Wednesday, March 21, 2007

Baby Sleep Routines for 0-1yr

"Is your baby a good sleeper?" is always one of the questions asked of new moms. A "yes" reply gets a "you're so lucky!" response, a "no" reply elicits a knowing welcome-to-parenthood half-smile.

It's so hard to know how much sleep, and on what schedule will work for your baby. The main problem, IMHO, is that the how much sleep and on what schedule changes so quickly in the first year. Just as you get the baby into a good pattern, something changes and it's time to move on to a new pattern.

The best book I've come across on the subject is Healthy Sleep Habits, Happy Child" (HSH) (see my reference books posting). It gives great research results on how much sleep a baby should be getting for a given age, but is so wishy-washy about how to accomplish it. The Baby Whisperer (BW) talks about schedules, but the clues to what schedule is right for what age baby are not so forthcoming.

Here's my run down on the progression of sleep schedules based on the advice in the two books and what ended up working for HB.

Routine 1:
2.5 - 3hr cycle
When: from newborn

Follow the EASY routine in the BW. Eat-Activity-Sleep-You-Time. Feed the baby upon waking. Feeding takes 30-45 min. Awake for a total of 1 to 1.5 hours. Watch for second yawn. Then, 15-20 min to fall asleep, and sleep for 1.5 to 2 hours. For a total cycle of anywhere between 2.5 to 3 hours. If the baby sleeps for less than 1 hour, try to get him to go back to sleep. Otherwise, let him wake up and begin the routine again with a feeding.

Nighttime:
Night time starts around 7pm and goes to around 5:30-7am. Follow the same routine, except skip the activity/awake time. When they wake up, feed them, diaper change if needed, and put them back to bed. Keep the lights low and keep the interaction to a minimum. Don't talk or make eye contact, and keep things really sedate. This gives them the clue that it's not time to wake up and play. They should stay half-asleep and groggy through the whole endeavor and go back to sleep almost immediately upon going back into their crib.

Things to watch out for:
If they seem to be hungry more often than every 2.5 hours, then they just need to suck. Use a pacifier.

If they seem sleepy after they feed, and it's during the day, wake them up! It's just an oxytocin overload from the breast milk. Make sure they get their awake activity period during every daytime cycle.

If during the day they sleep longer than 2 hours, wake them up. Keep the whole cycle to less than 3.25 hours during the day for the first few weeks when you are trying to establish the schedule. You want them to sleep their long stretches at night, not during the day.

Routine 2:
Skip one night feed
When: around 4-6 weeks (BW says when baby weighs more than 10 lbs and consumes 25-30oz during the daytime or 6-8 breast feedings per day). Make sure the day and night routines from Routine 1 are well-established before moving onto this Routine.

Same as Routine 1, but during the night, baby can skip one night feed. See BW pg. 185 on how to accomplish this transition. Basically, use pacifier or pick-up-put-down method to comfort them when they wake up for the feed. After a few nights, they will not wake up anymore.

Routine 3:
Longer Stretches of Night Sleep
When: around 6 weeks

To get longer stretches of sleep at night, use cluster and dream feeds. See BW p. 185. Our typical schedule: Cluster feed at 6pm and 8pm. Dream feed at 10:30 or 11:00pm.

Routine 4:
Skip cluster feed
When: baby starts taking less and less milk during dream feed

At some point, the baby will be getting enough calories during the day that she will not need the cluster feeding. You will notice that she takes less and less at each dream feed. Stop cluster feeding. Before she goes to bed, just keep on the 3-hour routine. Continue the dream feed.

Note: for Routines 2, 3, and 4.
You can move at any time to a set schedule, rather than a rotating routine. We switched over to a set schedule about two weeks before I returned to work. It's still the EASY cycle, but you feed at the same time every day. For us it was 7, 10, 1, 4, and 7. At work, I pumped at exactly the same time as the baby was eating, and it seemed to keep my milk supply very consistent. It also made the night routine happen at the same time every night, which added a lot of predictability to our evenings. Our policy was 15 minutes of wiggle room. That is, we would move the feeding no more than + or - 15 minutes off the schedule depending on how the baby was doing that day. If the baby is waking up at random times at night, try switching to a set schedule during the day. This will add a lot more predictability.

Routine 5:
4-hour schedule with dream feed
When: 3-4 months

This is where you need to read the Baby Whisperer's second book. At some point around 3-4 months, the baby will go through a growth spurt and her sleep habits will start to go haywire. She will start to sleep shorter more erratic periods and want to be fed at odd times. This is your clue that she needs to move to the 4-hour schedule. The 4-hour schedule is WONDERFUL!! Skipping one feed at night means a whole 8 hours of sleep for Mom! During the day, you have more time to be out and about without worrying about the logistics of feeding the baby.

Move baby from the 3-hr to 4-hour schedule by slipping the schedule by 15 minutes every day. So, Day 1 is a 3.25 hour schedule. Day 2 is a 3.5 hour schedule. Day 3 is a 3.75 hour schedule, and Day 4 you are on the 4-hour schedule.

Keep the dream feed at night. Dream feed at any time before 11pm (after which point, the BW says you would be cutting into the night sleep pattern).

Routine 6:
Skip evening catnap, move bedtime earlier
When: when baby seems to erratically take evening catnap, or evening catnap cuts into night sleep and baby isn't going down for the night until after 8pm. Or when baby seems to want to start their day routine too early (like 4:30 or 5am).

Babies should be going to bed around 7pm. Later than 8pm is not right. Earlier bedtime will actually result in a later wake-up time. Sleep begets sleep. See HSH.

Routine 7:
Skip dream feed
When: 7-8 months

You will notice baby taking less and less at the dream feed. Once they get down to only a few ounces at each dream feed, it's your clue that it's safe to stop it. Use pacifier to wean them off this one. Transition should take 3-4 days.

Note: during growth spurts, the baby may wake up in the middle of the night wanting to eat. How do you tell the difference between habitual waking, and waking for hunger? BW says that if the baby is waking up at the same time every night, it's habitual. Use pacifier or pick-up-put-down method to wean them off (see BW second book). If the baby is waking at different times every night, they are waking out of hunger. Feed them. Try to get more calories in during the day (i.e. by starting solids if you haven't already, or if on solids, squeezing in a few more snacks during the day).

Most nights, HB sleeps from 7pm to 6 or 6:30 am. She greets us with a huge grin in the morning -- a good indication that she is well-rested!

If you have any questions about sleep routines, feel free to send me an email (josie(at)organizedmommyblog.com). I would love to hear from you!

Related Articles:
Ask Josie - Establishing a Sleep Routine
Organized Mommy Baby Log (free download!)
Newborn Reference Books
Your Baby Does Not Have Colic!
Fan In Baby's Room Lowers SIDS Risk
Newborn Gear List

2 comments:

  1. This is so helpful. I have an almost 5 month old and we are working hard to improve her schedule and sleep habits! The books are so confusing at times. We are trying to follow HSHHC and we also do the EASY pattern. Wish I would have found this when my daughter was firstborn!!

    ReplyDelete

Note: Only a member of this blog may post a comment.