days and nights sorted, put baby down for naps in a bright-lit area [we had baby W napping in her crib right away but I would keep the curtains open for naps]. Once days and nights are sorted, naps should be in the dark to ensure good-quality sleep. Nighttime should always be dark and boring - try not to interact or stimulate baby during nighttime hours [nighttime should begin somewhere between 9:00-11:00pm for babies up to 6 weeks of age and 8:00-10:00pm at 6+ weeks of age].

Attempt independent sleep from day 1

Most of us have read at some point that putting baby down 'drowsy but awake' is important. With my first 2 children, by the time I had read or thought about that, I was already in the thick of rocking/feeding to sleep. So I wanted to experiment this time around with independent sleep from day 1 [and I'm not kidding, I put baby W down awake in that plastic crib in the hospital - ha!] I was absolutely amazed at how she had this innate ability to put herself to sleep [I'm sure you've read newborns can't self-soothe - I beg to differ!] I would turn the white noise on, swaddle her up, rock her for a minute, and lay her down awake. And she'd lay there silently, close her eyes, and fall asleep. I'm not gonna lie - it almost felt wrong! It felt like I should be rocking her to sleep! But I didn't have to! My mind-set this time around has been to work on things in the early months that will make it easier on her down the road. Working on independent sleep right away should mean that sleep training is not necessary [or at least not any major sleep training!]. But trying to start right away is the key, as once baby has been accustomed to one way of falling asleep, it becomes more challenging to undo it. Now, as baby W gets older and more alert and aware, independent sleep doesn't have the 100% success rate it did in the early weeks. Just keep in mind that independent sleep is the ultimate goal, not the be all and end all. What that means is that if by attempting independent sleep baby is on the verge of becoming overtired, you want to rescue that sleep time. I gave baby W 20 minutes to attempt to fall asleep on her own. If independent sleep didn't happen within those 20 minutes, I'd resort to rocking, nursing, using a swing, carrier, etc. to help her fall asleep. At such a young age, avoiding the overtired state is extremely important.
So what would I do during those 20 minutes that I was attempting independent sleep? From the get-go I established a solid nap routine [short but sweet!] I'd walk up to her room saying, 'it's nap time!', I'd turn on the white noise [this was a HUGE cue for sleep from day 1 - I was that crazy lady using white noise in the hospital but it has proven extremely helpful in signaling sleep for her], dim the lights, swaddle her up snug [using this technique - a snug swaddle is KEY!], lights off, sing her a song while walking around the room, then stand in front of the crib and bounce/shush until she was drowsy [I gauged 'drowsy' by waiting for one long, slow blink]. I would then lay her down awake and put my hand on her chest while continuing to shush and sometimes rocking her back and forth in the crib. If she cried I would give her a few seconds [it was actually quite amazing how on a number of occasions it was almost as if she needed to have a little 10 second cry to release energy and then she would calm and close her eyes] and if the crying was escalating, I would pick her up and bounce/shush again. The crying I experience is never very intense [not nearly as intense as when I am putting on her lotion at bedtime!] and a lot of it just seems to be her releasing energy [remember, not all crying means that something is wrong, sometimes crying is just a baby saying 'I'm tired!'] I would repeat this process until baby W was calm in the crib and then I would leave. If she cried once I left, I would wait 5 minutes [I have used a baseline of a 5 minute wait from day 1 - of course if the crying was escalating I would go in sooner but this almost never happened], and go in and repeat again [until we hit that 20 minute mark where I would rescue the nap instead].
This process was very similar to how I would approach bedtime as well. The difference there is that I have been doing a bath every single night since night 1 [the bath, I think, is what really helped with sorting out days and nights and has been a big cue for bedtime]. I only use soap every 3 nights to avoid drying out her skin and we lotion every night. As well for bedtime, I split the bedtime feed in half - meaning I start the bedtime routine by nursing her on one side [if you are bottle feeding then feed half the bottle], then we proceed to bath, lotion [hates that part!], jammies, nurse on the other side [rest of bottle], swaddle, sing, bounce/shush, down in bed. Again, we attempt for 20 minutes before rescuing the bedtime [rocking to sleep, nursing to sleep, or as a last-ditch effort on a particularly rough night - using the swing].
It's not always perfect but even just attempting independent sleep in the early weeks will be helpful to establish fully independent sleep down the road! The big key to being successful with independent sleep is nailing those waketimes. Babies are SO sensitive to overtiredness in this early months that trying to put a baby down awake and overtired is a bit like trying to wrestle my cats into their carrier to go to the vet, which brings me to my next point....

Keep awake times SHORT

Keeping intervals of wakefulness short for newborns is extremely important. This was one area where I went drastically wrong with my first-born and likely contributed to her colic-like symptoms that we experienced [I thought my newborn was a genius for being able to stay awake for 6 hours but then wondered why she screamed all night every night - oy!]. Newborns need a LOT of sleep and they need to sleep often. It's sometimes hard to believe how often we should be putting young babies down for naps but as I have mentioned a few times, avoiding that overtired state is key. Once you hit that overtired point, any chance of independent sleep will be extremely difficult and if you do manage it, you will likely experience a lovely 25 minute micro-nap - not fun! Babies up to about 3 months of age should basically stay awake long enough to eat, have a change, and then it's time to go back down again. This can feel extremely frustrating and exhausting but it does get better! A few times I kept baby W up just because I wanted to hang out with her longer than 10 minutes and it majorly back-fired every single time. So how long are we shooting for?

0-1 months: 40 minutes maximum
1-2 months: 40-60 minutes maximum
2-3 months: 60-80 minutes maximum

That's it. Seems crazy, right? I hear you! But babies up to 2 months of age require 16-20 hours of sleep. That only leaves about 4-8 hours of awake time every single day. Baby W is currently 7 weeks old and I aim to start her nap routine at 40 minutes of awake time. This leaves about 10-15 minutes of 'play time' after changing and feeding. Any longer than this and we hit that overtired state and more than likely will have to rescue the nap.

Separate food from sleep AND encourage full feeds

When encouraging independent sleep, we want to ensure we remove any associations that can negatively impact sleep. An association is something that occurs at or near sleep times. Some of these associations are positive [white noise, swaddle, lovey] and others can negatively impact sleep [rocking to sleep, feeding to sleep, etc.] Basically, anything a baby cannot re-create on their own is an association we try to avoid! Milk is definitely a strong association and something that ideally we would try to separate from sleep times as much as possible. Therefore, once baby starts to have longer periods of wakefulness, it's a good idea to feed them at the beginning of their awake time, followed by changing and play, and then down for a nap [there may not be much time in the early months between the two but we can still try to separate it, even if it's only by 10 minutes!]
The other key with helping to establish good sleep in the early months is encouraging full feeds. This is something I've actively tried to do this time around and it has really helped. If baby falls asleep eating - wake baby up. I did this by feeding one side, burping [try to always get a good burp out! Newborns can be very easily bothered by gas!], changing, then feeding the other side [nighttime feeds included]. By encouraging full feeds, especially during the day, we should see longer stretches of sleep emerge earlier on as sleep is closely tied to food in the early months. 
 

