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A Good Night's Sleep

Three Different Approaches for Dealing with Night Waking

Every parent dreams of having the 'perfect' baby who will sleep peacefully and for nice long stretches of time. However, many parents don't experience this "dream." Instead, many parents experience sleepless nights, filled with on and off crying fits - their baby's and their own! But there is hope for these families.

Pediatricians and child development experts continue to study infant sleep in hopes of finding out why some babies are "good" sleepers and some are not "good" sleepers. As a result, many theories have been developed to explain poor sleepers. And many ideas have been formulated as to how parents can help their babies sleep better - and longer.

First let's start with some of the commonly held myths about infant sleep. (Research in infant sleep provides us with the facts.)

MYTH:If a baby is a "good" sleeper, she will never wake up at night.
FACT: Waking at night is normal as baby cycles through light and deep sleep. Problems occur when baby wakes up fully or can't get herself back to sleep without help.

MYTH:Some babies don't need to nap during the day.
FACT: All babies need daytime naps, which actually help them have easier nighttime sleep. Nap deprivation causes night waking.

MYTH:It is normal for some babies to wake up grumpy.
FACT: Babies who wake up appearing fussy or grumpy did not get enough quality sleep. Well-rested babies wake up cheerful and alert.

MYTH:Feeding baby more at bedtime, through cereal in the bottle or large quantities of milk, will help the baby sleep better.
FACT: Babies do not sleep better after large evening meals. Excessive food right before sleep will cause the baby's digestive system to work overtime during the night, which may disrupt sleep.

MYTH:If you keep baby awake late into the evening, he will sleep better at night.
FACT: Keeping baby awake in the evening, after she has shown even minor signs of tiredness, will help develop a 'hyper-alert' state in the baby, making nighttime sleep even more difficult. A wired baby may be a tired baby.

MYTH: Large babies sleep better than small babies.
FACT: The baby's size is not related to his ability to fall asleep or stay asleep.

There are a few popular approaches to dealing with nighttime waking in infants. Each approach has its pros and cons. Parents must carefully consider which approach will best meet their family needs, while considering their temperament and the temperament of their baby. Each of these approaches is nicely defined and explained in detail in Rebecca Huntley's book The Sleep Book for Tired Parents.

For each of these approaches, there are doctors and child development experts who claim that there are no negative consequences to the baby. At the same time, there are other doctors and child development experts who believe there may be negative consequences for each approach. These claims are based on personal experience and parent report, not on research. So it is parents who must decide how to deal with their baby's night crying.

Co-sleeping method, or the family bed, is one approach to dealing with sleep issues in infancy. Families and professionals who believe in the parenting philosophy called "Attachment Parenting" support this approach, which they believe provides the most emotionally supportive sleep environment for the baby.

PROS: Easy access to milk (breast or bottle), which allows mom to sleep better because she doesn't have to get up at night to nurse the baby. Baby feels secure all night long, since he's so close to mom. (Note: The Amercian Academy of Pediatrics does not support family bed practices due to concerns regarding Sudden Infant Death Syndrome.)

CONS: Parents may have a hard time sleeping soundly with baby so close. Baby may not want to leave the family bed, even as she becomes a toddler or preschooler. May be dangerous due to suffocation, from baby rolling too close to parent, or from fluffy or too soft bedding. (Note: The American Academy of Pediatrics does not support family bed practices due to concerns regarding Sudden Infant Death Syndrome.)

The "small steps approach" is another method for parents struggling with their baby's sleep problems. This approach involves eliminating 'negative sleep associations' for your baby. These negative associations are things that the baby can't duplicate or get for herself at night, like bottle or breast, pacifier, rocking with parent, singing from parent, etc. The idea is for parents to provide a relaxing nighttime routine for the baby, but place him in his crib before he is fully asleep. This helps the baby learn to fall sleep on his own. Then, as the baby cries, parents go in for brief 'checks' and reassurances. The time to wait before checking on the baby is slowly increased throughout the night, from 5 minutes, up to 20 minutes.

PROS: Recommended for young infants. Yields fairly quick results, from a few days to a week. Parents don't feel they are abandoning their baby. Lots of flexibility in the amount of time the baby is left to cry before parents check on her.

CONS: Crying may be difficult for parents to tolerate. Parents may abandon the plan before success. May take longer than other approaches.

Cry it out approach is recommended by some as a possibility for families dealing with infant sleep problems. This approach involves following all the recommendations for helping the infant relax at bedtime, then placing the infant in her own bed and walking away. No matter how long or how loud the infant cries, supporters of this approach recommend that the parent does not go back in for at least an hour, with some advocating not all night. If the parent is concerned that the baby might be hurt or sick, they may check in briefly. We cannot recommend this approach given the current information available on the importance of meeting the emotional needs of infants. At this time there is no research that has been able to prove that leaving a crying infant unattended for 1 hour or longer will not have negative emotional effects on the baby.

You know your baby best

As with almost all other aspects of being a parent, there is no 'definite' answer for how you deal with your baby's night crying. Careful consideration of your temperament, your baby's temperament, and your family needs will help you make the right choice for your family. If you find that you need help sorting out all the options, or have further questions, contact your pediatrician, the child development specialist at your Public Health Department.


Content provided with permission from the National Institute for Health.


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This content was last modified on: 09/08/2008

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