Thursday, June 15, 2017

Does Your Baby Sleep....Like a Baby?


by Glenni Lorick, IBCLC
Does your baby sleep like a baby? You know, waking every 2 or 3 hours, maybe crying, nursing or taking a bottle, then falling back asleep? Physiologically newborns are not programmed to sleep a stretch longer than about 4 hours. By about 6 months, they might be capable of sleeping a stretch of at least 6 hours (many infants do sleep longer) at night. The fact is that some babies are simply born with easier temperaments than others, making nighttime much easier for some parents than for others.

Why Babies Wake Up

A newborn has a tiny tummy. In fact at birth his tummy will hold about 5- 7 ml of breastmilk comfortably. Many formula feeding parents mistakenly think that their babies need to take most of the 60 ml formula bottle the hospital gives them. Even 20 ml can cause baby's stomach to be too full, leading to discomfort and spitting up. Newborns nurse very frequently - every 2-3 hours or perhaps even more often. Breastmilk is designed to digest quickly, so often newborns wake up hungry after just an hour or two.

Many infants will cluster feed in the evening because that is how they prepare for a slightly longer sleep stretch at bedtime. Breastmilk composition changes throughout the day. In the evening, there is less milk, but it is actually higher in long-chain fatty acids like tryptophan (that wonderful amino acid found in turkey that makes you want to fall asleep after Thanksgiving dinner). It is also higher in sleep-inducing melatonin. A lot of mothers worry that they don't have enough milk in the evening because baby is nursing non-stop. So they end up supplementing in the evening. But that really isn't necessary. The frequent nursing helps baby get what he needs and helps mama produce more milk.

As they approach about 2 months of age, some babies do start sleeping longer stretches of 4-8 hours at night. That is normal. But it is also normal for babies to continue waking several times at night to nurse. At this age babies are still sleeping pretty deeply when they are actually asleep.

Around 4 months many babies experience a sleep regression. A baby who was sleeping a 6-8 hour stretch may suddenly be waking every 3 hours again. The good news is that baby's brain is maturing. The bad news is that these changes are permanent. You will need to help your baby adjust to falling back asleep when he awakens. One way to do that is to help him learn to fall asleep in his crib without you. Most experts do not recommend letting baby "cry-it-out" because research has shown that can actually be harmful. However, there are gentle methods to help baby learn to sleep. The No Cry Sleep Solution by Elizabeth Pantley is a terrific resource that many parents have found to be invaluable.

Where Baby Sleeps

The American Academy of Pediatrics came out with revised sleep recommendations in 2016. They recommend that babies sleep in a "separate but proximate"sleep environment. That means that baby should sleep in Mom and Dad's room, but not in their bed. Nevertheless, in this revision, the AAP did acknowledge that mothers do sometimes fall asleep while nursing. 
"However, the AAP acknowledges that parents frequently fall asleep while feeding the infant. Evidence suggests that it is less hazardous to fall asleep with the infant in the adult bed than on a sofa or armchair, should the parent fall asleep. It is important to note that a large percentage of infants who die of SIDS are found with their head covered by bedding. Therefore, no pillows, sheets, blankets, or any other items that could obstruct infant breathing or cause overheating should be in the bed. Parents should also follow safe sleep recommendations outlined elsewhere in this statement. Because there is evidence that the risk of bed-sharing is higher with longer duration, if the parent falls asleep while feeding the infant in bed, the infant should be placed back on a separate sleep surface as soon as the parent awakens."

 Dr. James McKenna is a professor of Biological Anthropology and the director of the Notre Dame Mother-Baby Sleep Laboratory. He has written extensively on the biological reasons for mothers and babies to share sleep environments. He also has created safe co-sleeping guidelines that any family who is practicing co-sleeping should be very careful to follow. Everyone agrees that the most dangerous place for an infant to sleep is a recliner or sofa, even with a caring adult. If that adult falls asleep the risk of the infant suffocating is many times greater than it would be on a firm sleep surface such as a futon or firm mattress.

Getting Help 

Fortunately  we have a local infant sleep expert. Dana Stone is the mother of four children. When she had serious sleep issues with her last baby, she looked for answers. She knew that the traditional cry-it-out method wasn't right for her family, so she found a program that helped her gently teach her child to sleep. She ended up becoming a certified Sleep Sense consultant and has helped dozens of local families get a good nights' sleep.  She offers a free download for parents entitled "Five Steps to Getting Your Baby to Sleep Through the Night." It is important to recognize that nobody expects an infant to sleep through the night. Physiologically they just aren't ready to do that. However, later in the second half of the first year, many babies are capable of sleeping an 8 hour stretch. Dana is able to work with your individual situation and help your baby sleep a little less like a baby!

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