Wait it out

I have found that waiting it out [i.e. not rushing to baby] has become easier and easier with each subsequent child. With my first, I wouldn't even let her make a peep before I rushed in to rescue her. If your baby cries, that means you're doing something wrong, right?! No! Babies can be noisy sleepers and remember that a lot of crying can just be baby's way of expressing fatigue or trying to blow off steam [especially if overtired/overstimulated]. Now we're not talking about letting a newborn cry-it-out, but if baby is crying at a sleep time [either trying to fall asleep or trying to fall back asleep] try to wait a few seconds and really listen - is the crying very intense or not? Does the crying seem to be tapering off or becoming stronger? Is there a lot of breaks in the cries? You know what you're comfortable with and that is important - there's certain cries that I would go in immediately for and there's cries that I would wait out a bit. As I mentioned above I tried to have a baseline of a 5 minute wait once baby W was a few weeks old, but if the crying was getting more intense then I would go in sooner. With time, I've been able to build up to closer to 10 minutes [again, gauging it by the type of crying] and it's quite amazing how many times baby W has been able to settle or re-settle on her own if I give her that opportunity. I want her to know that I believe in her ability to self-soothe - that she can do it on her own but that I'm here to help her if she needs it. To me, this is helping her build confidence, something that I feel she might not learn as well if I do it all for her! But of course, keeping age-appropriate expectations is important, remembering that independent sleep is just a goal we are working towards, not something we insist on. Fully independent sleep can come later, right now we are just practicing.

Find that sweet spot bedtime

Newborns naturally have a later bedtime and trying to find that sweet spot bedtime for your newborn is important. With my second-born, I tried to shift bedtime too early too quickly and I believe it contributed to the shorter stretches of sleep and evening wakefulness that we experienced. While I love me an early bedtime, I've found that not trying to push bedtime too early too quickly has really helped. Sometimes the later bedtime can be stressful as those evening naps can be tricky to get [most of the time I don't even attempt the crib for the last nap of the day and instead we go for a stroller walk/jog or I use the swing or carrier] but working hard to get them in should ensure a more peaceful night of sleep. 
From the get-go, I would call any sleep after 8:00pm nighttime sleep. So if baby W woke up at 8:30pm from a sleep time, I would start my bedtime routine right after she woke and the next sleep time [around 9:30pm] would be bedtime. Remember, bedtime up to 6 weeks of age can be anytime between 9:00-11:00pm [so the sweet spot may be different for your baby] but I tried to keep it on the early end so I would be able to shift it earlier more easily [I am not a night owl!] Once I had that 9:30pm bedtime established, every week I would try to shift it a bit earlier by ending the last nap earlier by 15 minutes. A good goal to have would be to end your last nap at 7:30pm by 1 month, 6:30pm by 2 months, and 5:30pm by 3 months. Additionally, if you're trying to shift bedtime earlier, try to ensure baby isn't sleeping in too late in the morning, as this can make it hard for baby to settle earlier in the evening. As a general rule, the wake-up time should be 12 hours before your goal bedtime. So if your goal bedtime is 9:00pm, I would wake baby up at 9:00am. If goal bedtime is 8:30pm, wake baby up at 8:30am. This ensures sufficient awake time during the day.
I have also found that the awake time before bed can often be a bit longer than in between naps, and it's good to aim for about 1-2 hours of awake time between last nap and bedtime up to the 3 month mark. 

If you have found this post helpful, you will love my Comprehensive Newborn Sleep Guide, check it out here!

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I hope you have found this information helpful as you navigate through those difficult early months! I am so happy to share this with you all and welcome your thoughts/opinions. 

Pam Edwards is a Certified Infant & Child Sleep Consultant and founder of Wee Bee Dreaming Pediatric Sleep Consulting in Kamloops, BC. Healthy sleep is addicting and she has made it her life mission to help families all across the world get the sleep they deserve - a good night's sleep doesn't have to be a dream!

My Top 10 Twin Sleep Tips

Say that 5 times fast!
I wanted to give some love to my twin families - there's a lot of you out there! At any given time, I am working with at least one twin family (I think my record was seven sets of multiples at once - wowza!) I can still remember my first twin case and how nervous I was. I don't personally have multiples so how the heck am I going to help a family with two babies!? Well you know what? A lot of the same rules still apply with multiples vs. a singleton child. There are definitely some difference and a lot of extra factors that come into play but I've actually come to find that my twin babies are my best sleepers. They are so adaptable and resilient - they've had to be! They have to be able to sleep through their siblings' noises and that can be a lot of noise! With that, I wanted to offer up my TOP 10 TIPS on twin sleep to help you amazing moms and dads out there get a few extra winks tonight:
**note that while I've consistently written 'twin' babies throughout this article, these tips apply to all multiple families - twins, triplets, quads (this is the sound of me bowing down to you, by the way).

TWIN TIP#1 - WHITE NOISE

This had to be my #1 tip, there's just nothing else that compares to the need for white noise with twins. White noise has not only been shown to reduce stress in children and help them sleep, but it also works really well to block out sound. Now, usually we're trying to block sound from the house from reaching baby but in the case of twins, we're trying to block sound from one side of the nursery to the other side. White noise is a very effective way to help Baby A sleep through Baby B's noises, and vice versa. In fact, with twin families, I actually recommend double white noise in the babies' room (for example, a white noise machine and a noisy fan). You would place one source of white noise (noise machine) halfway between the cribs and the other source of white noise (fan) on the noisiest wall of the nursery (for example, a wall that's adjacent to your living room, kitchen, a noisy street, etc.) Using double white noise really helps to muffle sounds coming from inside and outside the room so our babies can sleep peacefully day and night.

TWIN TIP#2 - START AS YOU MEAN TO GO ON

I can imagine that when you are pregnant with twins, you envision the sleeping arrangement your children will have. Will they share a crib for the first few months? Will they start out in separate cribs next to each other? Will you start them in the same room but split them up eventually? Now, what you envision might not be exactly what ends up happening (lots of families who contact me end up resorting to sticking one baby in another for naps or even naps and nights because Baby A naps much worse than Baby B) but if you decide after the 16 week mark to sleep train those babies, sleep train them where you want them to be sleeping eventually. Even if you're worried that this will = less sleep for Baby B - go for it. This helps them to become acclimated to each other's sounds (and you're using double white noise now, right?) and it avoids yet another transition down the road when you do decide to move them back in together. Maybe you're okay with them being separate for naps and only together at night - it's completely up to you and what works best for your family. What's important is making sure where you start is where you want to end up.

TWIN TIP#3 - WRITE IT ALL DOWN

I'm not sure how any family with 2+ babies can make it through a day without writing everything down but I'm surprised to find out that some don't! Heck, I have to write things down with only 1 baby or I forget what time they woke up, what time I have to put them down, etc. Especially once you decide to make sleep a priority and really focus on establishing healthy sleep habits for your babies, keeping a sleep log is of utmost importance. This really helps you to see patterns, progress, where things need to be tweaked, and helps you to stay on track. On my sleep logs, I recommend families include:
- Morning wake-up time
- All feedings (breast/bottle/solids)
- Mood before naps (happy, tired, fussy, alert, yawning, etc.)
- Put down times for naps, asleep times, and wake-up times
- Mood upon wake-up from sleep (did they wake up happy? Crying? Babbling? Fussing?)
- Bedtime put down and asleep time
- Any nightwakings, nightfeedings, sleep-cries

TWIN TIP#4 - KEEP THEM ON SCHEDULE

Now this tip is not only for your babies' sake but for your own sanity's sake. I remember when my son was 9 months old and my daughter was 3. He was on a 2 nap schedule and she was on a 1 nap schedule. This meant that I had a child sleeping from 1000am-1130am, 100pm-300pm, and 300pm-400pm. OY! That gave me a window of less than 2 hours in the morning, 1.5 hours in the afternoon, and a few hours in the evening to actually leave the house. It was TOUGH. Now, this is sometimes life with two kids of different ages and with different sleep needs but this is an example of why keeping your multiples on the same sleep schedule is so important - to avoid having one baby sleeping all.day.long. This becomes especially important if you decide to sleep train - I recommend to my families that you always wake the babies within 15 minutes of eachother. If Baby A wakes at 700am, we wake Baby B at 715am. If Baby A takes a 30 minute catnap, unfortunately, we wake Baby B at the 45 minute mark. With time and consistency, most multiples end up 'syncing up' their schedules and while it's unfortunate to short-change one child, in the long-run it's worth it. This is another reason I say it's okay if they are waking each other up from each other's sounds - we want them on the same schedule anyway so they are doing the dirty work for you!

