settling and sleep – how you can help your baby sleep

Settling and Sleep: What’s normal?

What is it about settling and sleep that gets people so worked up? After having a baby seemingly the most important piece of information is, “Are they sleeping through the night!?!”

This question is really misleading (it’s LESS common for babies to sleep through the night) and also potentially damaging! Making ‘sleeping through the night’ the default for a ‘good baby’ (shudder) sets women and babies up for failure and disappointment.

So what is normal infant behaviour as far as sleep and settling goes.?

It is biologically normal for babies to:

1. Wake regularly in the night. This protects against SIDS and promotes breastfeeding!
2. Breastfeed frequently during the night. This helps babies maintain your milk supply and ‘refuel’ (remember, they only have small tummies!)
3. Fall asleep when breastfeeding! This is a big one! The hormones, amino acids and nucleotides in breastmilk are specifically geared to do this. IT IS OK TO LET YOUR BABY FALL ASLEEP AT THE BREAST!
4. Expect to be close to mum. Innate physiology tells us to stay close to our protectors lest we be eaten by predators!
5. Want to feed for all sorts of reasons. Babies don’t just feed overnight because they’re hungry! Breastfeeding is a cure all: thirst, pain, needing comfort or closeness and almost every other thing that upsets babies can be ‘fixed’ by breastfeeding!
6. Slowly stop waking in the night at a developmentally appropriate age.

Great! I’m glad we got that cleared up. So, if it’s normal for babies to wake in the night, how often do they usually wake and when does it stop?

Settling and Sleep Science

Well, research from Bruni et al. (2014) tells us that in the first year of life the vast majority of babies wake at least once a night. More interestingly, the incidence of infants waking 3 or more times a night increases with age, decreasing at 12 months old.

So knowing that you’re potentially night waking for a while yet, what can you do?

Settling and Sleep Training?

Many parents feel that in order to obtain more sleep, they must ‘sleep train’ their babies. Sleep training does not improve outcomes for mothers or babies in the first 6 months of life (Douglas and Hill, 2013).

Louder for those in the back:

Sleep Training Does NOT Improve Outcomes For Mothers Or Babies In The First 6 Months Of Life

What settling and sleep training results in is elevated levels of the stress hormone, Cortisol. The effects of this hormone elevation are seen even long term after sleep training has occurred (Middlemiss et al., 2012). So no, you don’t ‘need’ to sleep train your baby!

What can we do then?

LeBourgeois et al. (2013) note that alignment between children’s circadian physiology and parent-initiated bed times improve settling and reduce nighttime sleep difficulties in early childhood. What does that mean? It means try to get baby to sleep when you sleep, or my favourite statement:

Sleep when the baby sleeps, Clean when the baby cleans 😉

For gentle techniques for settling babies during the day and night, check out the “No Cry Sleep Solution” by Elizabeth Pantley. Dr. James McKenna is also a wonderful resource and provides some great links too. Something that I suggest considering is what would make the situation sustainable for you and your family? How many hours of sleep do you need? How can you get those hours? Be Creative!! There is of course another option too…

What About In Your Room Or Bed?

Human evolution and physiology has geared us towards sleeping with and/or near our infants (Ball et al., 2019). Whether you co-sleep (sleep in the same room) or bed-share (what it says), it’s worth knowing the benefits and risks. Many parents feel very concerned about sleeping with their infants because of suffocation and/or SIDS, but have you actually looked at the research? Almost all bed-sharing deaths occur when other risk factors are present (Blabey and Gessner, 2009).

So let’s delve into the science of bed-sharing and co-sleeping:

Safe Settling and Sleep Practices

Sleep behaviour is intimately linked with breathing patterns, changes in sleep architecture, body temperature and maternal physiology and behaviour. Because of this, bed sharing babies experience fewer obstructive apneas (breathing stopping; McKenna, 2014; Richard, Mosko and McKenna, 1998). Furthermore, breastfeeding provides a protective effect against SIDS, and co-sleeping improves rates of breastfeeding. We need a way forward towards ‘breast-sleeping’ not being demonised and support being provided for families who choose this sleep arrangement (Marinelli et al., 2019; Volpe, Ball and McKenna, 2013).

In order to establish and maintain breastfeeding, and increase breastmilk supply, infants do tend to wake frequently in the night (Kent et al., 2006). This has the added benefits of protection against SIDS (McKenna and McDade, 2005; Gettler and McKenna, 2011) and easy resettling due to breastmilk containing substances that assist sleep for mum and baby (Sanchez et al., 2009). Infants and mothers awaken at similar times, creating inter-connected, mutually dependent, synchronous wakings (Mosko, Richard and McKenna, 1997). McKenna and Joyce provide a beautiful summary of why babies do not and should not have to sleep alone (McKenna and Joyce, 2008) whether that involves co-sleeping (sharing a bed room) or bed sharing (sharing a sleep surface).

So, what can you do to share your bed safely?

1. No smoking! The odds of SIDS are much greater for babies who bed share with a mum or other adult who smokes (Horsley et al 2007; Carpenter et al 2013).
2. Solid sleep surfaces! Falling asleep on chairs, waterbeds and sofas increase the risk 60-fold for babies (Tappin et al 2005).
3. No ‘excess stuff’ including pillows, doonas, soft toys, bed rails…Additional bits and pieces, even blankets and sheets, increase the risk for babies (Nakamura et al 1999; Kemp et al 2000).
4. Baby with mum. Mums are aware of their babies and don’t obstruct their airways, cocooning baby appropriately for safe sleep (Baddock et al 2006).
5. No drugs or alcohol. Babies are at higher risk when bed sharing with adults who’ve consumed drugs or alcohol (Carpenter et al 2004; Blair et al 1999; McGarvey et al 2006).
6. Not when extremely fatigued. This is a tough one, because often bed-sharing is used to HELP with fatigue. But if you are extremely fatigued it’s worthwhile being cautious as risk increases for babies sleeping with extremely tired adults who aren’t able to wake to the baby’s needs (Blair et al 1999).
7. No medical conditions resulting in mum being a ‘heavy’ or ‘restless’ sleeper.
8. As few people as possible. The more people in the bed, the higher the risk (Hauck and Herman 2006).
9. Mattress low to the ground to prevent falls.

I hope this helps! I’d love to hear about your experiences with cosleeping, bed-sharing and settling and sleep techniques!

---

If you’d like to read some of my other blog posts, here are some good ones! Check out Why Hire a Doula, What Is a Doula?, Why Home Birth?, My Take on Stretch and Sweeps and Willow’s, Hamish’s and Evalie’s Birth stories!

Would you like to stay up to date with Birth Aims? Subscribe below!