Sleeping like a baby

Sleeping (or not) is one of the most confusing aspects of parenting a child.  Whether they are one week old or four years old (not to mention the teen years) our cultural expectations of children and their sleep patterns rarely match up with the reality of our own children.

The primary reason for night waking in children under a year or two of age is hunger.  Your baby’s stomach is tiny.  A newborn has a stomach the size of a marble.  From about day 7-10, it is the size of a ping pong ball or a walnut.  It remains this size until around the middle of the first year.  Even after the introduction of complementary foods, your baby’s primary source of nourishment will be breastmilk until after the first year.  Babies need calories at night.

Until after the first year breastmilk is their primary source of calories and nutrients even if they eat a lot of solids. Even well into the second year and beyond, a toddler who is breastfed takes in almost 30% more calories a day than their non-breastfed counterparts. Those are calories they need and use for their rapid brain growth in the second year.

So, babies and even toddlers do need to wake up at night to eat, but their sleep patterns vary dramatically, from baby to baby and week to week.

Reasons for Increased Night Waking

*Growth Spurts:  Babies will nurse more right before a growth spurt.  Mothers are often told about the 2-3 week growth spurt and the six week growth spurt, but they happen at other times as well.  Your milk has higher fat content at night and your prolactin levels are higher at night, so night nursing actually stimulates your milk supply even more than nursing during the day.  Prior to a growth spurt, babies will nurse more night and day to stimulate your production to meet their growing needs. Even older children will eat very little for weeks and then suddenly be hungry all the time right before they grow.

*Developmental milestones:  It’s like our babies are practicing their new skills in their sleep – sitting up, crawling, walking, climbing etc. Many children started to wake more right before hitting another milestone.  This is even true of older children, who might have more need for night time parenting when they are going through a big shift in their development.

*Getting sick: Often our babies will nurse quite a bit more day and night right before they get sick.  Their little bodies are arming themselves to fight whatever bug they've been exposed too, but we often don’t realize it until the illness sets in.

*Teething:  One of the most common causes of night waking.  Often it starts when the teeth are pushing out of the bone, long before the first tooth erupts.  Nursing has analgesic effects and decreases the sensation of pain by 95% so it makes sense that they want to (and need to) nurse when they are hurting.  Teething returns with the arrival of adult teeth.  Crankiness often appears in the child expecting their 6 or 12 year molars (do you remember getting your wisdom teeth?)

* Over-stimulation:  Going too many places, seeing too many people can often lead to more night waking. It's not always avoidable, but it can help to know that when you've been at a family reunion, out on errands all day, at your own baby shower or at playgoup your baby isn’t suddenly broken, s/he’s just had more than they can process and needs to reconnect.

*Wet diapers or the need to pee:  We often overlook this, but babies can be quite squirmy when they need to pee or have a wet diaper. Sometimes it makes sense to change them at night as quietly and gently as possible.  Some parents, who practice Elimination Communication (EC), find that this can help with naps as well.  You can find out more about EC in the Winter 2011 issue of Birthing Magazine and at www.diaperfreebaby.org.

*Temperature: Babies will wake more when they are too cold or too hot.  The change of seasons brings changing temperatures even in our bedrooms. Babies are often overdressed, but sometimes they are underdressed.  You’ll need to check with your own baby, but think about how warm/cool their sleeping environment is and how they are dressed.  If you are co-sleeping, your body will help them regulate their temperature and they won’t need to be dressed as warmly as they would be in a separate sleeping environment.

*Allergies: Sometimes extreme night waking can be caused by food sensitivities. This situation is usually extreme and it’s important to rule out everything else and be aware of normal infant sleep patterns before jumping to allergies as the culprit.  If you do suspect allergies, the most common culprit is dairy, but it can be anything.  Make sure to rule out other options before embarking on a food elimination program.

*Mom’s absence or return to work outside the home: Little ones will likely nurse quite a bit more in the evenings and at night when you have been apart during the day. If you need to be apart regularly, due to paid employment or for other reasons, this will continue regularly and is sometimes called reverse cycle nursing. This makes up for the time you’ve spent apart, not just nutritionally but also emotionally.  However, it can be exhausting. Some mothers find co-sleeping particularly helpful in this situation.  (Two good books on breastfeeding and paid work are: Hirkani's Daughters by Jennifer Hicks and Nursing Mother, Working Mother by Kathleen Huggins and Gale Pryor)

* Comfort:  Babies nurse at night for comfort.  You are their eco-system, their home-base. You invited them to join you in this world and they rely on you as their compass as they find their way.   If they can return to you when they need to, they are more confident as they go out and explore the world.  Breastmilk has high levels of tryptophan which helps your baby go to sleep and go back to sleep. The prolactin level spikes that happen while breastfeeding also help make mom sleepy. Nursing to sleep isn’t a “bad habit” it is how we were designed.

What are some strategies for getting more sleep?

*Co-sleeping: Although often discouraged in our culture, our babies and young children are designed biologically to stay close to us while they are sleeping.  When your baby is right next to you, s/he doesn't need to wake up as much to let you know s/he needs you and you can stay horizontal and nurse lying down. Also your sleep cycles sync up so you both wake up out of light sleep instead of deep sleep. Many parents find that they get a lot more sleep that way.  It is important to follow safe co-sleeping guidelines and it doesn’t work for every family, but bringing your baby to bed with you can mean more sleep for everyone.  A great resource of mother-baby sleep, including safe co-sleeping guidelines is Dr. James McKenna’s Mother-Baby Sleep Lab.

Even older children often don’t like sleeping alone.  Bedtime can be a significant challenge for parents long past infancy.  It’s important to realize that our children are born with instincts designed to keep them alive in much more hostile environments.  For most of human history, a child who slept alone would have been food for predators.

*Babywearing: Daytime babywearing seems to improve night-time sleep for many parents.  This makes sense if we look at the kangaroo care literature where premature infants demonstrate more organized sleep-wake cycles throughout infancy if they received kangaroo care in the NICU. There is also related research that demonstrates that babywearing significantly reduces infant crying particularly in the evening.

You can find out more about Babywearing in the Summer 2010 and Winter 2011 issues of Birthing Magazine and at http://thebabywearer.com/.

*Nap with (or without) your baby:  This become more difficult when you have more than one child, but it is a luxury worth taking advantage of when you have the chance.  The dishes and laundry will wait.  When you are tired, you need to sleep.  Napping with your baby can be enjoyable and restful.  Sometimes when you’ve been up all night and baby isn’t sleepy, having a trusted caregiver take the baby for awhile can allow you to get some much needed sleep.  Meeting our own needs is challenging when we have young children, and we learn quickly that many things are non-essential.  However, it is crucial that we take care of ourselves in those few things that are important, including sleep. We are much better and happier parents if we aren’t burnt out.

There are always times in our parenting journey where sleep is elusive.  Hopefully some of this information will help you get a little more rest or at least understand why you are getting so little sometimes.  Hopefully it also helps you relax and enjoy your little ones more.  Take what works for you and trust your instincts, you are the expert on your child and you will find your way together.

A few more good resources on sleep:

Sleeping with Your Baby: A Parent’s Guide to Co-sleeping by Dr. James McKenna

Good Night's by Dr. Jay Gordon

Nighttime Parenting: How to Get Your Baby and Child to Sleep by William Sears

The No-Cry Sleep Solution by Elizabeth Pantley

Kirsten Goa is the Editor-in-Chief of Birthing Magazine, LLL leader and IBCLC.  Her articles have been featured in the Twindow and Birth Issues magazine.  All five of her children now sleep through the night, in their own beds (most of the time).