TWIN TIP#5 - FEED TOGETHER, FEED APART

In the beginning months when the babies are young and eating frequently throughout the night, it makes sense to feed Twin A when Twin B wakes for a nightfeeding. This avoids one child being awake all night (hey, the opposite of Tip#4!) so it helps buy you and your partner more sleep. But once we start to focus on the babies sleeping longer stretches at night, you want to give both children the opportunity to sleep through (whatever that means for their age). This means only feeding the child that wakes up and allowing the other child to wake naturally when they are hungry. Another option that can work amazingly well for many families is establishing a dreamfeed early on. This can help your babies' long stretch of sleep coincide with yours. Note that I don't recommend starting a dreamfeed with older babies that are not sleeping well at night (i.e. if you haven't started one yet and your 4 month old twins are not sleeping well at night and are waking 3+ times, a dreamfeed is not a good option for you. A dreamfeed is a better option for newborns (0-3 months) or for babies 4 months+ that are already sleeping fairly well at night).

TWIN TIP#6 - SLEEP TRAIN

Okay, okay, you don't have to if you don't want to but I would really, really recommend it. First and foremost, sleep training does not = cry it out. There is a stigma about sleep training and it entailing hours of dreadful crying while we sit back and think about how terrible and awful we feel about the whole process. It doesn't have to be like that. There are many gentle approaches we can use with young and older children alike to help them learn that oh-so-important skill of independent sleep. While it's true that sleep training twins is often more challenging than singleton babies, it is far from impossible. Yes things take longer to come together. Yes the gentler methods are often much more difficult when there's two babies to consider. But as I mentioned above, my twin babies are often my best-sleeping babies. Parents are usually more motivated because they lack the time/energy/patience to deal with sleep issues x 2 and they also are much more aware of the need for a solid schedule and foundation for sleep for their children. So if you find yourself at that 16 week mark and things just aren't going your way -  don't be afraid of change. While the prospect of less sleep is  daunting, it's short-term pain for long-term gain. The positive changes that you and your babies will experience from sleep coaching are endless. If you feel you can't go it alone? I'm here for you moms and dads :)

TWIN TIP#7 - ADJUSTED AGE

This is a short tip but it's a question I get a lot.  We always want to follow the babies' adjusted age when it comes to sleep scheduling. While 38 weeks is full-term for twins, I would still consider these babies two weeks early. This applies to starting sleep training (at 16 weeks adjusted), when trying to figure out the babies' schedule, sleep needs, amount of awake time, or even when anticipating sleep regressions or leaps.

TWIN TIP#8 - IDENTIFY THE SENSITIVE SLEEPER

There's always one of them. One twin who is just a teeny bit more finicky than the other. One twin that puts up a little bit more of a fight. One twin who is just a little bit more sensitive to sleep. I can usually identify the 'Sensitive Sleeper' with ease by just reading the Intake Forms I receive from my families. Once we identify which one of the babies is the Sensitive Sally, we stick closer to their schedule. What do I mean by that? For young babies especially, 15 minutes can make or break a nap or bedtime. Putting them down just 15 minutes early can result in 30 minutes of playing/hanging out/laughing/whatever else those crazy babies can do while lying awake in a dark room (!?!). Put her down 15 minutes too late? Crying/yelling/I-can't-handle-life screaming. So you now know we are to be waking the babies within 15 minutes of each other but what does that mean for the timing of the next nap? How do we know what time to put them down? Let's take twin babies who are 6 months old (adjusted), for example. We know that at 6 months of age, the babies could probably handle about 2 hours of awake time between 1st and 2nd naps. Baby A woke up at 10:00am from his 1st nap and we woke Baby B woke up at 10:15am. We know baby B is the sensitive baby so we'd count our 2 hours from the time she woke up, so as to avoid one of the above situations arising.

TWIN TIP#9 - HAVE REALISTIC EXPECTATIONS

The biggest difference between sleep training a singleton baby and sleep training multiples is the time it takes to see full progress. Many families ask me, "How long will it take until I see results?" and while there's no for-sure answer to this question, this is a general guideline that most babies follow. Depending on the age of baby, method used, consistency of parents, etc. progress generally goes as follows:

• 3-5 nights - baby is now 'sleeping through the night' for their age

• 7 days - baby is now falling asleep within 30 minutes for all sleep times with some combination of babbling, fussing, soft crying

• 10 days - baby is now showing progress with longer naps although things may still not be consistent

• 2-4 weeks - baby is now showing consistency with naps (consistency meaning, for example, nap 1 is always the longest nap, nap 2 is over an hour but shorter than nap 1, nap 3 is 30-45 minutes long). Nap lengths may not be exact day-to-day and that is normal

Now what about for twins? I'd say you could multiply that time by 1.5 or even 2. Nighttime can take 5-10 nights to come together, the babies may take closer to 10-14 days until they are falling asleep easier for sleep times, longer naps may emerge after 2 weeks instead of a week and a half, and true consistency may not materialize until 3-8 weeks instead. But do not let these numbers deter you! As I mentioned above, many times my twin families are my quickest studies, and while these things take time (sleep training is a journey!) the end result is well-worth the effort.

TWIN TIP#10 - ALL OTHER RULES APPLY

As I mentioned above, many of the same principles apply to twins and singleton babies alike. The following sleep concepts are the same across the board:
- Swaddling newborns (especially those preemie twins - they need that snug feeling!)
- Super dark bedroom
- Feeding upon wake-up from sleep (i.e. an 'EASY' routine) or at least separating from sleep by 30 minutes and some sort of activity
- Consistent sleep routines (nap and bedtime)
- Early bedtimes 
- Avoiding the overtired state
- Not rushing in 
- Using all the tools in the first few months - you are in survival mode!
 

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Pam Edwards is a Certified Infant & Child Sleep Consultant and founder of Wee Bee Dreaming Pediatric Sleep Consulting in Grande Prairie, Alberta. Healthy sleep is addicting and she has made it her life mission to help families all across the world get the sleep they deserve - a good night's sleep doesn't have to be a dream!

A Letter to Your Family about Sleep

Dear helpful friend/family member/neighbour/random person at the grocery store,

This letter is intended to help you understand the complicated world of baby sleep. As we parents all know, things are always changing. Twenty years ago there wasn't any "Professional Sleep Consultants" to help teach babies to sleep. So why now and why should we listen to them? Because we are now discovering how important sleep is to children of all ages, and how detrimental sleep deprivation can be. There is no one single thing that will magically work for all babies to help them sleep, but there are many things that families may be doing (or advised to do) that can be the exact opposite of helpful. I hope that this article will help bring some of this unhelpful advice to the surface, and to help you understand why exactly it is ill-advised. The following "un-advice" is taken directly off my Facebook page from family members of my lovely followers.

Sleep Un-Advice #1 - "Your daughter doesn't need to sleep so much during the day. If she stays up longer, she will sleep better at night."

