Smart solutions to slumber problems

By Mary Lim, Lucy Dimbylow and Kate Crofts

“Sleep training can be hard on parents, but if you’re really determined, the process should be quick, and the results will benefit the whole family.”  “Any repeated action associated with falling asleep will very soon become a sleep trigger. This is why a consistent bedtime routine is so important.”  “Don’t allow your child to overnap, or nap too late in the day. It’s better to bring bedtime forward if he’s really tired.”  “It’s normal for babies to wake several times during the night. Babies who are able to resettle themselves are those who go to sleep at the start of the night independently, don’t expect a night feed, and aren’t in the habit of getting in bed to sleep with Mummy and Daddy.” “The key is not to let your baby fall asleep on the breast or bottle. Introduce a song or story after the feed and before she goes in her cot to break the milk/sleep association. After the feed, leave her to go to sleep on her own.” “Co-sleeping is a long-term commitment and could last up to four years. Once you begin, your child may eventually get used to the arrangement, so that it becomes difficult to bring him back to the cot.”

If your baby is to grow well, he needs to get sufficient sleep of a decent quality. To ensure that your mini-me gets enough rest, you’ll need to help him establish positive sleep patterns and habits. 

Your child’s moods are affected by the amount of shut-eye he has, notes Tammy Fontana, owner of Babysleepfairy, which helps mothers address sleep problems with their babies. Says Fontana, who conducts sleep workshops at Birth & Beyond Group Pte Ltd, “If your child does not have enough sleep, then he is likely to become cranky and frustrated. He will also find it difficult to concentrate and it affects his learning ability. Good sleep also keeps him healthy because it strengthens the immune system, thereby protecting him against colds and infections.” 

Mum-of-four Andrea Grace, an independent sleep specialist (www.andreagrace.co.uk), notes, “If your baby is over 6 months, healthy, gaining weight, and yet still isn’t sleeping through the night, it’s time to consider giving him some help.” Grace should know, having helped hundreds of families to overcome their children’s sleep problems. 

Sleep training is about getting organised, making a plan and then implementing this plan consistently and confidently. “Sleep training can be hard on parents, but if you’re really determined, the process should be quick, and the results will benefit the whole family.” 

Fontana and Grace share their wisdom on working out baby’s nap niggles and helping her to sleep through the night. 

Q: Now that my son is 6 weeks old, I want to get him into a bedtime routine so my husband and I can have our evenings back. What do you suggest?
Grace: Any repeated action associated with falling asleep will very soon become a sleep trigger. This is why a consistent bedtime routine is so important. Begin your routine shortly before your baby is ready for sleep. Follow a bedtime “script” by using familiar phrases and actions at key points. Give your baby a bath, singing the same song each time. Go directly to his bedroom afterwards and dress him for bed. Give him a milk feed, then read a story or sing a goodnight song. Finally, place him into his cot to settle for the night. Make sure to always put your baby down while he’s awake but sleepy. It’s alarming for a baby to wake in the night to find he’s no longer in your arms. You don’t have to leave him to cry ? it’s all right to sit reassuringly beside him. 

Q: My 6-month-old daughter sometimes takes an afternoon nap that lasts for as long as four hours and becomes very alert at night. Any tips?
Fontana: In the first place, whether a nap is needed depends on the age of the child. A 6-month-old typically requires 15 hours of sleep, with three hours spent on naps. If the nap lasts longer than that, she may be “stealing” sleep during the day, so it’s best to limit the number of hours she naps every day. Otherwise, adjust the number of hours she sleeps by pushing back her bedtime by the same number of hours she has “overslept” during the day. 

Q: My son is 6 months and reluctant to nap. Is there any way to improve his daytime sleep?
Grace: Between 6 and 12 months, most babies require two naps, totalling two to three-and-a-half hours. Note when your baby appears sleepy during the day and follow his lead. Then, use a mini bedtime routine before putting him in his cot and let him self-settle. Be prepared for protest, but don’t give in by getting him up. Praise him when he’s in his cot. If he wakes after a short time, don’t rush to get him up ? if you let him resettle, he may sleep for longer. 

Q: My younger daughter, who is 7 months old, gets woken up constantly from her afternoon naps by my active 3-year-old son. What can I do?
Fontana: This is a parenting issue. Work with your older child to set appropriate boundaries. He may not understand why his sibling needs to sleep, so try to interest him in quieter activities, such as painting, colouring or reading. Alternatively, you may wish to bring him to the nearby park for a stroll. 

Q: My 9-month-old used to sleep well, but since a bout of teething, he’s hard to settle and wakes in the night. Can you help?
Grace: There are two methods. The first is controlled crying (not recommended for babies under 6 months). Put your baby in his cot awake and leave the room. Let him cry for five minutes before going back to resettle him. Spend no more than a minute with him, then leave again, even if he cries. This time, leave 10 minutes before returning to him briefly, as before. From then on, go in every 15 minutes until he’s asleep. The next night, leave him first for 10 minutes, then increase it by five minutes at a time, up to 20 minutes. If he’s still crying, continue to go in every 20 minutes. On night three, leave him for 15 minutes, increasing in five-minute intervals up to 25 minutes. After night three, he should be sleeping through. 

A gentler way is gradual withdrawal. Step one (for about two nights) is to put your baby in his cot awake and stay next to him until he’s asleep. Give him as much contact as he needs to settle, but don’t take him out of the cot or feed him. Step two (again for about two nights) is to withdraw some contact now he’s comfortable going to sleep without it. Stay beside him, but cut down on eye contact and be sure you’re not touching him as he nods off. The final step, which can take up to two weeks, is to move further from your baby’s cot each night until you’re outside his room. Do this in tiny stages, so your baby gets used to the change. 

