Baby Sleep

Family Health Diary

Most new parents assume that sleep deprivation is all part of the job, unless of course they should hit the jackpot and land themselves a ‘good sleeper’.

According to a new class of experts, however, a good night’s sleep has nothing to do with luck: instil the right habits in the early weeks, and most babies are capable of a full 12 hours sleep from as early as 3-4 months.

If you find this idea hard to swallow, you can take up the argument with two women from opposite sides of the globe, who have never met one another yet swear by a strikingly similar routine for getting babies to sleep peacefully through the night.

One is New Zealand’s own ‘baby whisperer’, Sharlene Poole, who did her early childhood training in Christchurch before moving to England eight years ago and finding her vocation as a maternity nurse; since then she has trained over 90 babies to sleep through the night, and been in demand everywhere from the United States through to India. The other – Jo Tantum – has been dubbed the UK’s ‘baby guru’, and in her 20 years of working with babies has never met one who didn’t thrive on routine.

“Instead of snacking all day, a routine-fed baby builds an appetite for regular meals, meaning his tummy is full after eating and he feels satisfied,” explains Jo Tantum in her book, Baby Secrets: How to know your baby’s needs. That means he’ll nap better by day, sleep better at night, and feel secure in knowing what is happening and when – babies crave certainty, she says.

But the word ‘routine’ shouldn’t conjure up the regimented, one-size-fits-all methods of old. These often led to errors and extremes, which is why ‘routine feeding’ is not promoted by New Zealand’s Plunket Society or in the UK where the preference is ‘cue-based’ or ‘demand-feeding’. The rule of thumb, says Plunket, is to watch your baby’s hunger cues, and feed him/her when they’re hungry, not by the clock. Many mums, too, say their babies don’t abide by routines, after-all children are as unique as the adults they grow into.

Instead, the routines suggested by Sharlene Poole and Jo Tantum take a bit of the old paired with the new, and amount to scheduled feeds (breast is best) that match your baby’s age, size and natural feeding patterns at different stages of his or her early life. And judging by these women’s 100% success rate with babies to date, it’s fair to say they may know something the rest of us don’t.

Top Tips
These experts have a swag of secrets to help babies sleep better. Topping Jo Tantum’s list is:

  • Don’t use sleep props: Always lay your baby to sleep while he’s still awake, from the day he is born, so he can do the falling asleep bit by himself. Otherwise, he will not learn to fall asleep without being rocked, cuddled or given a breast.
  • If you want to take him out in the pushchair, wait (if you can) until he is asleep in the pushchair before leaving, so that the motion doesn’t become a prerequisite for falling asleep.
  • By all means rock a pushchair or rocker chair to soothe your baby if unsettled or fretful, but try and stop rocking just before he falls asleep.
  • Help your baby differentiate between daytime ‘naps’ and night-time ‘sleep’. Ensure daytime is only for napping, not long stretches of sleep. A newborn baby will be very sleepy, but it’s really important to wake him for feeds and ensure he gets a full feed every time. Leaving him to sleep means he won’t get enough milk during the day and will be starving at night, wide awake with hunger.
  • Ensure he spends his night hours in a quiet, darkened room, and help establish bedtime cues, such as giving him a bath, a very gentle massage or playing soothing music to help him wind down.
  • Practice ‘spaced soothing’ as a way of calming an unsettled baby in the night. Babies cry because they might be sick, hungry or have too much wind, but sometimes they grizzle when merely trying to fall asleep. Wait for one minute to determine if it’s a grizzle or a distress call, then go to him but keep the lights low and don’t pick him up. Then, with your index finger, stroke your baby’s ‘soothing point’ in the middle of his forehead down to the nose; place the palm of your other hand on your baby’s chest to make him secure, and whisper ‘ssshhhh’ softly and repeatedly. If the cry then softens and turns into a grizzle, then you should back away to let him fall asleep on his own. This helps your baby know you’re there, and helps you determine if he actually needs feeding or simple comforting.

Sharlene Poole has her own settling technique for babies crying in the night, which also involves the reassuring ‘ssshhhh’ and 3-5 minutes of comforting hand contact and bottom-patting (while baby’s in the cot) until the cry weakens into a grizzle. The aim is to settle babies back to sleep, and ever so gradually nudge out their middle-of-the-night feed cycle until they’re sleeping through till morning. But if after five minutes of soothing, they’re still crying, then they should always be fed.

“I always tell mums to keep a clock in the room to see what five minutes actually is, because in the middle of the night five minutes feels like an eternity,” she says.