Ahhh yes. The 'ol "keep them up so they will sleep longer" schpiel. This is the crème de la crème of poor sleep advice. I strongly believe that sleep is the area that the most poor advice is given simply because there is so much with baby sleep that is opposite of what you would think. As the saying goes, "sleep is not logical, it's biological". Babies need to sleep. A lot. WAY more than most would think. To give you an idea, here is a breakdown of sleep needs per day over the first 12 months of life:

Under 2 months: 16-20 hours
3 months: 15.5-18 hours
4 months: 15.5 hours
5 months: 15 hours
6 months: 14.5 hours
7/8 months: 14-14.5 hours
9-11 months: 14 hours
12-14 months: 13.5-13.75 hours

Do you know what happens when a baby is overtired? There is a hormone in our bodies called 'cortisol'. This is the same hormone that is secreted when we are stressed....or when we are sleep-deprived. The more sleep-deprived we are, the more this hormone is secreted. Once we have reached the state of overtiredness, with all this cortisol pumping through our bodies, it is nearly impossible to fall asleep. I'm sure you have experienced a time when you are so dead exhausted, you go lay down in your bed, only to find yourself staring at the ceiling for hours because you simply cannot fall asleep. The same rule applies to babies, only amplified since they are so young and sensitive to sleep. In order to avoid this overtired state, babies need to sleep...A LOT. To give you an idea of how long a baby can tolerate being awake before they become overtired, here is a breakdown of the maximum awake times for the first year:

Under 2 months: 45-60 minutes
3 months: 1.5 hours
4 months: 1.75-2 hours
5 months: 2 hours
6 months: 2.5 hours
7 months: 2.75 hours
8/9 months: 3 hours
10-14 months: 3-4 hours

Keep in mind, these are the maximum awake times. Meaning we want baby to be asleep before we hit this maximum time. As well, some babies may require a bit less awake time before they reach that overtired state (especially between morning wake-up and first nap, this time is often very short as this nap is a continuation of nightsleep).

How much a baby needs to sleep and how often a baby needs to sleep is often something that is grandly underestimated by families. Sleep is a biological need, not a luxury - it's food for the brain! Sleep begets sleep - the more sleep a little baby gets, the more its little body wants!

“I get the same thing. My child naps too much during the day and if I just kept him up he would sleep longer at night. And I also get that a 6:30-7:00pm bedtime is ridiculous and that I’m too tied down to a schedule. I love that my child is a happy baby because he has a great sleep routine! I will preserve that for as long as I can! And frankly I’m ready for bed by 8pm anyways! ”

— Momma C

Sleep Un-Advice #2 - "No one believes me when I say the earlier you put the baby to bed the longer he/she will sleep."

I know I said the above 'advice' was the cherry on top, but I might have to call it a tie here. Not only are early bedtimes something that families push back on, but it's something that a vast majority of my clients push back on as well. I don't blame them, it really does seem opposite that an early bedtime would = a later wake-up but it couldn't be more true. Now why is that?

Babies all have natural wake-up times that are predetermined before they are even born. As an adult, you are likely either a night owl or a morning lark. I bet if you asked your Mom or Dad whether this rang true while you were a baby as well, they would agree. We can't fight biology. We can't fight these natural wake-up times. All we can do is respect them and put baby to bed at an appropriate time so as to allow them to clock the 11-12 hours of nightsleep they need. Every single night. In 90% of cases, a baby's natural wake-up time is anywhere between 6:00-8:00am.

Let's take a 5 month old baby named Julia for example. Julia has a natural wake-up time of 7:00am. Julia's mother knows this because Julia is very well-rested and she sleeps through the night for her age (meaning two nightfeedings). Knowing that Julia's natural wake-up time is 7:00am and that she needs 11-12 hours of nightsleep with two nightfeedings, that would mean Julia would have to be asleep for the night between 6:30-7:30pm in order to clock a full 11-12 hours of nightsleep (subtracting, of course, the time it takes for her to eat twice at night). What will happen if we put Julia to bed at 9:00pm because 6:30pm is "just too early to be going to bed"? She will wake up at the same time in the morning but will only have slept 9.5 hours. As well, since Julia's bedtime was too late for her, she may wake up crying several times in the night. Now Julia will be extremely overtired, which may lead her to take short naps the next day and thus perpetuate the cycle of overtiredness. There really is no advantage to a later bedtime if baby is up every 3-4 hours crying because the bedtime was too late. This goes hand-in-hand with Un-Advice#1 - babies need a lot of sleep, and we need to respect their need for said sleep.

Sleep Un-Advice #3 - " I get told that I am letting my children run my life, they should be fitting into my lifestyle instead of me working around theirs."

This criticism always really baffles me. I know for me, when I became pregnant with my first child, I knew my life was about to change drastically. I knew that I wouldn't get to do all the things I used to do, to take vacations on a whim or meet my friends for coffee at the drop of a hat. Babies change your life. When you have a child, your mission in life is to take care of this little person - to feed them, clothe them, nurture them, and to ensure they are healthy and happy. Babies are never convenient, and especially where it comes to sleep, they are highly inconvenient. A baby's sleep needs are SO high, as I've mentioned above. They need to sleep - A LOT. But this sleep is just as important to them as being fed nutritious food. We wouldn't starve our babies, so why sleep-starve them? We wouldn't feed our children junk food so why feed them junk sleep? Now, of course I am not staying that you are now house-bound for the first 2 years of your life because your baby needs to sleep, we all know life happens. An occasional nap on-the-go here or a late-ish bedtime there is not going to be detrimental to your child. But guess who deals with the ramifications of these late bedtimes or missed naps? Especially for those babies who are especially sleep-sensitive, a late bedtime can lead to a sleepless night and an extra early wake-up the next day....for baby AND Mom/Dad.
We are all just trying to do what's best for our children, and healthy sleep IS what's best for them. Babies are only babies once. Their sleep needs are ever-changing and there will come a time when they don't need to nap, where they don't need to be asleep for the night in the 6's, and where a late bedtime won't throw them off for the next 3-5 days. But for now, adhering to a good sleep schedule and allowing your baby the opportunity for lots of good quality, healthy sleep is only going to benefit them in the long-run.

“I’m on baby #3. The first two slept anywhere and everywhere and still do. My third was a whole different baby who is an absolute nightmare when she even slightly deviates from her norm. She’s been called a “bad baby”, I’ve been told that we shouldn’t have more because she’s “too much”. Sleep training has saved my marriage and given me a sweet, happy baby. So while I am strong in my convictions that our sleep habits work - I do get worn down when I hear all the complaints listed here: “your kid controls your life”, “she should/shouldn’t be tired”, “she needs to learn to sleep anywhere”, etc.”

— Momma J

Sleep Un-Advice #4 - "A baby will be more portable and sleep anywhere if they're taught to."

I have written about this popular 'advice' on another one of my articles (as well as a few other helpful 'suggestions' that friends and family love to share including starting cereal to help baby sleep and crying it out damaging babies), you can check it out here . But I will write about it again now because I am just very passionate about this topic. While it seems logical that always putting baby to bed in his/her crib, in a pitch black bedroom with some lovely, soothing white noise is going to spoil baby and cause them to not be able to adapt to any other situation, this is entirely false.

