Five Steps to Get Your Baby to Sleep Better

The Baby Sleep Book : The Complete Guide to a Good Night's Rest for the Whole Family
by William Sears, M. D., Martha Sears, R. N., Robert W. Sears, M.D.

For every parent who has ever been deprived of sleep by a restless infant or toddler, now there's hope. The Baby Sleep Book is the comprehensive, reassuring, solution-filled sleep resource that every family will want to own.

Babies don't automatically know how to sleep through the night; they need to be taught. The Searses have learned from decades of pediatric practice, bolstered by their own parenting experiences, that different babies have different nighttime temperaments - and, of course, different families have different lifestyles. In The Baby Sleep Book, instead of espousing the "one method fits all" approach advocated in other baby sleep guides, the Searses explain how you can create a sleep plan that suits the needs of your entire family.

With a sharp focus on the practical tools and techniques that you can use in a wide variety of sleep situations, The Baby Sleep Book covers such topics as:

• the facts of infant sleep vs. adult sleep

• figuring out where, when, and how your child sleeps best

• fail-safe methods for soothing a crying infant

• how to make night nursing easier, and how to stop

• nighttime fathering tips

• whether cosleeping makes sense for you

• naptime strategies that work

• medical and physical causes of night waking

• sleep habits in special situations such as traveling, teething, and illness

Like all the books in the highly popular Sears Parenting Library, The Baby Sleep Book is clear, comforting, and uniquely authoritative. Its flexible, sensitive approach to solving babies' sleep problems distinguishes it as definitive - an unrivaled book that offers immediate results.

Chapter 1

YOU ARE PROBABLY THINKING, Wow, it's only the first chapter, and the authors are getting right to the point—five ways to get my baby to sleep better! We've arranged the book this way because we assume that you are a tired parent who needs help right away, and you are probably too tired to wade through a lot of facts, theories, and introductory material.

But here's the deal. To get these five steps to work really well for you and your baby, you need to understand more about how babies sleep. They fall asleep and stay asleep differently than adults do. It's important for you to know about this so that your expectations for your family's nightlife are realistic. So, as you put the five steps in this first chapter into action, please read further into this book. The better you understand your baby's nighttime needs, the better everyone in your family will sleep.

This first chapter has many ideas for you to use at bedtime and in the wee hours when baby awakens. These steps will help your baby fall asleep more predictably and go back to sleep faster. Your baby may or may not be ready to sleep through the night, but we promise you that the advice we offer in this chapter will help you develop a plan so that you can all get a better night's sleep.

Here's a preview of the five steps in this chapter:

1. Find out where you and baby sleep best.

2. Learn baby's tired times.

3. Create a safe and comfortable environment conducive to sleep.

4. Create a variety of bedtime rituals.

5. Help baby sleep for longer stretches.

One precaution: If your baby is a newborn (less than two months old), do not jump into this sleep plan or any other sleep plan. Newborn babies are not ready to learn more mature sleep patterns. At this stage, getting to know your baby in a relaxed, intuitive way is more important than establishing a set routine for sleep. Getting attached to your baby in these early weeks will make nighttime parenting easier in the months to come.

Be aware that not everything we suggest will be right for your baby. We don't like parenting books that tell parents, "This is how you have to do it. This is the only right way. Tough luck if it doesn't fit with your own ideas or your baby's personality." We believe that parents who know and love their baby are the best judge of how to care for that baby. This is why it's so important to first get attached to your baby. That way, you'll have the wisdom to know what's best for your baby. In this book, we will give you lots of strategies to help your baby develop healthy sleep habits. Which ones you choose depends on your baby's unique sleep temperament.

So let's get started—and here's to a good night's sleep . . . finally!

Step 1. Find Out Where You and Baby Sleep Best

Where will your baby sleep best? With you in your bed? In a co-sleeper, bassinet, cradle, or crib next to your bed? In a crib in your room? In a crib in his own room? Where do you sleep best? Where do you want your baby to sleep?

Realistically, be prepared to play musical beds with all of these sleeping arrangements as you try to figure out where everyone gets the best night's sleep. And expect these sleeping arrangements to change at various stages of your baby's development. The only persons who can answer the question "Where should baby sleep?" are mom and dad. Listen to what your baby and your inner voice are trying to tell you!

