Healthcare professionals are often asked for help because of what parents perceive as a baby's sleeping problem. Many parents expect that the baby will be sleeping continuously through the night from a given age, often as early as six weeks old. The conflict between the parents' expectations and the baby's behaviour leads the parents to seek help.
Analysis of the first 640 questionnaires received from the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC). Study show that many six-month-old babies have broken nights. Only 16% slept through the night at six months old. Half woke occasionally, 9% woke most nights, 5% woke once every night and a further 17% woke more than once per night, ranging from twice to eight times. For 16% of six-month-olds there was no regular sleeping pattern.
Parents use a variety of strategies when the baby wakes at night, including rocking or cuddling, giving a dummy or feeding with milk or another drink. By six months old, 61% of babies slept in a room on their own, but 15% were always or usually brought into the parents' bed if they woke, and 34% sometimes 28% of babies aged six months routinely slept in the parents' bedroom. Knowing that their baby's behaviour pattern is "normal" and shared by many other babies of the same age is often reassuring to parents.
Well known children’s behaviour psychologist and parenting author, Sarah Ockwell-Smith states, "We always make it out that the baby's got the problem and it's the baby that needs to be fixed, when actually I think it should be the parents adjusting things."
"So I would help parents to look at things like, 'Is the environment right? Is the baby eating something that's causing an issue, is there something physiological underlying it, is it something to do with the timings of things that's causing an issue?'"
"Nobody in 10 years' time is going to think, 'Oh I wish I hadn't hugged my baby so much'. You're not going to regret rocking your baby to sleep or feeding them to sleep."
Ockwell-Smith says she is concerned that the sleep consultant industry is unregulated and that many individuals are in practice without qualification. She advises parents to do as much research into practitioners as possible before enlisting them.
Professor Helen Ball, Director of the Parent Infant Sleep Lab at Durham University argues that it's crucial for parents to ensure that their consultant sticks to safe infant sleep practices - and does not, for example, advise putting babies to sleep on their tummies, which dramatically increases the risk of Sudden Infant Death Syndrome.
There are, in fact, of course many reasons for a baby to struggle to settle and/or stay asleep. In my experience, the number one reason for having difficulty settling is being overtired. Restless arms, legs and a busy mind kick in (much the same as adult’s experience when overtired). Other reasons for unsettled behaviour include wind, pain (ie. teething), hunger and cold. These should therefore be eliminated first.
Staying asleep is a whole different ball game, with much the same causes. Often an overtired baby will catnap by day, waking each sleep cycle (ie. every 20-45mins) and then sleep for a block in the evening (from sheer exhaustion), followed by a wakeful second half of the night.
A suitably trained sleep consultant will thoroughly assess circumstances, including pregnancy and birth history that may contribute to unsettled behaviours, patterning of sleep and settling behaviours, parent-infant attachment relationship, the presence of satisfactory infant health and development and contributing parental health factors and approaches to parenting.
The consultant should then be suitably qualified to educate parents regarding the finer points of infant sleep, interpret findings from the history taking, develop a plan with practical settling and re-settling applications that can not only be taught to the parent, but will also fit into the family’s lifestyle … research is great, but it must inform practical application, otherwise what’s the point?
Copyright Louise Shalders