Why do we use a dark bedroom for baby sleep? First off, because babies (especially older babies) can be stimulated by just about anything - a wallpaper pattern, a toy across the room, a shadow on the wall. All of this stimulation can lead to poor sleep. As well, from a scientific standpoint, a dark bedroom stimulates the production of melatonin (the sleepy hormone). The brighter the days and the darker the sleep times, the more melatonin is secreted (and therefore, the quality and quantity of sleep is increased).
And as for white noise? A baby in the womb is subjected to constant noise - the sound of mom's blood pumping, her heart beating, and muffled voices from the outside. It is quite daunting to go from constant sound for 9 months to dead silence. White noise has been shown to reduce stress in babies and to help them sleep better - it helps them to power down at the end of the day, a day that is filled with 100 new sights, sounds, and experiences. In addition to white noise helping babies to decompress, it also is crucial in muffling the sounds of the house which can wake baby during naps and/or the night. While some may say that "baby should get used to the noise" what would you do if you finally fell asleep for a nap and then someone started vacuuming outside your door, the dog started barking, doorbells are ringing, kids are running around outside your room screaming. You wouldn't be too impressed. So why shouldn't a baby have the luxury of a quiet and peaceful sleep time, especially when we know how important this sleep is to the child? Sure there are going to be times where the child may need to sleep in a noisy environment or perhaps a bedroom that is not pitch black but this is the beauty of healthy sleep - a child who is well-rested and given the opportunity to have quality, restorative sleep learns to LOVE sleep. They don't care where they do it, their bodies just love it. Why should we provide our children with improper sleeping conditions 100% of the time just so that the 10% of the time when they are sleeping in these non-ideal conditions (say at the beach, or camping,etc.) that they might be adapted to it already? Well-rested children are extremely adaptable, and the key to helping a child become well-rested is providing them with opportunities for healthy sleep.

“My son (who is currently 18 months) has slept in his pitch black bedroom, in his crib, with his double white noise blaring for every single sleep time since the day he was born. We took a leap of faith and went camping one day, mainly because I wanted to experiment with how he would do in these non-ideal sleeping conditions. In the bright camper, with no white noise, dogs barking, kids screaming, he took his usual 3 hour nap. His body loves to sleep, it doesn’t care where it’s doing it, it just knows it WANTS it!”

— Pam

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Any way you slice it, we are all just trying to do what's best for our kids. Not all babies are easy babies, and it can be hard to walk in the shoes of someone with a more sleep-sensitive child if all you've had are easy children. Not all babies can sleep anywhere, anytime, in any environment. If you had a child like this - consider yourself lucky! And to be honest, it likely wasn't anything you did to make them that way, you were just dealt a lucky hand. As well, our expectations of 'good sleep' are vastly different across the board. While one mom might consider it 'normal' for her 12 month old to be waking up 2-3 times at night (and therefore she doesn't feel the need to keep baby on an age-appropriate schedule during the day), other parents know that life can be better than that! That a baby can sleep much better than that if we provide them with the right tools. So the next time you are ready to criticize a friend/family member/neighbor/etc. on what they choose to do in order to help their child sleep better, consider instead applauding them for respecting their child's need for sleep, even if it means sacrificing a bit of their own time to attain it.

Pam Edwards is a Certified Infant & Child Sleep Consultant and founder of Wee Bee Dreaming Pediatric Sleep Consulting in Grande Prairie, Alberta. Healthy sleep is addicting and she has made it her life mission to help families all across the world get the sleep they deserve - a good night's sleep doesn't have to be a dream!

How to Create a Routine for Your Baby

I have been reading a lot of questions from parents about how and when to create a routine for your baby so I thought it'd be best if I created a blog post to help do just that! What I want to mention is that there is a big difference between a 'routine' and a 'schedule'.  I don't necessarily believe in rigidly scheduling a baby, I believe that there needs to be flexibility as babies can be very unpredictable. But without a doubt, babies thrive on routines. Babies like to know what to expect and they do not like surprises! If everyday is different, every naptime is in a different location at a different time, feedings are erratic and chaotic, then a baby may become overstimulated, stressed, overtired, and just miserable! This post is aimed at helping you decide if and when you should start a routine with your baby, or if your current routine needs a tune-up. 

When should I start a routine with my baby?

I honestly think that it is never too soon to get into a loose routine with your baby. As we all know, newborns are never predictable. They sleep erratically, they eat around the clock, they spend as many hours awake during the day as they do at night. But you can still begin to incorporate a very flexible routine to your baby, and you may find that by 6-8 weeks, they fall into a very predictable pattern. So what type of a routine can you begin with a baby this age?

1. Soothing nap routines. As I mentioned above, newborn babies sleep around the clock. They are pretty much awake long enough to eat, and then they are back asleep. This is how it should be. Starting around 2-3 weeks, you will likely find that baby is starting to have more distinct awake periods, but still no more than 45 minutes at a time. This is a good time to start incorporating a soothing nap routine that does not involve feeding. We can do this by following the E.A.S.Y. routine (Eat, Activity, Sleep, You). What this means, is that once baby is awake from a nap they would receive a feeding -EAT- either nursing or a bottle. Depending on the length of the feeding, they would have about 15-25 minutes of -ACTIVITY- time (which at this age would likely involve looking at mom, a toy, tummy time, playmat time, etc.) Then it would be time for your soothing nap routine. This is a very short routine, only about 5 minutes long, and could involve a combination of diaper changing in a dimly lit room, swaddling, rocking, singing, books, etc. Again, the soothing routine should be short, only about 5 minutes, as we don't want baby to become overstimulated or overtired. At the end of the routine you would put baby down in her chose nap location -SLEEP- (possibly in her crib/bassinet/playpen, in a swing, or even on mom!) Then the Y in E.A.S.Y. which means -YOU- time which if you're like most moms involves some combination of cleaning, caring for older kids, cooking, and hopefully taking a nap yourself! Once she is awake from the nap, the routine would repeat itself again (and again...and again...babies sleep a lot!!)

2. Consistent bedtime routines. A bedtime routine is something else that can be started from day one. Bedtime routines are so incredibly important for all children, and even for adults! If you only take away one thing from this post, let it be the importance of a consistent bedtime routine for your child. The bedtime routine should't be anything too fancy or too long and drawn out - make it 30 minutes max. A feeding, a bath, a massage, jammies, books, songs, bed. This bedtime routine is going to help relax baby and prepare them for sleep (think of how chaotic the life of a baby is. Everything is new to them!) They need some time to decompress at the end of the day, and a bedtime routine helps them do just that.

What does a day in the life of a newborn (6 weeks) look like?

8:00am - wake-up, feeding, play time, then nap routine
8:45am-10:45am - nap, feeding upon wake-up, play time, then nap routine
11:45am-12:30pm - nap, feeding upon wake-up, play time, then nap routine
1:30pm-2:00pm - nap, feeding upon wake-up, play time, then nap routine
2:45pm-4:45pm - nap, feeding upon wake-up, play time, then nap routine
5:45pm-6:45pm - nap, feeding upon wake-up, play time, then bedtime routine
7:45pm - asleep for the night, likely 3+ feedings throughout the night

 

Routines at 3-6 months

By the time baby is 3 months old, they are very alert, curious, and vocal! While they should still only be awake 1.5 hours at a time, it gives you a lot more time to play and explore. If you haven't already, this is a really great age to start following the E.A.S.Y. routine (see above) to try and really start separating feeding from sleeping. In addition to the soothing nap routine and consistent bedtime routine, you can also start to implement a consistent sleeping place. If you had planned on your baby sleeping in their crib long-term, now is a great time to start making that the only place that baby sleeps (unless of course they fall asleep in the car or stroller). Babies this age learn habits at lightning speed (good or bad!) so as long as you are consistent with putting baby in the crib for sleep times, they will catch on very quickly.
Now that we have our consistent sleep place, we also want to ensure that this sleeping place is conducive to sleep. We want that room to be pitch black (daytime and nighttime!), white noise should be playing continuously, and the temperature should be kept fairly cool.

What does the day in the life of a 3 month old look like?

