bond with baby

Caregiving Routines

Sleep-time

All babies need sleep for growth, development and their happiness, and importantly from the very beginning they need a safe sleeping environment. To provide Baby with the protection and comfort needed, parents need to be aware of the facts associated with Sudden Infant Death Syndrome (SIDS), Sudden Unexpected Death In Infancy (SUDI) and other fatal sleeping accidents (as discussed in Babies' Safety → During Caregiving Routines).

While they are sleeping babies go through 'deep/quiet' and 'light/active' phases in a sleep cycle - just as adults do. When babies are 'deep' asleep they are breathing deeply and are not restless. During the 'light' sleep phase their breathing is shallow, as they rouse frequently, making little squirming sounds and movements. They may even open their eyes briefly but without fully waking or becoming distressed. It is thought that during these times, there is a greater flow of blood to the brain essential for babies' early development. From about 8 weeks their 'active' sleep phases begin to shorten as they settle into longer, 'quiet' phases.

The amount of sleep babies need depends on the baby, her development and needs. Some healthy newborns sleep for a about 18 out of 24 hours, while others are more wakeful and may sleep a total of 16 hours. What is for certain, babies' early sleep patterns revolve around their feeding for healthy development. By about 6-8 weeks the amount of time babies sleep during the day will be lessening and by about 3 months many babies are sleeping longer at night. By 6 months, they are usually having 2-3 short naps during the day totally about 3-4 hours (of course, this will depend on how much sleep they get during the night) as most are sleeping through the night without needing a feed. Importantly, parents should never underestimate their baby's need for sleep and learning to recognise Baby's early 'tired signs' (discussed below) is the beginning of getting Baby into a good sleeping pattern. With the first tired sign, comes your need for getting him prepared for sleep.

Developing a Sleep Routine

 

When to Begin

Mother and Baby Developing a sleeptime routine is helping Baby settle into good sleep habits. Having constant irregularity of sleep and lack of routineness can cause a baby to have difficulty in settling and enjoying sleep. The big question most parents ask is 'when should a sleeping routine begin?'. Answer, 'It begins as soon as possible by learning to read Baby's tired signs' (discussed below). And in doing so, creating a relaxed and comfy sleeping space is important to all babies - just as adults enjoy a relaxed, comfy sleeping space!

Peaceful Sleeping

Parents' calm, relaxed approach and guiding interactions are needed for settling Baby. It should be no surprise that if parents are stressed at the time of trying to settle their baby then the baby too becomes tense. Then, like all other caregiving routines, sleep-time needs to consist of a predictable sequence of your loving interactions. Baby will quickly learn to associate these with calm and rest.

While household sounds are a part of your baby's home environment, an overly loud background of noise is not a setting for inducing calm and sleep with any baby. For example, if a television is on in the room where you are trying to settle Baby, the sound and flashing of colours/light can stimulate/excite him. SO, babies don't need excessive noise going on while they are desperate for calm and sleep!!! Toys in and around cribs/cots and hanging mobiles can over-stimulate babies. Instead of going to bed for rest, some babies become over-tired just because of what they have to look at. So they need the surroundings that induce a feeling of secure comfort, safety and calmness NOT for play and stimulation.

Daylight & Night Darkness

Some newborns need time to adjust to this 'whole new world', which includes sleeping in daylight and night darkness. So to help Baby, during the day she needs to sleeps with natural light - not in a darkened room. Some parents prefer Baby to sleep in a sling or pouch attached to them during part of the day, and research shows it can be effective in reducing crying. However, there is a warning regarding slings.

Baby in SlingSling warning: In the US, Canada and Australia there have been incidences of infant deaths while sleeping in slings, and injuries caused by infants falling out or from the sling slipping. Parents need to constantly monitor their baby in a sling: A baby's face needs to be seen - facing outward - with no covering of the mouth and nose, and the chin should NOT be pushed down into the chest (as in the fetal position) as this can block the airway.

As for nighttime sleep, the room will be darkened. While some parents have Baby sleep with a dim light on, this is a personal choice. Some sleep experts suggest this may develop into Baby becoming dependent on light to fall asleep yet many parents feel more comfortable with a dim light on. When feeding Baby at night, have just enough light on to attend to him. Then, back to bed.

Routine Steps

Supported by scientific evidence, below are general steps to help develop a sleep routine. Depending on Baby's development and whether it is day or night-time sleep, adjust the routine to suit. The preparation for Baby's daytime sleep will generally be 'short and sweet' compared to getting him ready for his nighttime sleep. Nighttime represents the end of the day, a time that everyone in the house is looking forward to. So this routine needs to develop into a special uninterrupted time (as discussed in Parenting Styles → Establishing Family Rituals and Traditions) and eventually stories will be told that will continue right throughout Baby's developing years.

However, the emphasis will always be on your reassuring interactions that form into a predicable pattern for Baby's sense of wellbeing. Sleep-time safety is to be practiced at all times.

Step 1: Read Baby's first show of 'tired signs' before he gets too grumpy, as then it can be difficult to settle him.