Q: Ever since he learnt to pull himself up, my 10-month-old won’t lie down in his cot. What can I do?
Grace: It’s important you show him how to lie down, get comfortable and go to sleep. First, place him in a good sleeping position. If he springs back up, there are two options. One is to place your hands reassuringly around him, and wait for him to lie down. Help him get comfy if you need to, but follow his lead to teach him how to resettle himself. The alternative is to reposition him, then leave the room. Return every five minutes just to lie him down. Reinforce your actions by saying “lie down now” in a calm voice. Your baby will learn to settle by receiving a clear message that you expect him to lie down in his cot. 

Q: At 11 months, my daughter still wakes three times a night for milk. How can I cut the feeds?
Grace: It’s normal for babies to wake several times during the night due to sleep cycles. Babies who are able to resettle themselves are those who go to sleep at the start of the night independently, don’t expect a night feed, and aren’t in the habit of getting in bed to sleep with Mummy and Daddy. The key to cutting those night feeds is not to let your baby fall asleep on the breast or bottle. Introduce a song or story after the feed and before she goes in her cot to break the milk/sleep association. She will protest at going into her cot awake; if necessary, stay with her, but don’t lift her out. Your baby will only sleep through when she can settle without you in the room, so over the next few nights, gradually withdraw as she goes to sleep. You can go back every five minutes and stroke her back for a minute if need be, but don’t go in if she’s just grumbling. When your baby wakes in the night, if she’s breastfed, keep the feed short. If she’s bottle-fed, gradually dilute the formula, and from night seven, don’t give anything. After the feed, leave her to go to sleep on her own.
Q: My son is 12 months old and refuses to stick to a routine of going to bed at 8pm. Help!
Fontana: The number of hours of sleep a baby needs varies with age. Many parents think their child should get as much sleep as possible. But the older the child, the less sleep he requires. Incidentally, a child’s sleep pattern changes the most in his first year. For instance, at 3 months, he may spend up to 16 hours sleeping, while at 12 months old, he needs only 13 hours at most. Learning to sleep is much like learning to walk or talk, and his progress will vary according to age. Parents should also learn to reinforce a suitable bedtime for their child. If he takes long naps during the day, consider having a later bedtime. Or to ensure that your baby gets sufficient night-time sleep, you can try reducing the number of hours he naps during the day. But don’t stop him from taking naps during the day, in the hope that he’ll go to bed early at night ? this may make him tired and moody. 

Q Should we have my 12-month-old son in bed with us? What are the safety precautions to take?
Fontana: Co-sleeping is a personal choice and common in some cultures, especially the Japanese. Parents must understand that co-sleeping is a long-term commitment and could last up to four years. Once you begin, your child may eventually get used to the arrangement, so that it becomes difficult to bring him back to the cot. If you want your baby to sleep with you, take these safety precautions:

- Sleep on a hard mattress, and ensure that there is no gap between the bed and headboard so baby is less likely to be squashed by you or to get suffocated. 

- Don’t sleep with your baby if you are under the influence of alcohol or medication, because you may not realise what’s happening to him. 

Q: My 1-year-old daughter sleeps with a pacifier, but wakes up the moment it falls off. What can I do?
Fontana: Your child associates her pacifier with sleep, so it becomes the earliest sleeping pattern she picks up. One way to reassure a newborn at bedtime is to guide her hand to a pacifier and then to her mouth, so she understands that it is always near. If it drops off while she is sleeping and she starts crying, repeat the action. 

While it may be fine when your child is younger, it is better to wean her off the pacifier in the long run, especially since sucking on the pacifier has repercussions on teeth alignment. Start by eliminating the pacifier from her bedtime routine altogether. This may require some patience initially, since she may refuse to sleep or bawl for the pacifier. Some will get used to it and fall asleep eventually, while others may need to be patted to sleep. 

Q: My daughter, 13 months, always wakes at 5am. Help!
Grace: Treat anything before 7am as a night waking. If she cries before this, go to her, but keep her in her cot and be prepared to stay with her if she’s upset. Don’t offer milk. If she’s still awake and shows no signs of sleep at 7am, open her curtains to show her it’s now daytime, and say good morning. Then you can get her up. She’ll soon realise that if the curtains are closed, it means it’s sleep time. 

Q: My 14-month-old goes to bed at around 11pm. He usually takes a late afternoon nap of about three hours. We’re exhausted by the time he’s ready for bed, while he’s still bursting with energy. Can you help? 
Grace: Don’t allow your child to overnap, or nap too late in the day. Try to keep him awake if he still hasn’t napped after 3pm. It’s better to bring bedtime forward if he’s really tired. Then, you can all have an early night. 

Q: My toddler needs me in her bed to fall asleep at night, and comes looking for me whenever she wakes up. Is it too late to retrain her to sleep on her own?
Grace: Since she’s already walking, she’ll get out of bed and into your room whenever she wakes. The first thing to do is to place a safety gate in the doorway to her room. This will keep her safe and give you control. Start a bedtime routine ? bath, pyjamas, and a story and milk on the floor, away from the bed. Then, put on a CD of soft music, tuck your tot in bed, and potter around tidying up. Last, give her a kiss, tell her she’s a good girl and say you’ll be back in a minute. Return to the room every minute until she’s settled. Always leave the room while she’s awake, so she’s not alarmed if she wakes up in the night and you’re not there. Expect her to protest and yell. She’s also likely to get up every time you leave the room. But if you keep at it consistently, she will get better.

If you have any comments or practical suggestions, write to us at editor@family.sg 

- Mother & Baby
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