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How soon can I get my new infant to sleep?

Dr. M. Douglas Becker, M.D.
Hagerstown, Maryland May 2005

PART I

A baby's sleep pattern relates to their feeding schedule. They go to sleep when their tummies are full and wake up when empty. Even a large feeding of mothers' milk or eight ounces of formula will be digested within four hours. But, infants are highly adaptable. They can overcome that hollow feeling and sleep longer. There is no harm if a term full-size baby decides to sleep beyond empty, even eight hours or more, very early so long as he or she is feeding and gaining normally. Your job as parent is to shape the pattern to include a long stretch during the night.
If your child is premature or small or slow to gain, wait to start the extension of sleep until about eight pounds. Do not try this with an infant who has health problems unless your pediatrician gives you the go-ahead.

Fresh out of the womb, an unpredictable schedule is the rule. Normally, the young infant will sleep two to four hours and then need that feeding. The newborn typically requires several weeks to achieve consistency and predictability, but should have it well established by six weeks. At two months your baby's schedule should include a consistent bedtime feeding followed by four hours of sound sleep, wake to feed and sleep about another four hours. That means waking once! Make bedtime hour fit into the routine of your family, whatever that is. Ten p.m. baby bedtime is the most commonly used. A feeding should take no longer than thirty minutes. Middle-of-the-night feedings are "strictly business." Finish eating, change and back into bed! By six months a normal, healthy child does not require an overnight feeding. Period! Therefore, over the span from two to six months the first sleep interval will extend from about three hours to nearly eight hours. Some really good sleepers consistently go ten or twelve hours without refueling. For example, the baby will drain a full milk feeding (bottle or breast) plus some solid foods and slumber from seven p.m. to seven a.m. Now, how would you like that? It can and should be attainable by any healthy, normally growing, six month old.
Most infants have begun daytime solid feedings by six months of age. This may be helpful but it is not required to ensure sleeping-through.

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PART II

Here's how to make good overnight sleep happen in your household. Believe me, this will be worth the effort because; an infant who sleeps well will grow into a child who sleeps well. Always smile. Each time upon waking and before going to bed, your child should experience your best, most genuine smile. That reassurance imprints a measure of joy on the bedtime/sleep routine. Begin with the expectation that your baby wants to sleep through, since their body needs uninterrupted sleep. Also, every individual appreciates privacy and lack of disturbance while they are asleep. You do feel that way about your own rest, don't you? By two months, your little one needs to be in a quiet private area with minimal or no light. Station the baby bed in a room alone or an enclosed corner of some other room. It should be far enough away from other sleepers, yourself included, that minor noises do not disturb either. I do not recommend infant monitors. (The catastrophic events are silent!) Place baby in bed, drowsy, at the appointed time. If the infant is already asleep, you may leave. Stand by touching your child for up to five minutes, and then leave the area. Do not immediately respond to crying if it occurs. Allow fifteen minutes for settling down. If your child continues to cry, I recommend approaching the crib and place a soothing hand on the baby to assist calming down. Avoid holding the child. Once your infant is asleep do not allow yourself to go back to "check on things." Get your rest!

Know how long your child should stay asleep. If waking occurs earlier than that hour, wait for several minutes. The delay gives baby a chance to resume sleep. This is where it is handy to have the infant sleeping alone. Your expectation at two months is four hours; at six months, eight hours. If you cannot wait the entire time, keep notes and extend each successive night by five to ten minutes until your child reaches the desired time. This operation is like paint drying. It requires patience.

PART III

Crying, which is a normal component of this process, will do no physical or psychological harm to your child. In fact, the child learns patience by adapting to the overnight sleep schedule. You will probably experience less crying at other times and a more predictable daytime feeding/napping schedule. Most parents tell me that they cannot tolerate crying. That hearing their child cry is painful. My reply is connected to the fact that crying is really the most powerful way an infant communicates with you. They quickly learn to get your attention by crying. And, they enjoy the ability to manipulate you with their power. As you analyze your infant's crying patterns, look for the elements of a power struggle. I tell you that this one is just the first in what will be a long relationship between child and parents, with many such battles of will. You want to win this one and your strategy is simple: Leave the dear one in bed to cry it out! There will not be a traumatic event, no emotional scarring, so long as you understand that you are extinguishing an unreasonable demand.

So! Expect your infant to sleep well. Begin the scheduling around two months of age. Feed plenty at all feedings but end the feeding within thirty minutes. Give your child privacy while in the crib. Work with the model or four hours of sleep by two months and all night by six months. Accept some crying. And, smile because you love your baby and you know that your baby will respond by sleeping through the night.


© Anurag Sharma