A recent study published in Sleep Medicine may offer comfort to parents who are struggling to develop a sleep routine with their babies.

What the Study Found

Researchers recruited 44 6-month-old babies who were tracked for two weeks and learned that their sleeping patterns varied weekly, sometimes daily. All told, 72% of the babies showed erratic sleep behaviors for the two weeks. Most did not even sleep for six straight hours half of the two weeks. Only one of the babies studied slept for a full eight hours every night of the study.  Study co-author Marie-Hélène Pennestri explains, “Parents are often exposed to a lot of contradictory information about infant sleep. They shouldn’t worry if their baby doesn’t sleep through the night at a specific age because sleep patterns differ a lot in infancy.” The study also found that babies’ sleeping routines often are influenced by the parents’ habits, especially co-sleeping and breastfeeding. These parents seemed to notice more erratic sleep, but this could be attributed to the fact that proximity allowed parents to be more attentive to movement. The study concluded, “Parents and clinicians should be aware that occasional sleeping through the night does not necessarily indicate a consolidation of this behavior.”

Babies’ Sleep Needs Change as They Grow

Connie Domingo, MD, FAAP, FAAPMR, states that as babies get older, their sleep needs change. “From birth, up to their first three months of life, they’re going to be sleeping a lot, averaging about about 16-17 hours of sleep," she says. “It’s basically eat, sleep, poop.” She explains that they may cat nap then wake up to be fed. “They may sleep for about an hour or so and then wake up again, depending on the temperament of the child.” Babies need less sleep at about 4-6 weeks, and less as they get older. A solid sleep schedule feels essential for parents–especially with their first child. “With most households having both parents working, it’s really important that you know that the parents are collaborating and trying to create the best possible routine schedule so that the child can keep on a sleeping regimen,” says Domingo.

What does a sleep routine look like? 

A 2009 study in the journal Sleep found that establishing a routine reduced problematic sleep behavior in infants and toddlers, including falling asleep and staying asleep. The routine resulted in an overall significant improvement in maternal mood. A routine typically begins an hour before bed, and just like adults, babies need to wind down. This could mean dimming the room, turning off the TV, and drawing a warm bath. Domingo, who is the medical director of Weisman’s Children’s Rehabilitation Hospital, recommends, “Find a bedtime that works for the family dynamics, but typically it should be after the last feed, around 7 or 8 p.m.” Teaching a baby to self-soothe, rather than assisting it back to sleep every time it wakes, may also help to create consistency. Infants who are put to bed awake so they can self-soothe have longer continuous periods of sleep.  Many factors can influence a baby’s ability to sleep soundly, including environmental factors like noise. Managing this can be tough if there are other children in the house, or if there is a lot of chaos. Families in urban areas get less sleep as well.  According to Domingo, “A lot of parents, especially low-income families, co-sleep with their kids, which is not usually ideal. Some young moms, especially teenagers, are propping the bottles up at night so that they can sleep.” Such feeding habits can lead babies to have reflux, which can disrupt sleep. “The sphincter, which is the junction from the stomach to the intestine, is tighter and not fully developed. That is why parents need to help their baby get into a feeding pattern and then burp them appropriately," she says.

When to Seek Help 

If the baby is in a routine in an environment conducive to sleep, yet they are not getting sound sleep, it may be time to visit your pediatrician. If there were no prenatal complications or any during the postnatal period (such as premature birth or a stay in the NICU), then Domingo says, “I’ll ask parents to give me a scenario of what their day is like from the time they wake up to the time they go to sleep. I ask if they’ve had any infections, if the baby is on medication, and if the mom is on any medication or smoking while breastfeeding. I also ask if the child is co-sleeping or in a crib.”   It is possible that sleep disruption accompanied by inconsolable crying means a baby is suffering from colic. This can be treated with medication. “Colic usually peaks about when the child’s about 6 weeks old and then it kind of tapers off… by the time they’re about 3 or 4," Domingo says. “It’ll definitely resolve with time.” Domingo explains that the mother’s mental and physical wellbeing is extremely important to the baby’s development, and that a happy baby requires a healthy, happy mom. She says, “If the parents, specifically mom, has not been taking good care of herself, if she’s sleep-deprived, or not eating, that’s going to affect the baby because ultimately it’s going to affect mom’s breast milk production and her bonding time with the child.”