7:00am - wake-up, feeding, play time, nap routine
8:00am-10:30am - nap, feeding, play time, nap routine
11:45am-12:45pm - nap, feeding, play time, nap routine
2:15pm-3:15pm - nap, feeding, play time, nap routine
4:45pm-5:30pm - nap, feeding, play time, bedtime routine
7:00pm - asleep for the night, likely 3 feedings throughout the night

Routines at 6+ months

If you've waited this long to begin a routine with baby, it's still not too late! If you are finding that baby is still completely unpredictable and erratic, take a look at the environment that you have created for him. Does he nap on the go all day long? Are some naps in the swing, others in the car, some in the crib? Does he sometimes get nursed to sleep, other times you let him cry in hopes he'll fall asleep, and other times he gets rocked to sleep? If so, then it's quite obvious that the inconsistency in his day-to-day life is leading to an inconsistency in his sleep patterns. It's worth mentioning again that babies thrive on routines and predictability. Now that baby is on a solid 3 (or less) nap schedule, it is easier to ensure that we are home for the majority of naps so that baby can get healthy, restorative sleep in their crib. If you're wondering how often babies 6 months and up should be sleeping, check out my blog post here for sample schedules, and note the amount of awake time I recommend in between naps. This is a great guide for you to know how long baby should be kept awake in between sleep times.
Baby is also now at a great age to really work on healthy sleep habits and falling asleep independently with no associations. If you are finding that your previous short soothing routines are now turning into hour-long ordeals before baby will fall asleep, only to find them awake 30 minutes later, that is a pretty clear indication that these soothing efforts are no longer working for your child and that they need to learn how to fall asleep on their own. 
 

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It is a pretty amazing feeling to be able to put your child down in their crib, walk out, and know that they will fall asleep quickly and easily, and wake up feeling refreshed and ready to take on the day. And everybody can attain this! It's all about being consistent and having these routines in place for baby so that they know what to expect and that their sleep space is a safe place.

Dreamfeeding

Thinking about trying a dreamfeed with your baby? Read here to find out if this technique is right for you, what the right way to implement it is, and how to wean off of it when you are ready.

What is a dreamfeed?

A dreamfeed is a method of 'tanking baby up' at night to reduce nightwakings and disturbances caused by hunger. Infants normally have a single long sleep period that is around 4-8 hours long (depending on their age) but because baby does not go to bed at the same time as Mom and Dad (or they shouldn't be!) this long sleep period does not coincide with their parents' sleep. Some of the advantages of dreamfeeding are:

• Parents get to sleep through the night instead of waking for a feeding in the middle of the night.

• Takes some of the guesswork away as to whether baby is truly hungry when they wake throughout the night.

• Weaning from a dreamfeed is easier than weaning from a nightfeed.

Who should try a dreamfeed?

I would usually recommend starting a dreamfeed on a baby that is under 4 months of age, and the earlier you start, the better. The reason it is not highly recommended to use after the 4 month mark is because at this age (as we know from my post about the 4 month sleep regression) sleep is more adult-like. What that means is that baby's first chunk of sleep at night (the time when you'll be wanting to dreamfeed) is very deep sleep. Because of this, it may be difficult to get baby interested in feeding, and if he does eat, it may not be a very big meal. If baby is dreamfeeding and then waking up a couple of hours later for another meal, the dreamfeed is not working. Dreamfeeding does not work with all children, and it almost never works on babies who are chronically overtired or who are already having disrupted/fragmented sleep. In order for a dreamfeed to be considered ‘successful’ at each age, we should be seeing the following stretches:

0-2 months of age: 3+ hour stretch after the dreamfeed
3 months of age: 4+ hour stretch after the dreamfeed
4 months of age: 5+ hour stretch after the dreamfeed
5 months of age: 6+ hour stretch after the dreamfeed
6 months of age: 7+ hour stretch after the dreamfeed and by the end of the 6th month, baby should be sleeping through the full night after the dreamfeed
7+ months of age: dreamfeed only, no other wakings

If after a week of attempting a dreamfeed, your baby is sleeping a shorter stretch than this, or if you’ve been doing a dreamfeed for a while and the stretch of sleep starts shortening to less than these above goal stretches, it could mean that a dreamfeed will not work for your baby/is no longer working for your baby.

How do you dreamfeed?

Breastfeeding mommas: gently lift baby out of the crib and place her at the breast. Encourage baby to latch by stroking her cheek, or tickling her lips with your nipple. It may take some time for baby to rouse enough to latch. Once baby is done, place her back into the crib (one side is sufficient while dreamfeeding and helps baby to get more of the hindmilk). Burping is not necessary after dreamfeeding because baby is so relaxed that little to no air is taken in. Swaddling is very helpful when dreamfeeding as it makes it easier to lift baby out of/into the crib and helps to prevent them from startling when you place them back to bed. This might be one of the best feedings you have as a nursing mother as baby is very calm and there are no distractions.
Bottlefeeding moms/dads: when dreamfeeding with a bottle, baby stays in her crib the whole time. Gently slip the nipple of the bottle in between baby's lips - this and the taste of the milk is often enough to induce baby to drink. If baby is too sleepy, you can help rouse her a bit by tickling her cheeks or chest. Make sure there is plenty of milk/formula in the bottle as insufficient milk may frustrate or waken baby! Again, no burping is necessary. Some moms who exclusively breastfeed find it is easier to dreamfeed with a bottle, and it also lets Dad get involved in the nightfeeding process.

The dreamfeed should be conducted around 9:00-11:00pm [typically at least 3 hours from the bedtime feed], before the parents go to sleep. It is important not to dreamfeed baby too late or it may disrupt sleep and/or cause nightwakings. If you are new to dreamfeeding, you'll want to try it for a week before deciding if it is working or not. It can take that long for baby to get used to it. At first, baby may not latch or drink very much but it becomes easier with time.

When and how to wean from the dreamfeed

Most parents wean from the dreamfeed around 8 months once solids are well-established and baby is able to last the whole night on just the dreamfeed. Some babies may be ready to wean from the dreamfeed as early as 6 months of age. Weaning from the dreamfeed is done by moving the dreamfeed 15 minutes earlier every 3 days or so, hence gradually extending the time in between feedings. The baby is less hungry with the earlier dreamfeed and therefore will not drink as much.

How to Maximize Your Newborn's Sleep

Your little bundle of joy is here - yay! Congratulations!  Woo hoo!  You have been waiting for this moment for a long time!  If you're like me, you read all the books out there on pregnancy and the first years but did any of those books tell you much about sleep?  Probably not.  Maybe a page or two.  Something along the lines of, "make sure you put baby down drowsy but awake and your life will be a breeze!" Ahem.  I beg to differ.

3.5 years ago I was in your shoes.  A first-time mom (or maybe you're not a first time mom but your other children slept like angels!) who thought she was prepared for it all.  But most books don't really prepare you for baby sleep, which is crazy considering newborns sleep for 16-20 hours per day!  That's what this blog post is here to do.  Let's get you ready and set you up for success... or at least hopefully less sleepless nights ;)

How does newborn sleep work?

