Infants and Sleep

There are basically three schools of thought on this issue.

The first, made popular by the book authored by pediatrician Richard Ferber, advocates teaching babies over the age of three months to sleep through the night in their own cribs, by letting them "cry it out" for increasingly longer periods of time. While most babies eventually give up and fall asleep, the process is often traumatic for parents (and we can assume for the baby), and frequently needs to be repeated following any disruption in routine. Critics point out that Ferber has no psychology training and question whether letting babies cry it out has permanent, harmful effects. More on Ferber.

The second school of thought, practiced by advocates of the Family Bed, says that infants are hard-wired to sleep with their mothers, and nurse at night, for many months, probably until toddlerhood. They point out that babies who sleep with their mothers are less likely to die of SIDS (Sudden Infant Death Syndrome), and that the mothers get much more sleep. My personal experience is that the family bed was heavenly. Critics of this method express concern that parents might inadvertently roll on their babies in the night, and point out that babies who sleep with their mothers and nurse on demand take much longer to sleep through the night. They also wonder why any self-respecting toddler who is accustomed to sleeping with his parents will give that up for a new, lonely, "big-boy-bed." Dr. James McKenna is one of my favorite resources on safe cosleeping.

The third school, perhaps best represented by No Cry Sleep Solution author Elizabeth Pantley, understands that parents may desperately need some sleep and agrees with Ferber that babies need to learn to fall back asleep on their own, but argues that this can be accomplished without the trauma of letting babies cry it out. More on Pantley's No Cry Sleep Solution.

My own view

After substantial research, and working with many parents, I've come to the conclusion that many little ones who are helped to sleep by parents (nursing or rocking), simply can't put themselves back to sleep when they re-awaken during the night. If they're nursing, they may well awaken to nurse, but then will need to nurse again every time they re-awaken a little at night. Eventually, if they don't figure out how to fall back asleep on their own when they awaken at night, they will need our loving help to learn how to fall asleep without rocking or nursing.

Is this a problem? Not necessarily. Some moms are able to nurse at night as long as their child wants. However, I often speak with moms who are ready to stop night-nursing their little one, but find the prospect of night-weaning upsetting.

There are safe ways for you to get more sleep, without leaving your baby to cry, and without necessarily sharing a bed. You can even start encouraging an infant in that direction, but ONLY if you listen to the infant when he tells you he's hungry or needs you to hold him. In other words, this is a gentle, gradual process. See this article on helping your baby develop good sleep habits for how to begin this process: Teaching Your Baby to Put Himself to Sleep.

Does that mean we should always put infants down awake so they can learn to put themselves to sleep when tiny, so they won't develop bad habits? Since almost all newborns fall asleep at the breast (or bottle), that would be impossible. It is completely appropriate to nurse babies to sleep. Nursing to sleep is no more a "bad habit" than peeing in a diaper. As they get older, the time will come when they can learn to fall asleep themselves, just as they will eventually give up diapers.

Does that mean that a time will come when to teach our baby or toddler to fall asleep, we can leave him to cry? No, in my view, if you want an emotionally healthy child.  But then how do kids learn to fall asleep on their own, without nursing back to sleep? They learn in the safe comfort of your arms, once they're old enough. For more on teaching a toddler to learn to fall asleep without nursing or rocking, click here.

Sleep is, of course, a very personal decision. I believe that

There is a sleep solution that fits every unique family, from co-sleeping to baby bunks that attach to the parents' bed, to baby hammocks, to cribs.

Of course you want your children to know from the earliest age that they can always ask for and get help. That said, we all need sleep to function and be good parents. I don't think CIO is good for babies, but I think exhausted parents who yell at their kids may be even worse. So my recommendations are biased in favor of keeping your infant close so you can get more sleep. But this is a very individual choice. Read as much as you can, and then lose the guilt. Do what works for you and your baby.

How can you get some sleep, when your infant is still waking up to eat?

1. Sleep whenever and wherever you can.

Keep your baby near you while he's still nursing at night, so you don't have to get out of bed. Breastmilk is designed to be given every few hours. It simply cannot hold a baby for much longer. Rats, on the other hand, give their baby food much higher in fat, so that the mother rat can leave the babies for eight hours while she’s off foraging. Baby humans could not survive predators if they were left for long periods, so nature has designed them to require their mother's presence fairly constantly. That means your baby needs to be nursed at night, for a minimum of six months and probably until she is a year old.

2. Afraid of rolling over on your baby?

Unlikely, since mothers are designed not to (unless her natural warning system has been interfered with by drugs or alcohol). There is actually evidence that babies who sleep with their mothers are less likely to die of SIDS because the co-sleeping babies' sleep cycles are in sync with their moms', and her presence stimulates him not to fall into such a deep sleep. There are experts who say that a father could suffocate a very young baby, especially if he's had a drink before bed, so most safe co-sleeping checklists say to position the baby between mom and the wall rather than between the parents. However, the fathers I hear from tell me they're very conscious of their baby, even while asleep. We know that Dads do have a hormonal response to becoming fathers, which includes a natural protectiveness toward the baby, so Paternal Instinct is as real as Maternal Instinct. I personally think that any Dad will be a better father if we honor his paternal instinct and give him the opportunity to sleep snuggled with his baby, but that's an individual decision. In any case, make sure you set up your bed for safe cosleeping. Don't start without reading this detailed checklist for safe co-sleeping.

3. If you don't feel comfortable with your baby in bed with you, try a “Moses basket,” cradle or baby bunk within arm's reach.

Some moms are such light sleepers that they just can't get any sleep at all if the baby is in their bed. There are wonderful baby bunks that can be anchored to your bed, at the same level, and opened so that the baby has his own space but you can roll him into your bed with you to nurse. 

Room-sharing decreases the risk of SIDS by as much as 50 percent, so even if you don't want to have your baby in your bed, consider setting up a separate sleeping space for her nearby. 

4. Learn to nurse lying down so you can sleep while he feeds.

It may take a week, while you get the hang of nursing, but learn to nurse lying down, so you can doze, and you'll feel much more rested. Just wedge pillows behind you and between your knees for support, and put a folded blanket under Baby if necessary to raise him to the level of your breast so neither of you is straining to reach. He should be on his side, facing you.

5. Help your baby set her metabolic clock.

She doesn't know it's night and she should sleep. She'll learn, eventually, but you can help your little night-owl adjust faster to the world outside your womb by making sure she doesn't sleep all day. Take her out in the sun. Go for walks. Let her feast her eyes and ears on the wonders of the world. All humans really do sleep better at night when they've been exposed to fresh air and sunshine during the day. Also, you should know that babies who sleep with their moms end up synchronizing their REM sleep cycles, which means she's more likely to treat night as sleep time and day as waking time. And of course, keep things dark and quiet at night. Nurse her when she wakes, and change her if you must (not all babies are sensitive enough to require changes at night), but don't make it into playtime.

6. Take a long maternity leave, so you can nap when your baby naps during the day.

This is the golden rule. Forget the shower, who cares? Go for the nap.

6. If your partner can take the baby in the morning to let you sleep in for an hour, it can make all the difference in the world.

Don't feel guilty about it. Eight hours of sleep with interruptions to feed your baby is not the same as the eight hours you used to get. You need lots more now.

7. Go to bed early.

When you were pregnant you did it. Don't feel bad about it, this is not the time to resume an active evening life. You have the rest of your life to stay up late.

8. Encourage sleep associations that your baby can control.

You can begin, even from early on, helping your baby learn to fall asleep without sucking or being held. This is a gradual, gentle process. Here's a whole article on how to encourage good sleep habits as your baby grows.