Perhaps you have a new baby (or will have soon) and you are trying to decide where baby will sleep. Or maybe your current sleeping arrangement is one of the reasons you and your baby are not getting a restful night's sleep. Whatever your situation, let's explore your three options:

1. Baby sleeps alone in her own room. This is the traditional picture that many first-time parents envision for their babies. As you flip through baby magazines and furniture catalogs, you see pictures of smiling parents (who look like they've had plenty of sleep) placing their baby in a crib or cradle in the corner of a beautifully decorated nursery with the evening sunset filtering through the drapes. The parents gaze happily at their baby, who smiles up at them. You imagine that this is how your baby will go to sleep, too. You'll pat her little tummy, kiss her on the cheek, and say "night-night." She'll close her eyes, you'll tiptoe out of the room, and you and your husband will enjoy a nice quiet evening together. Your baby will sleep peacefully the whole night through.

Sounds like a fairy tale, doesn't it? Will it all come true? Eventually, but not in the early months. Most, if not all, younger babies need more out of their parents at bedtime than this magazine picture suggests. This is "quality time" for babies. They often do not willingly succumb to quick-to-sleep methods.

Will this sleeping arrangement work? It may work for easygoing babies. Mellow babies tend to fall asleep more easily and awaken less often at night regardless of where they sleep. Some of you parents-to-be are nodding your head. "Yup, that's the kind of baby we are going to have, right, honey?" Yet many of you have already discovered that you have been blessed with a baby who is going to need more nighttime closeness than this distant arrangement offers.

Those of you with crib sleepers are probably in one of two situations right now: (1) your baby had been sleeping well in a crib for months but is now waking up too often, or (2) you have been trying to get your baby to sleep in a crib for months, but she has never slept well in the other room, and you (and she) are tired.

You have two choices. You can either continue to try to teach baby to sleep well in the crib, using the rest of the steps in our plan, or you can explore some other options for where baby will sleep.

Why doesn't your baby sleep well in a crib in her own room? It may be that teething or another temporary physical cause is suddenly rousing her at night. We discuss many such causes of night waking in chapters 3 and 12. But there may be much more to this picture. If your baby has never slept well alone, and nights of stumbling down the hallway to rescue your crying baby every two hours have taken their toll, it may be that your baby is trying to tell you that she needs more nighttime comfort and closeness.

"But our baby sleeps just fine through the night in her own room," your friends may tell you. Every baby has a different personality. Some needier babies simply need more of their parents day and night. On pages 73 to 75 we discuss infant personalities and temperaments and how they relate to baby's nighttime needs. It's time to lose the magazine fantasy and figure out on your own

what is best for you and your baby. If we

had to pick the single most important message of this book, it would be this: Trust your own instincts and make your own decisions about what is best for your individual baby and you.

2. Baby sleeps in your room but not in your bed. This is a common sleep setup for two types of families: those who are living in a one-bedroom apartment (like medical resident Dr. Bob when his second son was born—four people sleeping in one room!), and those who want their baby close by (but not so close that baby's tiny feet are kicking them in the ribs). Maybe you want baby nearby simply for convenient nursing, because baby wakes up several times each night. Or perhaps your baby is a great sleeper, but you prefer having baby sleep near you for your own peace of mind.

Having baby in your room has these advantages:

• When baby wakes, he is within arm's reach or just a step away from you.

• You can get to baby quickly to rock or nurse him back to sleep before he fully wakens.

• If you wake up, you can easily check on baby to reassure yourself all is well.

• You are close to baby, yet you and your spouse have the bed to yourselves.

• Baby enjoys a sense of security.

• You can easily bring baby into your bed to nurse back to sleep, so your comfort is less disturbed.

Of course, there are possible disadvantages as well:

• If you are a light sleeper, you may find yourself disturbed by every sound that baby makes.

• Baby may grow accustomed to your proximity and may wake up more often because there is something to wake up for (nursing) and someone to wake up to.

Here are some common options for finding a safe place for baby to sleep in your room:

The Arm's Reach Co-Sleeper. This is as close as you can get to having baby nearby but not technically in your bed. With the co-sleeper, you can truthfully tell your in-laws, "No, our baby is not sleeping in our bed with us." Since baby is on a separate mattress, he won't feel your every movement, and you won't feel his. You and your spouse can enjoy your intimate space. It also gives you instant access to baby when he wakes (he's within arm's reach), so you can move close to him and nurse or pat him back to sleep before he fully wakes up and cries. (Visit www.armsreach.com and see page 127 for an illustration of the co-sleeper.)

