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The What, When, How, and Why of Babies Sleeping Through the Night
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Sara DuMond, MD, FAAP posted:
I absolutely love the discussions in this newborn community! I have noticed lots of discussions lately about sleep issues in babies that all seem to be variations on the same theme...the what/when/how/why of babies sleeping through the night. Keep in mind, that I'm well aware there are many approaches to sleep with babies. The tips that follow may or may not gel with your personal parenting approach. I do, however, claim some "street cred", - I have three children of my own - each very unique in personality and temperment, and each brough their own unique issues to the table when it came to sleeping through the night as babies. I feel comfortable dishing out advice, because I've been there. I also have 3 great sleepers now, and I absolutely do not believe it's by chance, luck, or some sort of "law of averages." Here are my tips/opinion, for what they're worth!

1. Babies are capable of sleeping through the night from 4 months on. This applies to 99.9% of babies, excluding those with medical conditions that might interfere. (Example, I had a patient with both hips, legs casted from his waist down, with a lovely bar between his legs, making it very difficult to find a comfortable position.) Aside from major medical issues of that degree, there is absolutely no reason that babies cannot sleep 10-12 hours a night, without waking, from 4 months on.
2. Parents have to truly want their babies to sleep through the night, in order for this to happen. I am well-aware that many parents desire a family bed, and adhere to an attachment parenting theory. That's absolutely fine, and in these instances, I acknowledge that parents probably aren't looking for their baby to sleep through the night at an early age. You won't catch a judgemental stare from me - I simply recognize that my advice really won't apply in these situations.
3. Rarely have I met a baby who refuses food in the middle of the night. I've been there! The baby that ravenously attacks the breast in the middle of the night when offered - I know her well - she sleeps down the hallway from me! Nighttime eating beyond 4 months is a habit. It doesn't matter how much they appear hungry. Feeding and cuddling feel good to a baby, and there's not one on the planet, that I know of, that will refuse it, if offered.
4. Habits are said to be hard to break for a reason! A baby, older than 4 months, who is still getting middle-of-the-night feedings, will protest if/when you try to shut this down! My oldest daughter has an extremely feisty and persistent personality, even now at the age of 8, and believe me when I tell you that she protested when I stopped offering nighttime feedings to her at 4 months of age! I lost count of how many hours she cried, (and in all honesty, I turned off the monitor!). What I didn't lose count of, was how many nights it took of her crying, before she got the message loud and clear: three. That's right - three nights and she was sleeping through the night. It would have taken much, much longer, had I broken over and "rescued her" and the older a baby is, when they're still waking and feeding at night, the harder that habit is going to be to break.
5. Babies who are not allowed to sleep through the night are chronically sleep-deprived. What does this look like? Here's the picture: a baby who is overly fussy, doesn't nap well during the day, may or may not be gaining weight well, only sleeps in someone's arms or a carseat or swing, and would be described as having a "high-maintenance" personality. Babies who are well-rested, wake up happy, not crying. The more tired a baby is, the more fussy he or she gets. Remember that crying doesn't always signal that they need us to pick them up, cuddle them, or feed them. Sometimes crying is a signal that they're exhausted and need to sleep.

Those are just a few highlights, but hope it helps!
Dr. DuMond
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phoenix31674 responded:
So when my son wakes up in the night, should I check and change his diaper if required or just let him cry? We are looking at moving him across the hall to the guest room (he's 7 months now) from a crib in our room. i will admit the reason for feeding him during the night has been mostly to allow DH to get some sleep so that he can function at work. DD was an automatic and great sleeper, though her personality has been very different from DS's. He had colic and constantly had to be held the first 3 months. She was very independent and easy going. Now he does just fine playing on his own on the floor or in his activity center and actually sleeps quite well during the day for his naps (other than right now because he's teething) and he generally goes to bed quite easily for both nap and night time because I pay attention to the sleep cues he gives. But he won't sleep more than about 3 hours a stretch at night.

The only thing we've done different with the two of them is that DD would get a bottle to 'top her off' before bed and he has pretty much refused any bottle, though we are getting ready to start trying to push that again so that we can leave him with a sitter.
 