Swaddling babies for sleep is also a big part of Sharlene’s night-time ritual, but her signature move, she proudly proclaims, is her ‘burping technique’.

“Most reasons for not sleeping is excess wind.” Babies should be burped about 6-8 times between feeding and bed, she says. “Burping, burping, burping, burping, then sleep… I can’t emphasise it enough.”

In-Home Help
It’s no coincidence both Jo Tantum and Sharlene Poole follow a similar modus operandi – it’s because both started out as maternity nurses, which is essentially a live-in nanny for newborns. Their careers involved looking after babies from the moment they were brought home up until they were feeding well and sleeping soundly through the night.

Now, these experts aren’t doing the rearing, but handing down their knowledge to mums in need. For Sharlene Poole, a six-hour in-home session is usually enough, although 24-hour stints are sometimes called for.

“I don’t think mothers should be going it alone,” she says. “Naturally, we should be living in small communities – with mothers, aunts and grandmothers all supporting one another.

“When I’m called in, I’m playing the sister, the nana, the nurse – ‘the everybody’ that all new mums should have access to.”

No One Should Struggle
For both these women, it’s sad and frustrating to see mums lying on cushions on the floor waiting for babies to fall asleep in the early hours, or finding women with back problems from bending over babies’ cots for hours at a time each day and night.

The consequences are more wide-reaching than people think. Studies have shown sleep-deprived mums can feel isolated, alone and too tired to turn to those who can support them. Lack of sleep can also hinder coping skills, and lead to anxiety and depression. It can even cause weight retention in new mums.

Sleep-deprived babies don’t fare much better. There’s evidence to show babies who sleep longer are happier and have longer attention spans than poor sleepers.

If Jo Tantum is to be believed, none of this sleep-deprivation is normal or necessary. As she says in her book, “I’ve never failed to get a baby sleeping through the night. They can’t all have been ‘naturally’ good sleepers. The fact is that you can teach any baby to sleep through the night and you can do it in the first few weeks of life: good sleepers are made, not born.”

Routine Versus Demand Feeding
The routine these experts recommend typically involves 3-hourly feeds for babies, which can be adjusted depending on the baby’s weight and size. Of course the first couple of weeks should be very flexible until breast-feeding is established, but after that most breastfed babies can stay on a three-hour routine until they’re about 3 months old.Here are some of Jo Tantum’s secrets to a successful routine:

  • The first feed of the day should always be at the same time, between 7am and 7.30am.
  • The bedtime feed should always be at the same time, 12 hours after your baby’s woken.
  • All other feeds can be a bit more flexible, 15 minutes earlier or later.
  • Always follow the same order of events with every feed: wake your baby, change his nappy (this helps him wake up), feed him, play with him, then put him down to nap.
  • Ensure he only naps during the day and saves his long stretch of sleep for night. It’s important to wake him for feeds and ensure he gets a full feed every time, so he isn’t so hungry during the night.

In the first few weeks, your baby will need a dream feed at around 11pm, and a middle-of-the-night feed 3 hours after that. But the trick to Jo’s routine is to gradually nudge that middle-of-the-night feed out by 15 minutes every few nights, until eventually your baby doesn’t demand it and is comfortably sleeping through till morning.

She claims by following the routines as outlined in her book, your baby will eventually sleep from the dream feed through to 7am. And by as early as 3-4 months, you may be able to drop the dream feed so your baby sleeps from around 7pm to 7am each night – peacefully, without crying for food.

Cue-Based Feeding
Plunket advises ‘cue-based’ feeding as opposed to scheduled routines, and says that not every baby is ready to sleep through the night at 4 months.

Plunket clinical advisor Allison Jamieson says “some women are happy to go through a process like this (routine feeding) and achieve the results, but not every parent finds it necessary.”

If the baby is waking in the middle of the night for a feed, the best thing you can do is feed him, she says. But the key is to know what your baby wants – not every cry is one of hunger.

“The baby’s cues for feeding should be observed, as should the baby’s cues for tiredness.” Should the baby be hungry, crying is usually the last cue to look for.

Cue-based feeding also helps maintain breastmilk supply, adds Allison. “There will still be sufficient milk to feed, whether it’s been half-an-hour between feeds or four hours. If you intervene with the normal process, that will have an impact on the mother’s milk supply.”

For mums struggling with sleep and other issues, Plunket works with Community Karitane and Plunket Kaiawhina workers, who can provide extra family care and support in the form of home visits, when arranged by a Plunket nurse.

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