We've all heard the saying, "sleep like a baby" but what does "sleeping like a baby" really mean? While it's true that babies sleep a lot (babies under 1 month of age require 18-20 hours of sleep every single day) most babies don't sleep for very long.  This sleep will occur in 2-4 hour chunks all throughout the day and night (sigh).  There are a couple of factors that influence this fragmented sleep: 
Hunger.  Newborns grow at an alarming rate - most have doubled their birth weight by 6 months!  In order to ensure they are receiving all the nutrition they need to sustain this growth, they need to eat around the clock.  Trying to schedule feedings or eliminate nightfeedings at this age is a huge no-no.
Sleep Cycles.  In addition to this need for constant nourishment, newborn babies' sleep cycles are also vastly different from an adult's sleep cycles (or even from an older baby's sleep cycles!) Adults spend most of their sleep (about 80%) in non-REM (or deep sleep) whereas a newborn baby only spends about 25% of their time in deep sleep, and the majority (75%) in REM (or active) sleep.  In addition to most of their time being spent in active sleep, a newborn's sleep cycles are very short, only about 45-50 minutes long.  While an adult likely only has about 4-5 sleep cycles a night, your newborn baby has twice that many - and that means double the chances of waking up between sleep cycles.  In addition to the sleep cycle transitions being more frequent, active sleep is a much lighter sleep state.  These two factors combined is why we see frequent wakings in newborn babies.  So don't fret if your baby is up many times a night, these wakings are designed to keep your wee baby safe and healthy.  The fact that baby spends so much time in an active sleep state means that she will wake to feed and she will be protected from SIDS.  Although these every 3-4 hour wakings are completely normal, there is a lot we can do in order to ensure these wakings aren't occurring every single hour all night long, that they continue to improve rather than worsen, and that we are setting baby up for healthy sleep habits in the future.

So what can we do to maximize a newborn's sleep?

Keep the intervals of wakefulness short and sweet

Newborn babies need to literally sleep around the clock.  They are awake long enough to eat, and then are back down to sleep.  And this is how it should be!  Do not worry about separating feeding from sleeping at this young age because your attempts will be futile.  They will almost always fall asleep at the breast/on the bottle and then wake up again in time to eat and fall asleep again.  After the first few weeks, baby will start to become more alert and will be capable of staying awake for longer periods of time but these 'longer periods of time' are actually still very very short!  A baby 1 month or younger should not be awake any longer than 45 minutes, and a baby 2 months or younger should not be awake longer than 1 hour at a time.  This means that you need to be starting your soothing routine with enough time to ensure baby is asleep within these windows.  If not, you will have an overtired baby on your hands and an overtired will have more trouble falling asleep and staying asleep.  In addition to making sure baby's intervals of wakefulness are short, we also want to start shifting baby's bedtime earlier once they hit 7/8 weeks.  Newborns naturally have a late bedtime (anywhere between 9:00-11:00pm) but it's important we start moving it earlier (likely to around 8:30pm by 2 months).  This bedtime should shift 20 minutes earlier every 2 weeks or so and should be in the recommended 6:00-8:00pm range by 4 months.  See my blog post here for more about age-appropriate bedtimes for babies.

Swaddle

I cannot recommend swaddling enough to you.  "But my baby hates to be swaddled, he fusses and cries and kicks and squeals".  This is all normal.  It is the process of swaddling that babies dislike.  Once they are wrapped up nice and snug they sleep much better.  Helping newborns sleep better is all about recreating the womb.  And the womb was a cramped place!  Babies find comfort in this snugness.  In addition to comfort, swaddling helps to muffle the startle reflex (this startle reflex for babies is similar to how you feel when you get the sensation that you are falling while you are asleep.  Imagine if this happened to you all night long!  The worst!)  In order for the swaddle to be effective, it needs to be snug around the arms and loose around the legs. Check out this video here for the best swaddling technique out there.  My son was a little Houdini and we tried every swaddling contraption on the market but this technique ensured he was wrapped snug all night long.  To ensure your baby is safe while swaddling, make sure you are dressing them in lighter clothing (or even just a diaper) and that you are always placing them on their backs while swaddled.

Avoid day/night confusion

It is very normal for babies to come into this world with their days and nights confused.  If you think about the womb, it is dark 24/7 so a baby's biological clock has not had a chance to set itself to 'daysleep' and 'nightsleep', but there are ways we can help them to set their clocks.  Keep the daytime bright and noisy.  You can still put baby to sleep in his dark bedroom, but just ensure that baby's awake time (however short) is spent in sunlight (or artificial light, but sunlight is always much preferred!)  At nighttime, keep all the lights off.  When you feed baby, be completely boring.  Do not talk, sing, or engage baby in any way.  It's right to business and then back to sleep.  As well, if baby seems to be sleeping his entire day away, wake him up every 3 hours for a feeding.  There is no need to keep him awake as this will lead him to become overtired, but at the 3 hour mark gently rouse him, feed him, and let him fall back asleep if he wishes.  

Routines

Routines are so incredibly important for babies (for all children actually!)  It is never too early to begin a consistent and soothing nap/bedtime routine for your child.  The nap routine does not need to be long, only about 5 minutes and is generally a shortened version of the bedtime routine.  The bedtime routine is usually longer and may include a bath, massage, books, etc.  These routines are a cue for sleep for baby.  He will know that no matter where he is, no matter what time it is, that when this routine occurs, it is time for sleep.

E.A.S.Y. Method

The E.A.S.Y. Method is a great technique we can use to ensure that we are always separating feeding from sleeping in baby's little brain.  Very young infants, as I mentioned above, will only wake to eat, so we don't have to worry about feeding them to sleep - it's inevitable!  But once baby is a bit older and able to tolerate a bit more awake time, the E.A.S.Y. Method is great for ensuring that an association does not develop.  The acronym stands for Eat Activity Sleep You.  So basically you want to try to ensure that baby is eating upon wake-up from sleep times, followed by some light activity, then nap time, and then of course 'You' time (which if you are like most moms this involves some combination of cleaning and hopefully relaxing!) 

White noise

I am a big fan of white noise.  Check out my article here for the reasons why I love it so much.  It all really goes back to the theory that we want to recreate the womb for baby.  The womb was a noisy place, about as loud as if you were standing next to a lawnmower.  The sounds of your blood rushing, your heart beating, muffled voices.  It is a bit daunting to go from the noisy tummy to dead silence.  White noise has been shown to reduce stress in babies, and not to mention that it helps to drown out all the sounds of your house (especially helpful if you have older children or a dog that loves to bark during nap time!)  Due to the recent studies on white noise, you want to ensure you are not placing the machine right next to baby's head (it benefits baby more when it is placed on the wall that you are trying to block noise from) and we don't want it too loud.  If you are concerned about the volume, there are many free apps you can download that test decibels.  The white noise should be about 50 dB (by comparison, normal conversation is 50-60 dB).  In addition to a white noise machine, I recommend placing a fan in baby's room.  Not only does this provide more sound blockage (double white noise! woo!) but fans in baby's room have been shown to reduce the risk of SIDS.

The Swing

In addition to being a white noise lover, I am also a swing lover.  When you have a newborn baby, you really want to use all the tools you can to get that baby to sleep.  Do not worry about creating bad habits at this young age.  Womb Recreation 101 includes a little bit of motion.  Babies were in constant motion in mom's tummy, this movement would lull baby to sleep.  I'm sure you remember what would happen as soon as you laid down for the night - baby would start kicking up a storm!  So to help bring that tummy motion to your newborn baby, we introduce a swing.  And if the swing works for sleep - use it!  The key to successful swing sleep is ensuring we are still swaddling baby in the swing, putting the swing in baby's dark bedroom with white noise playing, and placing baby in the swing awake and allowing him to fall asleep on his own.  By allowing baby to fall asleep independently, you have helped teach a valuable skill and once it comes time to transition baby from the swing to the crib (usually somewhere around 4 months) the switch will be easy peasy!  My favorite swings are those that can swing both forwards and backwards and side-to-side, as I found that I was more successful when I switched up the swinging direction.  As well, most babies are soothed by a fast swing but feel free to turn it down once they are asleep (or even off if baby doesn't mind).

