The topic of sleep is one of the most frequent topics of conversation I have with parents. I’ve recently spent some time studying various sleep modules, to enhance both my own knowledge, and share with parents latest up to date evidence-based practice.
Here are some useful considerations for night-time sleeping.
Firstly, baby’s age. By 3 months, sleep at night should be easier due to their stomachs being larger. In addition their brain development should enable them to fall into deeper sleeps. The startle reflex also disappears at this stage. Be conscious however that babies can start to roll around 4 months!
Many concerns around sleep & settling in the first few months are often related to the transition to parenthood. Remember – consistency is the key! What you do during the day, you should do at night. For example if the last thing the baby remembers is being fed to sleep, they will also want to be fed to sleep later at night.
By 6 months, night-time feeds can start to be reduced. Similarly you can gradually reduce the amount of help you give your baby to help settle back to sleep. Sleep association habits are formed between 12 months and 3 years (i.e. the patting, feeding, rocking activities to help soothe to sleep). It is these children who rely on such activities who tend to wake frequently at night.
By 8 months, some 60% of babies self-settle.
If your child has suddenly started to wake more frequently at night, consider if he/she is teething, ill due to causes such as ear infections, or having a sleep regression. (For example, your child may be undergoing a growth spurt or there may have been a change in the family environment).
Taking a 24-hour history can be so beneficial. Consider factors such as how often little one is waking, (and waking time), time of bedtime, settling techniques used by parents, the sleep environment, use of bedtime routine, amount of rest, activity and eating habits conducted during the day. Hence many factors impact night-time sleep and there should be a holistic assessment.
If your baby is not self-settling after their deep sleep cycles, there are a number of evidence based responsive settling techniques which may be used. One of which includes the “Controlled Crying” method (suitable from 6 months to 2 years, endorsed by the Royal Childrens Hospital Melbourne and the Murdoch research Institute 2023). Evidence suggests that this technique is successful after 3 to 14 nights. Again consistency is the key to success, and the overall strategy will be dependent on the parents. The establishment of a good bedtime routine works for the majority of children.
If night-time sleeping remains problematic then it is best to seek expert advice from the GP, paediatrician, or Maternal Child Health Nurse. There are a number of really good useful online resources such as karitane.com.au, rch.org.au/kids info, and sleep with kip.com/strategies is an evidence-based resources for sleep strategies.
Here’s to a good night’s sleep everyone!