Sleep health for babies

July 21, 2016
Is your baby a morning lark or a night owl? Like adults, babies have different natural preferences when it comes to sleeping and waking, and their capacity to sleep also changes during the first six months of life. However, as parents also need their rest, baby's sleeping patterns are often a hot topic for discussion with health care providers, family members and other parents!
Sleep health for baby's first six months

Dr. Michael Farmer, who heads the Department of Family Practice at BC Women's, provides some insights into what to expect for newborns under six months old. As a family doctor who has delivered more than 5,000 babies, Farmer stresses that sleeping habits do vary from baby to baby, and it's impossible to pinpoint when your newborn will begin to sleep for longer periods during the night.  "I tell parents that it's like a development milestone, and it varies in the same way as when the baby is ready to walk, talk or stand up."

However, as your baby grows and develops, their sleeping patterns do change.

The first six weeks

The best way to describe the eating and sleeping habits of babies under six weeks is "on demand," Farmer explains, and parents need to go along with what the baby needs. At this stage, babies are often feeding every three hours around the clock. After four to six weeks, breastfeeding moms can be feeling stressed and exhausted by the baby's 24-hour feeding cycle. If your baby is well-established in breastfeeding and you have some extra milk, he recommends expressing breast milk so that your partner can handle some of the 3 a.m. feedings and you can get a longer stretch of sleep.

Although babies breastfeed often in the first few months of life, he explains that research indicates that mothers who breastfeed their babies actually get 45 minutes more sleep each night than those who choose to feed with formula.

Establishing a bedtime routine

Having survived the first six weeks, parents may be looking forward to longer sleeps. Farmer notes that babies normally sleep for longer periods at night once they get to about 10 weeks old or 10 lbs in weight. However, once the baby is older than six weeks, it's a good idea to establish a bedtime routine that will pave the way for healthy sleeping habits in the future. The routine can be simple, such as giving the baby less stimulation, bathing, providing the last feed of the day and putting on a sleeper for night time. Even with young babies, singing or reading a story before bedtime can be part of this routine.


However, if you want to teach your baby to fall asleep in the crib, it's very important to stop the bedtime soothing routine when the baby is drowsy rather than asleep in your arms. Placing a drowsy baby in the crib will help them learn how to go to sleep independently.

Helping your baby sleep during the night

Once your baby is old enough and big enough to be physically able to sleep for longer periods, you will find that different experts recommend different approaches to helping them settle down for the night. On one hand, some say that you should let the baby cry themselves to sleep. Others take an opposite view, recommending that parents comfort the child as needed. Farmer advises parents to decide which approach suits them best, or even combine the two. "There is no right answer. Every baby eventually sleeps through the night."


However, this is the time when you need to take your baby's natural sleeping and waking habits into account. For example if you have a "night owl" baby who doesn't normally settle for the night until 11 p.m., it's unrealistic to expect them to settle at 8 p.m. because you have started the bedtime routine earlier. Getting your baby into the habit of settling earlier has to be accomplished gradually by moving bedtime forward in small increments each day. The same principle of gradual change applies when you want to encourage your "morning lark" baby to stay up later and sleep in.

Parenting advice from your parents

When there is a newborn in the family, the grandparents often offer advice. In the Vancouver area, this is complicated by the fact that some couples may come from different cultural backgrounds with different customs around child raising. Farmer advises that parents use common sense before following any advice, and always have safety in mind. "There are things that have dramatically changed since the last generation." For example, your mother may have been taught to put you in the crib on your stomach or side, contrary to today's recommendation (based on evidence) that sleeping on the back is the safe way to go.

Safe sleeping

The Canadian Pediatric Society (CPS) has very clear advice on what's safe for your baby during the first six months. To help prevent sudden infant death syndrome (SIDS) and give the baby the best chance to breathe freely, the CPS recommends that babies should always be put to sleep on their backs, not on the side or stomach. The CPS also recommends that the baby be in its own crib, placed in the same room as the parents. Avoid putting anything in the crib that can be a choking or suffocation hazard for the baby, including soft toys and the side padding "bumpers" that your mother may have used.


If you do decide to co-sleep with the baby in your own bed or use one of the special cribs that can be attached to your bed, Farmer cautions that you need to be sure that you have not taken any medications (prescription or illegal) or alcohol that could make you sleep deeply and put the baby at risk of harm.

Resources

If you need advice on your baby's sleep, talk to your doctor, midwife or public health nurse. They can also recommend a good book or other resource that covers this topic. Farmer suggests:


What to Expect when You're Expecting (Heidi Murkoff)


Solve Your Child's Sleep Problems (Richard Ferber)


For more information about keeping your baby safe when sleeping, visit the Canadian Pediatric Society's Caring for Kids website.

This article was written by Anne McLaughlin with information provided by BC Women's Family Practice Department head, Dr. Michael Farmer


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Patient Story: Breath of Life

Thanks to our generous donors, BC Women’s Newborn ICU had the technology needed to help baby Francis’s underdeveloped lungs mature and grow.

Like all expectant mothers, Leah Stadelmann couldn't wait for the birth of her firstborn son. However, at 27 weeks, doctors at BC Women's Hospital discovered baby Francis was not developing properly. Leah’s excitement quickly turned to anxiety.

"They admitted me to BC Women’s on December 19," says Leah. "I was pretty terrified at the time. Francis wasn't due until March 19 – three months later." Just prior to his birth, Leah and her husband, Paul Fleming, met with Dr. Kevin Ansah, who walked them through the worst- and best-case scenarios, gently balancing hope with honesty.

"Dr. Ansah advocated for us; he listened to our concerns and he acted upon them right away," says Leah. "He didn't sugarcoat things for us, so we were prepared for what might happen. We really respected that."

It was discovered that Francis had a condition called reversed end diastolic flow. Instead of getting a continual blood supply from his mother, the baby was experiencing absent phases and then reversals in normal blood flow.

Fearing for Francis’s survival, doctors performed an emergency C-section four days later. He was born weighing just one pound eight ounces.

While delivery eliminated the one threat, Francis’s premature birth created another. His tiny lungs were severely underdeveloped and he needed highly specialized equipment simply to breathe.

Over the next three months, the Newborn ICU (NICU) was able to support Francis’s breathing using a vast range of neonatal breathing apparatus. Thanks to support from donors like you, the NICU was able to provide Francis with exactly the right breathing equipment throughout his growth and development, precisely when he needed it.

After 94 days in hospital, which included a successful battle against a serious blood infection and sepsis, Francis finally went home. Today, he’s thriving, and his future prognosis looks bright.

"He weighs 12.5 pounds and smiles all the time," says Leah, proudly. "We’re so grateful for the incredible care Francis received from the medical staff and especially Dr. Ansah."

Written by Michelle Hopkins
Photography by Brian Howell


Thank you to our Donors

Our donors make possible every program, every equipment purchase and every act of care at BC Women's Hospital + Health Centre. 

Pathfinder Partners Foundation
Nordstrom
Pansy Lo
Dr. Jayson Potts
Dr. Susan Purkiss
Michael Smith Foundation
Dr. John Smyth
Dr. Pascal Lavioe
Shannon Chung
Kenneth Nowlan

BC Women's Hospital thanks Odlum Brown for 18 years of continuous support.


 

The content provided in Women’s Health eNews is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition


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