By Jan Murray

Infant sleep and its importance during a baby's first 8 weeks of life has been well researched and documented. Sleep is a basic need of survival and there are several reasons why this is true for both babies and adults.

•Increased immunity to fight disease and illness
•Increased ability to learn from being more alert and attentive
•Increased mental co-operation and co-ordination in movement which enhances personal performance
•A child has an increased ability to concentrate and play on their own
•Promotes the release of the growth hormone responsible for stimulating human growth and cell replication
•Good sleep establishes security which builds confidence, self esteem and self control
•When children sleep, parents are better able to sleep which increases their family relationships and work productivity

Sleep has always been a topic of concern for parents with a newborn baby and as they grow "sleeping through the night' can turn into a stressful competition among moms. However, a baby is an individual and there are a variety of reasons why they find it difficult to settle and sleep well.

Cycles and Rhythms
 
Everyone sleeps in cycles which flow in and out of active and passive sleep phases within a given time period. A newborn sleep cycle rotates every 20 - 30 minutes, which means every 20 - 30 minutes they experience a light period in their sleep. This is when sleep issues often arise.

Human beings function with an internal "body clock" known as a Circadian Rhythm. This is what causes the natural peaks and troughs in alertness and tiredness over a 24 hour period. This rhythm is disrupted with shift work or the parent who is up frequently overnight with a wakeful baby. The Circadian Rhythm is not usually established until after 6 weeks of age which explains why some babies will wake regularly at night and want to sleep during the day.

It is helpful for a parent to assist in establishing their baby's rhythm to ensure restful nights as quickly as possible. This is done by waking a baby for milk feeds every 3 to 4 hours during the day if they are not waking themselves. By doing this it will lessen the need for them to wake frequently throughout the night. When they do nurse at night keep it quiet and dark with minimal fussing and get them back into bed as soon as possible.

A newborn will generally need 15 - 16 hours of sleep out of every 24 which is broken into 4-5 short naps of 1 - 1 ½ hours during the day and 2 longer periods overnight. Naturally there are always exceptions where some babies will happily develop on less or more sleep. During the first 2-3 weeks a baby will often just wake to feed and then go straight back to sleep but after 3 weeks there is a need to establish a wakeful period for sensory development and exercise before going back off to sleep. It is at this age that sleep issues may start to arise.
The naturally developing cycles and rhythms will be challenged when a baby's physical needs of food, comfort and security are not met.

A parent has several choices to ensure a baby's physical and psychological needs are met and settled sleep is obtained. Understanding some of the above facts on sleep and crying will help a parent to make the right choices for their family.

The amount of advice available both solicited and unsolicited can be overwhelming for a new parent. Elizabeth Pantley, 2002 writes in her book the no-cry sleep solution "Newborn babies do not have sleep problems, but their parents do. Newborns sleep when they are tired and wake when they are ready". This is true in some cases but certainly not all. In fact, there seems to be no blanket rule for ALL babies.

Waking at Night

There are several reasons why babies wake at night
1.Unestablished Circadian Rhythm.
2.Hungry, as their "tummy" does not hold enough milk to satisfy them longer than 4 - 5 hours.
3.Misunderstood parent perception of what night waking is. Waking at night between 11pm and 5am and the regular grunts and whimper sounds throughout the night are not considered waking. 4.Discomforts, such as bloating from an intolerance of lactose in breast milk or formula, burning pain in their chest due to reflux, gas pain due to immature digestive system, too hot, too cold, or a wet or dirty diaper.

Suggestions to help your baby sleep at night
 
•Ensure that your baby is fed at regular intervals throughout the day.
•Before bedtime, change your baby's diaper, put on diaper rash protective cream and swaddle them in a 100% cotton wrap when they show tired signs.
•Play some "white noise" to drown out the sounds of other children and loud sudden noises.
•Hold them in your arms until they are relaxed but not after their eyes close. Place them on their back in your chosen sleeping area allowing them to achieve the final stage of falling asleep on their own. Sleep patterns and associations are established at an early age. While most sleep associations such as cuddling, nursing and co-sleeping are peaceful and comfortable at this stage, this may not be so in several months when your baby is bigger and more alert and you are more tired.
•A newborn does not need to cry themselves to sleep, instead they need to feel loved, comforted and secure. If they do not go off to sleep when they are placed in their sleeping area and begin to cry, repeat the process and try again. If they are not asleep after 20 minutes of doing this hold them until they are asleep.
•When they wake during the night nurse them as quickly as possible before they start crying and get them back into bed. You don't have to change their diaper or unwrap them if you don't need to. Keep lights low and remain in a sleepy state yourself, that way you will both get back to sleep easier.
•If you co-sleep sit up and feed them so that you know they are getting a substantial feed. Nursing off and on all night can be gentle and pleasant in the early weeks but it will be setting up a strong association that can get tiring and difficult for both of you in the months ahead.

Day Sleeps:

Sleep promotes sleep and it is a fallacy to think that if you keep a baby awake all day they will sleep better at night. The reverse is actually true.
In these early weeks a baby is very portable and can usually sleep in any room. It is very important to watch for their tired signs and anticipate that they will occur. At this early age tired signs begin about 1 - 1 ½ hours after they wake.
A newborn will usually wake themselves with hunger, therefore nurse them straight away. You can always change their diaper part way through the feed. This will wake them up if they are falling asleep to ensure they complete a full feed.
Some babies during their first 2 weeks are sleepy day and night. If you have a sleepy baby during the day, ensure that you wake them for a feed every 3 hours. This will help them establish their day/night rhythm as well as providing them with the required nutrients for growth.
Babies love to suck; therefore a pacifier can come in very handy. If your baby stirs and wakes after only 20 minutes of sleep, use the pacifier to encourage them to go back to sleep for another cycle. Be conscious of not using it if they are due for a feed.

If you feel you have tried everything to help your baby settle and sleep but nothing seems to be working; they are not contented and happy and you are exhausted, then it is time to seek individual professional help. Your baby relies on you to be functioning well and not be exhausted from lack of sleep. By getting professional help early; a diagnosis can be made and sleep can be regained within a couple of days and will allow your baby to sleep well.

Jan Murray has studied and worked as a Registered Nurse, Midwife and Child Health Nurse for over 25 years. Jan is a mother of 5 and co-founder and director of Settle Petal - http://www.settlepetal.com Through her business Jan provides information and support for parents to develop their knowledge, understandings, skills and attitudes needed to maintain and enhance personal health and physical development of all members of their family.