Getting a good night's sleep

The baby’s not sleeping: tips for family survival 11:02 AM CST on Monday, January 12, 2009 By LISA MARTIN / Special Contributor to The Dallas Morning News

Good night, sleep tight. Right!

Sleep ranks No. 2 on the wish lists of many new parents, one notch below having a healthy baby. The first 12 months of an infant’s life are filled with surprises, none more significant (or life-altering for mom and dad) than sleep patterns. Yes, some babies sleep blissfully through the night at 6 weeks.

But for many more, sleep presents a range of problems, including flipped days and nights; night terrors (i.e., waking up screaming); and fighting sleep as if it signals the end of civilization. And it’s a problem that affects the whole family, possibly even playing a role in postpartum depression.

“Families have such a hard time with sleep, especially with their first child,” says Dr. Chris Straughn, a pediatrician at Medical City Dallas. “You can read 12 different books and get 13 different answers and opinions. You’ve got to find what works for you.”

According to Dr. Straughn, 6 weeks is the point at which infants peak in their crying; expect them to spend two to three hours a day doing everything from fussing to sobbing. “You have to get comfortable with the fact that baby’s going to cry, but it’s hard, especially at night,” he says. “It gets right to your heart, and that makes it hard to fix.”

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But don’t fret if your best friend’s baby sleeps through the night at 1 week of age. “Even if you’re doing everything right, it can take some babies a while to sleep through the night,” says Dr. Kamal Naqvi, an assistant professor of pediatrics at UT Southwestern Medical Center and the medical director of the pediatric sleep disorders clinic at Children’s Medical Center Dallas. On average, babies can sleep through the night at 2 to 3 months old, but that’s just an average. And premature babies tend to take longer.

Lisa Martin is a freelance writer in Arlington.

Instances of Sudden Infant Death Syndrome or SIDS have dropped significantly in the 15 years since the Back to Sleep campaign started encouraging parents to place babies on their backs for sleep. Despite the rate decrease, SIDS still claims the lives of thousands of babies a year in the U.S. The cause or causes of SIDS remain unknown.

Mostly likely to occur between 2 and 4 months of age, SIDS also strikes boys and black babies more frequently. The following guidelines from the American Academy of Pediatrics can help minimize the risk of SIDS.

•Never put a baby to sleep face down.

•Put babies to sleep in a crib.

•Avoid soft bedding materials; babies should be placed on a firm, tight-fitting crib mattress with no comforter. Use a light sheet to cover the baby. Do not use pillows, comforters or quilts.

•Make sure the room temperature is not too hot. The temperature should be comfortable for a lightly clothed adult.

•Let the baby sleep with a pacifier.

•For more recommendations and guidelines, see www.aap.org.

•Dr. Chris Straughn, the father of a toddler and expecting twins, offers one overarching guideline: “Put your baby in the crib when he or she is awake. Babies need to learn how to drift off to sleep on their own.” He says to watch for the baby’s eyelids getting heavy, then gently place him in the crib or bassinette. “He may bolt awake and startle and get activated again, but it’s such an important practice to … [get] them into good sleep habits in the beginning.”

These books about sleep can help parents and babies.

•The Happiest Baby on the Block: The New Way to Calm Crying and Help Your Newborn Baby Sleep Longer by Harvey Karp (Bantam, $14)

•The No-Cry Sleep Solution: Gentle Ways to Help Your Baby Sleep Through the Night by Elizabeth Pantley and William Sears (McGraw-Hill, $14.95)

•Solve Your Baby’s Sleep Problems by Richard Ferber (Simon & Schuster, $16)

•Secrets of the Baby Whisperer: How to Calm, Connect, and Communicate With Your Baby by Tracy Hogg and Melinda Blau (Random House, $8)

•”Double the duration,” says Dr. Kamal Naqvi, referring to how often you check on a baby when he or she is crying in the crib. “First time, go in after a minute and make sure the baby’s not too cold, too hot, hungry or sick. If the baby’s fine, don’t cuddle, pick them up or kiss them. Make it boring. And, next time, don’t go back in for two minutes. Keep doubling that duration.” Your baby may cry, but she’ll know you’re there. “You’re not neglecting your baby at all. You’re actively shaping a behavior and modifying their sleep habits.”

•Don’t bring your baby into bed with you, say Dr. Naqvi and Dr. Straughn. Both cite studies that indicate that bringing a baby into bed with you contributes to SIDS.

•Keep the nursery very dark at night and light during the day. “You need to work to flip an infant’s days and nights,” says Dr. John Herman, a psychologist at UT Southwestern who is board-certified in sleep medicine.

•Ditch the tricks: Rocking, nursing, walking, even driving around in the car until an infant falls asleep can backfire bigtime, Dr. Herman says. He routinely works with couples whose babies and toddlers “cannot fall asleep unless in physical contact with a parent.”

•Move the baby to his space as quickly as possible, Dr. Straughn says. Everyone will sleep better as a result.

•Nap when the baby crashes: Even if it’s only for half an hour, the caregiver (especially if she’s still recovering from childbirth) will do better if she catches rest when she can.

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