Baby Sleep Myths (Part 2): Night Time Sleep

If you read my previous blog post on sleep, this is a continuation of that with more myths/Q&A’s. This post is mostly focused on nighttime sleep.

*Disclaimer: This blog is intended for informational purposes only. The information on this blog should not be used as a substitute to medical advice or medical treatment. As always, your Primary Care Provider, a doctor, or another health professional is your best resource for specific questions and medical advice. If you believe you or a loved one are experiencing a medical emergency, please contact 911.*

Q: Is there anything I can do to get my baby to sleep better at night?

Often one of the hardest parts of having a newborn in particular is the loss of sleep. If you’re a new parent, you’re used to sleeping through the night (generally) without interruption. Everyone has warned you this won’t be the case any longer – and for the immediate future it likely won’t be. I already discussed why it is NOT unusual for your newborn to wake up in the night in my previous post. But is there anything you can do to encourage them to sleep for longer periods? Maybe – like everything with sleep, many “remedies” are baby dependent.

One thing you can do is *trying* to make sure they nap during the day (I say trying because this can be easier said than done some days – coming from a mom whose baby has decided she only naps once two times a day the past few days). Contrary to popular belief, keeping your baby up through naps actually will not help them sleep at night. Newborns aren’t exactly scheduled sleepers though, so you won’t really be able to determine their nap time, but you can let them nap if they fall asleep. I noticed if we changed our schedule drastically in the newborn stage, for example by going out for lunch with a family member, this could “throw off” Maggie’s (unscheduled) naps and I’d often end up with an overtired baby who then had trouble falling asleep at night or even for her next unpredictable nap time.

If your baby falls asleep and you don’t need to wake them up to feed (either because they’ve got the OK from their doctor, or they’re sleeping under 2-3 hrs if breastfed or 3-4 hrs if they are bottle fed – note: this timing may be different depending on your baby + their age, so ask your provider), then don’t! Let them sleep and get their naps in whenever they can – they need that sleep (unless you’ve been advised by your care provider, for any reason, to wake them up more frequently – always follow their advice!).

As baby gets a bit older you can try to encourage naps at more regular intervals. I absolutely love the Huckleberry app because it gives you a nap and bedtime “sweet spot” recommendation. For Maggie, who is now almost 4 months old, this has been helpful. We’re starting to see more regular nap times – but she’s still not really scheduled quite yet (whereas some other babies definitely might be). You can do a miniature bedtime routine for naps if that’s helpful, when they start to be more scheduled/regular. Just don’t be surprised, worried, or upset if your newborn doesn’t have a schedule for naps for a little bit – it’s normal. You just have to take things with newborns, like naps, as they come sometimes.

Other things that might help them sleep better at night are a bedtime routine (a lot of people swear by baths, but that’s not always possible for everyone to do each night). Bath, book, bed is a common pattern, but it can be whatever works for you and your baby.

Make sure your baby’s environment is supportive of sleep. I discussed this in my previous post as well but dim lighting or lights off, white noise or whatever they need to help them sleep, and so on. Make sure they aren’t overdressed or underdressed because this might cause wake ups if they get too hot or too cold. I’m not here to dictate how/where/when you put your baby to sleep – that’s a you thing and I’m just providing this blog for informational purposes and giving some suggestions from what I’ve read and learned from my short period of experience.

One final thing you can try is the dreamfeed if you find your baby is not sleeping for long periods in the night and they’re maybe a bit older or you just want to try it to see if it works. Taking Cara Babies explains the dream feed really well here. It does not work for everyone – although I had favourable responses to it in a previous poll on Twitter. It’s something you can try though and it might help you get the extra winks at night you need to feel more human! If it doesn’t work – then it’s a trial and error game from there. Try whatever you need to, that you’re comfortable doing every night for awhile or until your baby gets better at sleeping longer. AKA if you don’t want to rock your baby to sleep, maybe don’t start doing it. If you don’t mind then do it (I do)!

What do I do? Maggie sleeps at least 5-8 hrs in a stretch at the beginning of the night – she’s done this for a little bit now. It depends on her daytime nap regularity and length, and probably many other factors that are unknown to me. Some days she just wakes up – due to growth spurts likely, or just because she says “screw your sleep mom” and decides to do it. I don’t know. I have a flexible bedtime routine – we do bath every other night usually – this helped a lot when she was a newborn but is less effective now for her at almost 4 months as a sleep aid. However, she loves baths so we still do it before bed. Next I try to do a book, but some nights she’s too fussy or I’m too tired or we’re busy doing something else, so we skip right to breast & bed. She room shares with us so I feed her in bed and put her into her bassinet (now I’ll be the first to admit this is not what always happened at the beginning…). That’s now around 730-830 pm roughly – we do get a random night that is a bit later still. I then usually go downstairs with my husband and we do whatever, then I come up (lately) around 1030-11 pm and dreamfeed her. She doesn’t wake up at all – I just pick her up and she opens her mouth. If she woke up I probably wouldn’t do it – but it seems to help prolong her first stretch of sleep.

Right now, she wakes up about 1 time a night though she has had nights where it’s more (max. 2 usually) or nights where it’s no times at all! She’s still unpredictable in many ways and that’s ok. I know it’s normal – you might be luckier than me or you may be spending more time awake. Hopefully you can figure it out – but know that it takes time for them to become more regular with sleep. Can you imagine how difficult learning how to sleep is? Many adults still don’t have it figured out, so don’t expect a new baby to necessarily know how it works right away either.