Cradle or bassinet. These baby beds have the advantage of being right next to your bed, but they don't offer the convenience of easy-access nursing, as the co-sleeper does. Cradles and bassinets are portable, however, so you have the flexibility of seeing if baby would sleep well in his own room, too.

Amby Baby Motion Bed. This baby hammock is like a soft-bottom cradle. It hangs from a spring inside a steel frame, so every time baby moves, the spring gently moves, often lulling baby back to sleep. It, too, has the advantage of being portable, so baby can sleep in any room of the house. It can sit right next to your bed, providing you with easy access to baby at night. (See page 25 for more about this new sleeping tool and how it can help fussy babies sleep more comfortably.)

3. Baby sleeps with you in your bed. Some of you reading this book may be finding that your baby thinks being in the same room with you just isn't close enough. Baby needs to feel you right next to him, and if he doesn't, he wakes up. Or perhaps your baby isn't even born yet, but you've decided that you want to sleep with your baby right from the start. You may feel, "After all, she's a baby. She's been close to me for nine months." Or maybe you are just getting to know your newborn, and you aren't yet sure what you want to do. You may also have encountered this situation: When you put your baby in the crib, he wakes up a lot, but as soon as you bring him into your bed, he sleeps better—and so do you. Baby is trying to tell you something: "For my well-being I need to sleep closer to you." So, what do you do? You co-sleep!

Sleeping with your baby has some unique advantages:

• You can nurse baby back to sleep while you fall easily back to sleep.

• Baby can fall back to sleep more quickly because you can comfort him before he fully wakes up—and before you fully wake up.

• Baby may sleep longer and better because you are nearby.

• Baby benefits from eight extra hours of closeness each night.

• Working parents get extra "touch time" with baby.

• Studies have shown that even though sleep-sharing babies wake up more to nurse, co-sleeping mothers actually get more restful sleep than moms who don't sleep with their babies.

However, these very advantages can turn out to be disadvantages (depending on how you look at them):

• Baby may actually wake more frequently because he feels you nearby.

• Some parents don't sleep well with a baby in their bed. They want their baby close, but not that close.

• Mom may sleep great with baby, but dad may be a light sleeper who can't get used to the extra presence in the bed, so dad may not sleep well. This may prompt dad to find another room to sleep in (such as the pastel-colored nursery that he painted for the baby).

• Once baby gets used to sleeping with you, he may not want to give it up. For some people, this is an advantage because they welcome this long-term bonding arrangement. For others, co-sleeping may go on longer than they would have liked.

You may have enjoyed sharing sleep with your baby, but now one or all of these disadvantages are interfering with your sleep. If your co-sleeping baby is waking up too often, you can either choose to keep baby in your bed and work through the other steps in our plan or you can consider the other options for where baby may sleep.

Deciding about co-sleeping isn't as simple as weighing a short list of pros and cons. Co-sleeping is part of an attachment-parenting style that can be rewarding for families in many ways. Because most parents sleep with their baby at some time in the first couple years, we will later go into detail about sharing sleep with your baby and how to decide if it is the right arrangement for you.

4. All of the above. Most families play musical beds during their child's early years and juggle bits and pieces of all of these sleeping arrangements. For example, baby may start off in a separate bed or room and then move closer to mom sometime during the night. Remember, it's about what's best for you and your baby, and about adapting to everyone's changing nighttime needs.

Now let's move on to step 2.

Step 2. Learn Baby's Tired Times

When opportunity comes yawning, don't miss it! Watch for signs of drowsiness. Try to catch your baby by the third yawn. Observe her need-to-go-to-sleep signs like you do her hunger cues. When babies begin to show signs of being tired, there is a ten- to fifteen-minute window of opportunity in which they will fall asleep fairly easily. If you miss this window, the tired baby may get progressively more cranky and revved up as she gains the proverbial "second wind." Even though baby is growing more tired by the minute, this cranky mood makes it harder for her to relax and fall asleep.