For very young babies these tired signs can be any combination of:Baby Yawning

  • Yawning
  • Redness of the skin around the eyes
  • Turning his head away during face-to-face contact → glazed look
  • Fussing such as squirming/fidgety movements
  • Sudden outbursts of grizzling → crying
  • Clenches fists → becomes agitated with arm/leg movements
  • Grimacing 'unhappy' facial expressions.

By about 3 months babies' tired signs are likely to be more 'distinct' such as rubbing eyes, pulling ears and of course, fussing behaviour to full on crying.

Although it may be difficult for you to gauge how much time Baby will be awake between feeds during the early weeks as you become more attuned to his/her signals you will also become skilled in anticipating his tiredness and need for rest.

Step 2: Wind-down and prepare Baby for bed.

  • Talk reassuringly, such as ... Time to have a lovely sleep ... you will feel snug and comfy in bed. Let's change the nappy.
  • During changing, sing a bedtime song. Accompanying your singing will be your smiling face and reassuring touch. Your baby prefers hearing your voice compared to any other source of singing or background music.
  • If your baby sleeps best with being swaddled/wrapped prepare him in the wrap cloth while continuing with the singing (During the early months, some babies have very brisk moro reflex reactions and startle easily causing them to wake. Wrapping can help to provide a feeling of security. It is also thought to reduce the risk of SIDS because it holds babies in position on their backs). A light-weight cotton or muslin is ideal. For size, 1 metre sq. or a little larger is suitable.
    • Lay out the wrap. Fold down the top by approx. 20 cm.
    • Place Baby down in the middle with his head above the fold line.
    • Take left hand and bring it up under the left hand fold of fabric then bring the edge of the fabric across and tuck it comfortably under Baby's right side of his bottom and legs
    • Tuck the right hand up under the right hand fold and bring the fabric around under Baby's left side.
    • The lower edge can be tucked up under Baby's legs
    • Make sure Baby is not too tight as it can constrict breathing. Think about is in terms of Baby's comfort - Secure But Not Tight!
    • And, ensure the wrap does not come up around Baby's head, chin and ears.
  • Now ready for bed, you could finish off the routine by rocking/swaying with him while singing/humming. The motion of your rocking/swaying and the calm of your voice will further soothe your little one ... and you ... then ...

Step 3: When Baby is calm and drowsy but still awake, into bed he goes.

Sleeping Baby

  • Keep singing as you place him in bed. Then use reassuring words e.g. Sleep tight my beautiful one ... and maybe a stroke for his forehead if he enjoys this and a kiss goodnight ...
  • Then as he settles and self-soothes over the next few minutes ... gradually move away from the bed ... out of Baby's sight ... then when ready, quietly walk out of the room.

 

As scientific evidence shows, babies being put into bed while drowsy but still awake helps them to become familiar with their bed surroundings, learning that this is their secure space away from the comfort of parents' warmth and sensitive interactions. By doing this, babies learn to self-soothe - this meaning to comfort themselves just by feeling secure within their bed and to fall asleep. During the early weeks it is difficult to 'get the timing right' of putting Baby down into his bed while he is not yet asleep AND most need parents' comfort as they fall asleep during this time. However, as Baby develops and becomes more aware of his surroundings a pattern can develop: if he is put into bed asleep and then wakes, he wonders where you've gone, as the last thing he remembers is being held in your arms and being comforted.

For some parents it is very difficult leaving the room until the baby is fully asleep. If so just move out of Baby's sight and use a soft whisper ... with the aim of him learning not to be dependent on you to fall asleep. Also, while drifting off to sleep the faint sound of parents' voices in the house can be comforting to the baby knowing that you are close by.

Step 4: If he begins to grizzle after you have left the room. Wait to see if he resettles. Sometimes they give a little cry just before drifting off.

If the grizzle becomes a full cry, QUIETLY and CALMLY go back into the room but without taking him out of bed. Your gentle touch and whisper of words such as Shh ... Shh ... we are here ... etc will communicate your warmth. Or just a gentle pat on the mattress may be enough for him to feel soothed. When he is calm, quietly leave the room.

You could now be thinking this whole bedtime routine is easier said than done. Yet can I add that you need to practice at this so Baby gets to learn the routine and feels secure. It is only natural that a baby will initially feel some insecurity leaving the comfort of Mum/Dad's arms to be put into bed so it will take time for you all to get your own routine together. Remember, you and your baby are learning together. Take little steps. Don't set unreasonable expectations about what you think you should achieve. Give yourselves time to adjust ... and this way you will learn what works best for you both.

Note: Some CDs are promoted as being relaxing for babies to listen to during sleep. It has NOT been scientifically proven that background music relaxes babies during sleep. On the contrary, when they are asleep they tune out to the constancy of background music. However, there is scientific evidence showing that when babies are awake they get pleasure from listening to harmonious music and certainly parents' singing has been proven to attract babies' attention and to soothe them. My only comment about playing music as a background sound for Baby to drop off to sleep to is it may set up a pattern of dependency once Baby is in bed ... that is, he may become dependent on the sound of music in the room to settle instead of learning to settle himself to sleep. Some parents choose to play a short piece of music as they say goodnight to Baby but it is entirely up to you what you choose to do.

For more discussion on settling difficulties and nighttime waking, go to Baby's Not Sleeping.