Dark bedroom

Once again, we are going to recreate the good ol' womb.  So far we've wrapped baby up nice and snug, we've got the white noise playing, and we may even be using motion to help baby to sleep.  Now, we are going to get baby's bedroom nice and dark just like mom's tummy.  A lot of parents may feel bad for putting baby in their dark bedroom, and some may even think baby will be scared of the dark.  I can assure you that this is not the case.  A baby does not yet know that the dark is something they should be afraid of.  They have just spent the past 9 months in total darkness!  A dark bedroom is especially important as baby gets older and becomes more alert.  An older baby can be stimulated by wallpaper - no lie!  Ideally, we want that room so dark that we can't even see our hand in front of us - during the day and at night.  Cheap (and the most effective!) options include black construction paper, black garbage bags, or my personal favorite - tin foil!  You won't win any design awards but your baby will sleep better!

For more information on newborn sleep, check out my Comprehensive Newborn Sleep Guide here!

Life with a newborn baby is rarely easy but is incredibly short-lived.  The first few months are all about surviving.  I hope the above tips are helpful in making this time in your life and your baby's life a little bit easier and a little more restful :) 

The Dreaded 4 Month Sleep Regression

The '4 month sleep regression' has celebrity status in my sleep world.  I hear this phrase almost every single day; from an exhausted mom of a 5 month old, wondering why her baby's sleep has gone downhill in the last month, to parents of a toddler who say that "their baby has never slept well since 4 months of age", or even from a mom of a 3 month old, worried about the upcoming "regression".  I am here to help you realize what goes on around 4 months, and how we can prevent a true 'regression' from occurring.

What is a sleep regression?

A sleep regression is thought to occur when a baby who is normally sleeping well begins to wake frequently at night and/or fights/refuses naps.  These regressions seem to come out of nowhere and can last indefinitely.  There is thought to be a regression around 3/4 months, 9 months, and 18 months.  Not at all coincidentally, we can see that all of these 'regressions' occur around the same time as nap transitions (the 4-3 nap transition around 4 months, the 3-2 nap transition around 9 months, and the 2-1 nap transition around 18 months).  In my opinion, these regressions are really just our babies' sleep needs changing and parents are not prepared to handle these changes properly, thus leading to baby becoming overtired.  You know by now that an overtired baby will wake frequently at night and/or fight/refuse naps so - voila!- a 'sleep regression' is born.

So what causes the '4 month sleep regression'?

Four months is a very busy time for babies.  There is a lot that happens with our children's sleep at this age.  Four months is the time where a baby's sleep becomes more like an adult's.  I won't bore you with the details about how this happens, but it's important to know a little bit about why some of the things that you were previously doing (i.e. rocking/nursing to sleep) seem to quit working at four months of age.
Previous to 4 months, when a baby would fall asleep, they would immediately enter into a deeper non-REM sleep.  This is why you would have been able to rock/nurse your baby to sleep and then put them down without them waking up.  As well, they were likely able to sleep just about anywhere; in the car seat while grocery shopping, in the stroller while you took a walk, or in the carrier while you did your household errands.  Around 4 months, as sleep becomes more 'adult-like', your baby will not enter immediately into that non-REM deep sleep stage as soon as they fall asleep.  Instead, they will first enter into a lighter sleep stage of non-REM.  If we are nursing/rocking baby to sleep, and then try to put her down....POP!  She is up, wide awake, and ready to go.  Then the process of helping her to fall asleep is repeated again and again, only causing baby to become overtired.

Four months is also the age where some babies begin to roll.  This means that the swaddle is no longer safe to use.  The downside to this is that most babies at this age still have some, if not all, of their startle reflex (which is what we are trying to prevent with the swaddle).  Simply unswaddling our babies and moving straight to a sleepsack will often cause baby to begin waking themselves up at night or start to have difficulty falling asleep/staying asleep for naps.  This is why I am such a fan of the Baby Merlin's Magic Sleepsuit.  It is a fantastic tool for babies who aren't able to be swaddled but just aren't ready for a sleepsack quite yet.

At four months, we begin to see sleep patterns mature and nightsleep consolidate.  This means that your baby who was previously sleeping in until 7:00 or 8:00am may begin to shift his natural wake-up time earlier, to around 6:00-7:00am.  This then means that we need to begin shifting the bedtime earlier as well to account for this.  It is a very common misconception that putting your baby to bed later will help them to sleep in - it is the exact opposite that is true.  Putting your baby to bed later in hopes that they will start to sleep in will only backfire and lead to an overtired baby who will in turn wake up even earlier.  This early to bed, early to rise pattern is here to stay and trying to fight it is going against baby's natural sleep rhythms.  Check out my blog post here to find out if your baby's bedtime is too late for his/her age.

As I touched on briefly, 3-5 months is the average age that the 4-3 nap transition occurs.  The longer wakeful periods begin to push baby's naps later therefore making bedtime too late as well.  Remember, around this age we do not want any nap occurring later than 4:30-5:00pm.  If you are finding that the 4th nap is happening much past this time - it is time to drop that nap and move bedtime earlier.  That is the key!  Bedtime needs to move earlier to account for that entire sleep period that's been eliminated.  

For more information on newborn sleep, check out my Comprehensive Newborn Sleep Guide here!

As I mentioned above, at four months of age it becomes increasingly difficult for baby to fall asleep on-the-go.  Where a newborn could sleep through just about anything, babies at four months are becoming increasingly aware of their surroundings.  Many parents find it inconvenient to be home every 1.5 hours to get their baby the rest that she needs but if we keep trying to push babies to fit into our schedules, they are going to re-pay us by waking frequently at night.  In addition to this increasing awareness making it difficult for babies to nap on-the-go, it also means that your previous methods of soothing baby to sleep (i.e. nursing/rocking/bouncing/etc.) in fact become the opposite of soothing - they become too stimulating for baby.  If you are finding that you are spending hours using all of your tricks to get baby to sleep, she might be telling you that she needs to be falling asleep more on her own.

So what can we do to avoid this 'regression'?

It is all about recognizing our baby's changing needs and having a flexible schedule that is in sync with our child's natural sleep rhythm.  We as parents may think that because we started one way (by always nursing to sleep, by rocking to sleep, by holding baby for all sleep) that this is the way that baby will always need to sleep.  This is definitely not the case!  When these things stop working we need to switch it up and find something new to help our babies get the sleep they need.  Sometimes, a little bit of sleep coaching is necessary to break the cycle of overtiredness and to reinforce healthy sleep habits but at such a young age we are able to use super gentle methods and they unlearn these 'bad' habits very quickly.  But just remember, no amount of sleep coaching will work on a baby who is overtired and whose schedule is not meeting their needs, so do not be quick to 'sleep train' your child unless you are prepared to make sure baby is napping enough during the day and at the right times, and is in bed at night with an age-appropriate bedtime.  Otherwise, this sleep training will only lead to even more overtiredness and unnecessary crying.
We also always need to be sure that we have an age-appropriate schedule for baby that meets his needs.  Check out my blog post here for what a 'typical day' in the life of a 4 month old should look like.  While it is very true that a baby rarely fits into our schedule, the time that is spent in 'babyhood' is so very short, and besides food, there is nothing else that is more important to a little baby than sleep.

While it would be nice if this '4 month sleep regression' was only a phase that will disappear in time, unfortunately, it is not.  It is more often a product of poor sleep habits and an inappropriate schedule.  As long as we are aware of all the developmental points above and are prepared to adapt to meet our baby's new needs, we will be able to dodge this dreaded regression and continue to enjoy the benefits of a good night's sleep.