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MartinaWilliams responded:
I remember when i was having the same problem with DD when she was 4 months. You gave me the same advice and it worked!
Me (20), Bf (48) and DD,lilja born Nov.30.2010 . We Live in Jamaica for now :)
 
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Sara DuMond, MD, FAAP replied to MartinaWilliams's response:
Hi Phoenix31674! You are a such a valuable resource in this community and always give such well thought-out advice to all of our parents! I completely understand your nighttime tactic so far. Having him in your room certainly changes the dynamics -- spouses deserve to sleep too, and since those nighttime feedings have been a short-term solution, I understand that approach completely! Since you mentioned that you were thinking of moving him to a crib in a room across the hallway, this would be a perfect opportunity stop those nighttime feedings. Like I said in my post, he'll protest for sure, but try to think of it as an older child protesting to get candy at the check-out counter of a store. You wouldn't give in then, because you'd know that not only did your child not need the candy, it might actually be bad for him. The same is true for nighttime feedings. At his age, he doesn't need them for nutrition and growth, and it might actually be detrimental to him, since it can create an overtired baby and impact his interest in solids during the day. I am looking forward to hearing how things go with the move to the new room, and hope that you are successful with the bottle. Keep us updated!
Martina, I am glad to hear that the same advice worked for your DD when she was 4 months old! I would love to hear from other mothers who may have had similar experiences with getting their babies to sleep through the night.
Dr. DuMond
 
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MartinaWilliams replied to Sara DuMond, MD, FAAP's response:
Trust me, it was very hard. I mean she would cry and cry and cry and there were times when i was so tired that I wanted to feed her and let her fall asleep. But i stuck with it and it worked out for us. She now sleeps from 8 pm to around 5am and that is perfectly fine with us. Thanks so much Dr. DuMond.

Phoenix31674, I hope it works out for you also. Just be persistent and consistent. Good luck and keep us all posted
Me (20), Bf (48) and DD,lilja born Nov.30.2010 . We Live in Jamaica for now :)
 
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eliguns841984 responded:
Thank you for posting this! I took the same approach with both of my boys and they both slept through the night at about 6-7 weeks old. Of course, in the beginning I was careful to be sure they didn't actually need a feeding- I wouldn't ignore a small baby if I truly thought they needed to be fed. I have passed on basically the same advice that you have given here, but it's nice to get it from a doctor's perspective. A co-worker and I were talking about babies just this morning, actually. Babies who do not have health issues going on, IMO, will do what you teach them to do for the most part. So, if you want your healthy 4 month old to sleep in his own bed through the night, figure out what works for your baby and BE CONSISTENT!
Noel (26) DH (32) J.T. (7/23/2008) and Abram (11/08/2010)
 
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GermaphobeTeacher responded:
I am sure that this works great for some people, but it did not work for my daughter. She just turned four months, and she currently wakes once (usually around 5:00 am) to eat. She will refuse the bottle at night if she isn't hungry, just like she does during the day. She knows how to put herself back to sleep because she does it often during the night. I will hear her stirring, and then she quiets back down, so that is not a problem. I have discovered that if I let her cry for very long she starts rolling around in the crib until she manages to get a limb or two stuck out the slats of the crib or bumps her head on the side, and then she screams bloody murder, which wakes everyone up. I am not going to let her cry herself to sleep with her legs wedged in the crib slats (on her tummy, no less), so I go and get her (or at least move her back and give her a pacifier). I have also found several times that she has managed to pee her jammies or has a dirty diaper when she is crying in the middle of the night. If I had simply shut off the monitor (Which I would never do!), she would have had to lie in that all night. Yuck! Way to lose your child's trust! Despite having one middle of the night feeding, she always wakes up happy, naps well during the day, and eats plenty during the day. Our system works for us right now. We all get plenty of sleep, so I am not going to force the issue right now. I will probably try again in a month if she is still waking up, but she has gradually been sleeping for longer periods on her own.
 
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phoenix31674 replied to GermaphobeTeacher's response:
For the limbs stuck in the crib, look into the mesh bumpers. Babies can breath if they get up against them, but they keep arms and legs from getting stuck. They worked great with DD for a few months until she started getting up and over them, but it was infrequent that she would get caught in the slats with them on the crib.
 
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startingover57 responded:
EJ fits your description to a large degree. I would definitely describe him as a "high maintenance" baby, and sometimes it is draining to me. Not only am I in my 50's but I also have some health problems. I will say that my husband usually gets up with him at night. He always gets a bottle at those times. He is quite fussy much of the time, unless he has your full attention. We have a pack n play, a very nice bouncer activity seat, a swing, and an infant seat. Even so, he quickly grows tired of these. My husband sleeps in the room where the crib is. I sleep in the master bedroom. (We just sleep better alone} I can't put the baby in a room of his own, because we converted our small 3d bedroom into a home office. At this very moment, EJ is right beside me in his infant seat with toys and he is crying and trying to get out of it. And he just woke up from a nap and has been fed. I suggested to my husband that he try sleeping with me for awhile and implement your suggestions. Don't know if he is even willing to try it. He wouldn't even let me read him your suggestions. I have chronic fatigue syndrome, depression, plus other medical problems and sometimes I feel like I just can't take any more. If we could get him to a point where he could entertain himself for longer periods of time it sure would help. Despite the fatigue and frustration, I love him very much, and I definitely don't want him in the foster care system.
 
