I have yet to meet an infant that has truly slept through the night. I was taught in medical school that all infants wake in the night, yes, even those whose parents claim they have been sleeping through the night from day one. It is a natural function of sleep to awaken, be active, adjust and then fall back asleep. The difference is that there are signalers and non-signalers. Signalers are those babies who let the parents know that they are awake. Of course, all babies are signalers in the beginning and often they are reversed and sleeping more during the day and less at night. The non-signalers are those babies, either through efforts of training or naturally, don’t signal and drift back off to sleep.
It would be amazing if all babies would just naturally learn to self soothe and fall back asleep in the night. It is clear that there is not one-size-fits-all approach to helping your baby achieve such sleep magnificence. There are many variables that play a part in this including the need to feed your infant in the night to keep them growing. Yes, some women can make breast milk that seems to exceed the typical calories per ounce and sustain the infant through the night via multiple feeds in the day. However, the vast majority of breast milk is about 20 calories per ounce and therefore the vast majority of infants need about 8-10 feeds per day spread out through the 24 hours, which of course includes the night. As infants grow so do their stomachs and they are able to tolerate more volume in one moment and gradually do not need nighttime feeds.
There is also not a one-size-fits-all approach to sleep training. There are work schedules and living situations and siblings and special needs and fathers that snore that can all affect in one way or another an infants sleep. Each family has to decide for themselves what they are capable of doing to help their infant learn to sleep based on their own circumstances.
Sure they’re methods like unmodified extinction, crying it out without interventions, or graduated extinction, “Ferber” method of simple repeated interventions to remind the infant that parents are still there and aware of their needs. Beyond these, they’re any number of approaches to sleep training and one or a few of them would work to help your infant self soothe. As you navigate this world I would suggest the following ideas.
First focus on connection. The age old concept that you cannot spoil a newborn is absolutely true! As you the parents adjust to the new home life with a newborn and as mothers recover from delivery, focus on connecting with that newborn. Love them, kiss them, sing to them, talk to them, hold them close, read to them, feed them, change them, bathe them. I know many of these things come naturally but they really are essential for the emotional development of the newborn and emotional availability of the parent. As you connect to your infant you will start to recognize cues of their needs, specific cries for specific reasons and eventually some wonderful emotional reciprocity from your baby like a smile or a giggle or coo.
Next focus on safety. If you are not familiar with the updated guidelines for safe infant sleep then become familiar. The link is https://www.cpsc.gov/s3fs-public/AAP_Sleep%20Death%20Policy%20Statement%202016.pdf
We still recommend infants sleep on their back and in a separate sleep space compared to their parents. We still recommend to avoid any smoke exposure and for the mattress to be firm. The guidelines have additional recommendations that are worth your review to make sure you are doing all you can to keep your baby safe when they sleep.
Finally, I recommend that you as the parent consider your own personality type and your own emotional strength/mental health before you set out to sleep train your baby. If you are one that struggles to hear your baby cry then maybe that extinction method, crying it out, is not the best method to pursue for you and your baby. Don’t misunderstand me, we all tend to have empathy and strive to address the needs of our babies when they cry but some of us it affects just a little deeper, even pains an individual to listen to them cry. If you are one that actually sleeps better hearing your babies breathing in a bassinet in the same room, then maybe you don’t move your baby to their own room at 6 months. Maybe the crib eventually takes the place of the bassinet in the master bedroom.
As your pediatric providers we have ideas and we can feed you the ideas. We also have resources including other experts who specialize in infant sleep and we can refer you to them as you need. So please come to us with those concerns or questions and we can get you started but first focus on the three recommendations above. Again they are focus on connecting to your baby, learn about baby sleep safety and do some introspection on your own emotional availability to help you decide what method works best for you and your precious child.
We are Thrive Pediatrics, caring for Idaho’s future today.