Oh! I also forgot to mention swaddling, which is great for (some) newborns – again, baby dependent and something you’d have to try out. We swaddled Maggie until about 3-3.5 months – she wanted to stretch out by then and kept Houdini-ing out of it anyways so we stopped.

Q: My baby has nights and days messed up. Is there anything I can do?

I wish I could use the clapping emoji here but since I can’t, this is my best rendition: supportive. sleep. environment. This is not a guarantee – sometimes these things just take time. Yes I know this whole sleep discussion is basically just me telling you to practice patience. Seriously though – patience is a big part of it. Babies are new and they need to take time to learn and understand things. Parenting is also new to you (or it may not be but you may have forgotten some parts), and you need to be patient with yourself as well – so don’t forget that.

Sleep environment is one way to help them get there though – dark and quiet are key. Nighttime diaper changes should be done in dim lighting (I personally can’t do them in the pitch black because I wear glasses and already can’t see anything in the day time), and you should minimize interaction with baby. I know it’s hard because babies are just so cute and you want to talk to them and interact with them! However, keeping it quiet and business as usual should help them return to sleep & also support the idea that it is night time and this is how you do things at night.

Myth: Bottle fed babies sleep better than breastfed babies.

Did you find in pregnancy that a lot of people seem to ask you how you plan to feed your baby? That’s a whole other blog post on its own, because why is it anyone else’s business? Anyways – I found after I told people I was planning to try breastfeeding, many would say that I should expect my baby to not sleep as well.

So naturally as a person who likes to Google and research everything, I looked this up. I was worried – I hadn’t even had my baby yet and I was assuming I would know how her sleep habits would be because people, who also don’t know my (unborn) baby, were giving me unsolicited advice. Hmm.

The truth is – every. baby. is. different. Damn, another good spot for the clapping emoji. Some breastfed babies do sleep through the night in long stretches. However it’s not uncommon or wrong for them not to do this – just like a formula fed baby or a baby who is getting both formula & breastmilk might do either or based on their current developmental stage and needs, or how much comfort they like from their parents at night time, or a variety of other reasons that may cause nighttime wake ups.

What I can tell you specifically is what some of the research says:

If you are EBF your baby, according to Kellymom (and associated research) there is no evidence that adding formula into their diet will help them sleep better (keep in mind the article referenced on their site is from 2015 – I wasn’t able to find anything pointing to a different answer though).

What about EBF vs. formula-fed babies in general? Well, it seems to be kind of a mixed answer as many studies do show that EBF babies sleep short periods in the night from 0-6 months of age when compared to babies who are fed formula. One study from 2017 found that 2 week old EBF babies slept better than babies of the same age that were fed both breast milk and formula. However, the same study found that EBF babies slept less overnight than exclusively formula fed babies by 3 months of age. Babies that were fed a mix of formula and breast milk actually slept the longest periods overnight when compared to EBF and formula-fed only babies, by 6 months – which is very interesting.

Breast milk in the night time has melatonin in it (which is the ‘sleep hormone‘, many adults take it as a supplement to help with sleep regulation), which you would think would contribute to a long night’s sleep however it appears that breastfed babies sleep in a fragmented pattern. This is probably because, compared to formula, it is easier for a baby to digest and therefore is digested quicker leading to a baby that is hungrier faster. This may not necessarily mean that baby isn’t getting good sleep, just that they sleep in this pattern because they get hungry more frequently – or in some cases because they want the comfort and closeness of their mother. Kellymom also has a good Q&A page on why a baby might be waking up more frequently than normal during the night here.

A recent study from 2018 found that parents often incorrectly report the amount of time their baby sleeps. This is often the case when we rely on self-report – there is often some type of skew or misrepresentation. Many different errors can occur with self-report but it is sometimes the only way (or other times the easiest way) to get information on certain study topics. Why am I mentioning this? Because this study makes you question the results of other studies on the same topic using self-report as a measurement tool. (N.B. the sample size of this 2018 study was 283 women and it had a very low response rate so this is in no way conclusive – but it still makes you think!). The study I mentioned in the previous paragraph used self-report methods – just something to think about when you read or browse over studies.

Moral of the story is: yes, research supports that in general, breastfed babies do wake up more in the night than formula fed babies. Is this across the board, always going to be the case? NO – nothing ever is really. You may breastfeed and your baby may begin to sleep through the night earlier than expected or sooner than your friends EBF baby. There is no black and white answer to this question – but hopefully the above information can help explain why they may wake up so that you have a better understanding of their needs.

Trial & error is your friend too at night – if baby isn’t hungry, there’s a few other things you can try to get them back to sleep. Sometimes it is growth spurts, developmental ‘leaps’, teething, illness – these are all harder to deal with but the link I gave for Kellymom earlier has some useful information and so will your provider if you find you are struggling with nighttime wakings or find that you cannot figure out why your baby is waking at night (this is a good question to be asked over the phone or by telemedicine means – especially during a pandemic – but don’t hesitate to ask questions to your provider when you have them!).

Both articles I referenced in this post are linked, however here they are again:

Figueiredo, B., Dias, C. C., Pinto, T. M., & Field, T. (2017). Exclusive breastfeeding at three months and infant sleep-wake behaviours at two weeks, three and six months. Infant Behavior & Development, 49, 62-69.

Rudzik, A. E. F., Robinson-Smith, L., & Ball, H. L. (2018). Discrepancies in maternal reports of infant sleep vs. actigraphy by mode of feeding. Sleep Medicine, 49, 90-98.

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