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GermaphobeTeacher replied to phoenix31674's response:
I bought one of the mesh bumpers, but then I was reading that they have not actually been safety tested, so I am a little scared to use it. She only squirms around and gets stuck if I let her cry, and I really don't believe in the cry it out method anyway. I gave it a try, and it didn't work for us.
 
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phoenix31674 replied to GermaphobeTeacher's response:
My safety test for the mesh ones was to hold it up to my mouth and I could breathe pretty well. It's not like having your face in a pillow. and truthfully, there are a lot of baby products out there that aren't tested or tested to a unified standard until there are enough reports of something going wrong - witness all the crib and stroller recalls. It really did cut down on her limbs getting caught so it was worth it to me. We'll use them with DS when we finally get a crib for him (long story involving moving and not buying furniture until after that)
 
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phoenix31674 responded:
Well night one of his own room was an utter failure. He did sleep from 8pm until 1:15 or so, so he did not wake up around 10:30 when I go to bed. DH nudged me he was awake and I decided to change his diaper and put him back down. after 10-15 minutes of wailing, I gave up and fed him. He went right back to sleep. Took me another 30-40 minutes to fall back asleep as I was haunted by the echoes of his screams.

When he got up again at 5, I let him cry for about 16 minutes and then went in to change and feed him. I'm sorry, but I just cannot let him scream like that.

I think I'm going to resign myself to the fact that I have a baby who does not sleep through the night right now - just like me as a baby. Neither one of us has been feeling sleep deprived with the previous schedule of waking and he naps just fine during he day and is a wonderfully happy baby. This may be an 'if it ain't broke' type of moment. Maybe if I feed him solids shortly before bed it will help. He's been getting solids earlier in the day because between 6 and 8 I'm focused on dinner and getting my DD to bed, leaving little time for anything other than breastmilk before i put him down.

I'll see how he behaves during the day and decide if we are going to try this again. I won't be rushing over to check on him in the night - mostly since with no monitor I can't hear any of the little whimpers - but if he's still crying after a few minutes, I'll go to him. I'd rather only be up for 5-10 minutes during the night than for a whole hour.
 
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mom2laurenmckenna responded:
I wish I had seen this advise 4 months ago so that I could have tried it then. My DD is 7 months and doesn't sleep through the night. She sleeps 3 to 4 hours at a time and I bf her each wake up. She always goes back down quickly. Since my DJ has sleep issues he sometimes sleeps in our room but sometimes in lo room which is also the guest room. Lo still sleeps in the bassinet in the master. I try to get her back down quick as to not disturb him.

I don't know how I could implement the Dr advice in this situation. I guess if I move lo to her room my DJ will not go in there anymore. Maybe we should try it.

She is mostly pleasant during the day unless she needs a nap and is fighting going down. She doesn't self soothe at all. I confess I use the swing and rides in the car to get her to nap often.

Any other thoughts or advice?
 
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eliguns841984 replied to phoenix31674's response:
Is there a reason you feel like you should change him overnight? Is he extra sensitive to diaper rashes and stuff? I just wonder if he would have made it longer had you not changed him. I mean, he may have still shuffled around a bit but might have just gone back to sleep if he hadn't had the diaper change to wake him further. Unless they have pooped, there is no need to wake the baby to change them. Diapers keep the moisture away really well. I would also suggest maybe instead of picking him up when he cries, go to him and pat/rub his back, stroke his hair, etc. Let him know you are there and give him a bit of comfort without picking him up for a couple of nights and see how that goes
Noel (26) DH (32) J.T. (7/23/2008) and Abram (11/08/2010)
 
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sarah0323 responded:
MY LO would sleep in bed with us all night but we were tired of her sleeping in bed with us. Last night she slept in her own bed all night long. Not sure if it was a fluke or maybe the start to her sleeping in her own bed but Emily slept all night. I still put her to sleep in our bed and then moved her to her bed. Tonight I'm going to try putting her down in her own bed for her to go to sleep there.

Thank you Dr. DuMond for your courage to try to get her to sleep in her own bed. Both her daddy and I woke up much happier than we have in a long while because we actually got a good nights sleep.
Sarah 32, SO 32, DD1 11, DS1 7, DS2 4, DS3 3, DD2 3 months


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