How does baby sleep come undone? This is something I get asked about an awful lot.
There are many reasons why your baby is not sleeping.
The baby was never sleep trained/prevented in the first place. Remember all babies need to be taught how to sleep, it doesn’t occur organically or by chance no matter how hard you wish it did! If your baby can’t self-settle without sleep aids including being patted, rocked, held and fed to sleep there’s a high chance that will be the reason. This applies especially to babies over 4 months old and to babies who rely on a dummy to get to sleep. A dummy is still a sleep aid and is not true self-settling.
Sleep associations i.e. not re-creatable by the baby at the end of one sleep cycle and the start of the next e.g. patting and rocking to sleep, dummies constantly falling out and having to be replaced, being fed to the point of drowsy or asleep. Any sleep crutch that is not the baby completely self-settling is not your friend long term. And by self-settling, I mean being put down in their bassinet or cot completely awake and putting themselves off to sleep.
Development is not moved on at the correct pace and a stage is missed out on. Maybe not enough tummy time and floor time. Modern parents carry babies around a lot and don’t allow them to be and explore enough (helicopter) and are too safety aware.
Not allowing a baby’s development to move onwards at the desired rate by using devices that prevent this e.g. wrapping/swaddling past 4 months of age, using a Safe T Sleep style device that prevents the baby rolling over when this should naturally be occurring.
Moving a baby’s position in the cot. I went to help a family over a year ago now and their 11-month-old was waking up hourly after midnight. When I observed mum doing the bedtime routine and helping her get off to sleep she nailed it. I was really at a loss. Then it got to midnight and myself and dad were up watching a film. Mum had gone to bed early anticipating another disrupted night. I asked dad, ‘so do you go to bed at midnight most nights?’ He replied, ‘yes I do.’ I then asked, ‘so when you go to bed do you go into Anastasia’s nursery?’ ‘Yes I do’, he replied. Now I knew I was onto something. ‘OK, so when you go into her nursery do you go over to her cot and take a look at her?’ ‘Yes, I do.’ ‘Do you touch her or move her at all?’ He replied, ‘Well if she looks uncomfortable.’ ‘You move her position?’ ‘Yes, I do’. Now was the light-bulb moment. If you move a baby you will probably move them in the wrong part of the sleep cycle and disrupt their sleep cycle. That was what was happening here. Since that night dad has stopped moving Anastasia’s position and she has slept through every night. Bliss J I’ve come across this very issue and night waking an awful lot since. I find that parents want to problem solve and fix everything. We have to remember that most babies can get out of awkward positions and if they can’t they will alert us and cry out.
Babies need to feed to appetite. I often find when babies move onto solids the rate of introduction is too late and too little (past 6 months). ASCIA recommends the introduction of solids at 4-6 months.
Most of the paediatricians I know of in Sydney follow the ASCIA recommendations of 4-6 months.
I estimate that 90% of the sleep issues I come across and am asked to help have a dietary component to their sleep problem. We may be giving too little protein and carbohydrates. Remember the ideal ratio is a 1/3 protein, 1/3 carbs and 1/3 veggies or fruit. It’s a balance. Dessert and I mean a healthy one is often helpful. Babies from 6-8 months often plateau with their weight. We need to look at including high fat/calorie dense items in each meal i.e. cream, butter, grated cheese, coconut cream, avocado, oily fish like salmon and ocean trout. These foods have double the calories per weight compared to carbs. Fruit and veggies have very little calories. Yes, it needs to be a balanced diet but it can be too healthy.
After 6 months babies nutritionally no longer need a night-time milk feed. I see many babies having way too many night-feeds, sometimes as many as 8-10 at night. There is little wonder why they are not eating their solids. Also giving a night feed reinforces night waking and encourages this to happen. I’ve seen one feed end up being many, even as much as 10 at night!
I also see way too many day milk-feeds too. Yes, milk is important, especially breast milk but not to the detriment of solids. Iron deficiency is a big issue after 6 months and this alone can lead to sleep problems. Too much milk (breast and formula) intake can lead to iron deficiency as they’re too full of milk to eat food.
You have to sort the sleep out to sort out the weight and food issues. If your baby is a poor night sleeper after 6 months it often correlates to a poor solids eater. If you’re tired you tend to eat badly and snack, the same applies to babies. Sleep training will usually help babies eat more solids and so sleep better.
Lack of knowledge of baby sleep can lead to baby sleep problems. I hope this soon to be released sleep book can help reduce them!
Organic sleep problems are an issue and should never be ignored. They are out there and I’ve come across a few. Whilst most sleep problems are behavioural in origin and are very fixable there are still organic causes. These include tonsils and adenoids leading to sleep apnoea and severe gastro-oesophageal reflux. Always seek a medical opinion if things are not improving at the 3-4 week mark. Things should most definitely be getting better by then and I usually see results by 7-10 days and some big improvements.