It's important to figure out when your baby is most likely to be tired so that you can know when to begin your baby's bedtime ritual (see more about bedtime rituals below). If you wait until baby is actually showing signs of being tired and then give him a bath, put on his jammies, feed him, and rock him to sleep, the tired time will be over and baby will be revved up and ready to rock and roll for another hour. A better strategy is to begin the bedtime routine twenty or thirty minutes before the expected tired time. That way, baby will be feeling sleepy just as you get to the part of the bedtime routine when he is supposed to fall asleep. What's more, since sleepy feelings will begin to creep over baby as you go through the bedtime ritual, he will eventually learn to associate these drowsy feelings with his usual bedtime ritual.

A prompt response at tired times is especially important for energetic, alert babies and toddlers who fight sleep. The baby or child who is tired but who is resisting going to sleep is trying to tell you, "I don't know how to relax. Please help me!" The longer he fights it, the harder it gets. If you can jump in and ease baby off to sleep before he starts to put up a fight, he will go to sleep more easily and stay asleep longer. He will also learn to associate these first signs of being tired with going to sleep immediately—both at nap time and at nighttime.

As soon as he seems tired, I pick up on his cues. I talk very softly, hold him, nurse him, stroke him (but not in a stimulating way), and gradually lower my voice and slow down my lullaby. This is his cue that sleep is expected to follow.

Charting your baby's tired times. On the chart below, write down baby's tired time every evening for one week. Do you see a pattern? Does your baby get sleepy around the same time every night, give or take fifteen to thirty minutes? Most babies have their natural sleepy time between 6:30 and 7:30 p.m. if they routinely take a nap in the early afternoon, and around 8:30 or 9 p.m. if a late-afternoon nap is the norm.

Or does your baby get sleepy at times that vary by more than an hour? If so, your baby's internal clock may not yet have developed a routine sleepy time, especially if he's still quite young. Or it may be because baby's nap times are not yet consistent. Also, your family's day-to-day schedule may not be predictable.

If your chart is not showing a predictable evening sleepy time after one week of observation, continue charting for another week. Be sure baby's naps are on a fairly routine schedule. If you still don't find a routine evening sleepy time, you may need to focus more on nap scheduling. In that case, skip ahead and read chapter 9, Nap-Time Strategies that Work. It takes effort to get a baby on a nap schedule. It may be easier to let baby nap whenever he happens to, but in order to establish a predictable sleepy time in the evening, baby needs to take naps at predictable times as well most of the time.

Changing your baby's tired time. If you have determined your baby's tired time is around 7:30 and you want baby to have an early bedtime, then you're all set. But what if your baby is happily wide awake at 7:30, at 8:30, even at 9 p.m.? What if your baby doesn't act tired until 10 p.m.? You can either accept this and help baby fall asleep at his natural time or you can try to change it. If you want your baby to be in bed earlier in the evening (for whatever reasons), put baby down for a nap earlier in the afternoon. You may enjoy having baby's company at night, especially if you are away from your baby during the day. In this case, don't worry about working on an earlier bedtime. What if you would rather have your baby stay up late with you but baby is always tired by 7:30? Again, you can adjust baby's afternoon naps.

To summarize, find your baby's predictable tired time and schedule your baby's naps if needed to get a more predictable bedtime. Start your bedtime ritual about thirty minutes before tired time, and baby will eventually learn to fall asleep easily and predictably.

Copyright © 2005 by William Sears, Martha Sears, Robert Sears, and James Sears

About the Author

William Sears, M.D., received his pediatric training at Harvard Medical School's Children's Hospital and Toronto's Hospital for Sick Children. He has practiced as a pediatrician for more than thirty years.

Martha Sears is a registered nurse, childbirth educator, and breastfeeding consultant.

Robert Sears, M.D., earned his medical degree at Georgetown University School of Medicine. Having had the privilege to help raise three active boys, "Dr. Bob", as he likes to be called by his little patients, has grown fond of the "parenting" side of pediatrics. He has appeared on the Dr. Phil show to offer advice on child behavior and parenting issues. He has also appeared on the Ellen DeGeneris show and has appeared on CNN's House Call with Dr. Sanjay Gupta to offer advice to first time fathers. Dr. Bob is a regular guest on "A Place of Our Own" on PBS, helping parents and caregivers understand a variety of child health issues.