Sleep Difficulties in Infants
Around 20% of babies in the UK are reported to have sleeping difficulties in their first year – so if this is happening in your family, you’re not alone. Erratic, disrupted sleep can just be temporary while your baby gets used to things, but there may also be underlying issues for these problems. If your baby is having sleep problems that are concerning you, you may need to contact your healthcare professional.
A baby’s sleep cycle is different to that of an older child or adult: 4 stages of REM and non-REM sleep in 90 minute cycles, where only 20-25% of sleep is REM. Infants, on the other hand, have sleep cycles of around 50 minutes (for the first 9 months), and around half of it is REM sleep. REM sleep is used to consolidate memories and is critical to a baby’s development.
Shorter sleep cycles mean that they may wake more often, but they will normally just stir and fall back to sleep. They will wake up properly when they need to feed. In the first few weeks they may wake every 2-4 hours, but as their stomach gets bigger, they will take more in at each feed and only need to wake every 4-5 hours. It’s normal for your baby to have lots of night wakings when they are young, but then they learn to self soothe and fall back to sleep on their own as they adjust to the world. Remember to follow safe sleep advice when it comes to your baby’s sleep environment.
From around 6 months, your baby could stop needing night feeds so may wake up less often and eventually sleep through the night. It’s possible that children who previously slept through the night can sometimes resume night awakening, usually because of social factors rather than maturational ones. It may take a while and they may even regress, but don’t panic if your baby is taking their time to get settled into their routine. It may be difficult, but by not responding to your baby straight away, they can learn to self soothe and fall back to sleep by themselves (although it’s best if you don’t leave them to cry).
If you move your baby into their own room after 6 months, they may experience separation anxiety. It is completely normal, but it can be a difficult time. At around 4-7 months your baby will develop object permanence, which means that they can understand that objects (i.e. mum or dad) still exist even when they can’t be seen. This may lead to fussing or crying (instead of sleeping) when they’re left in their own room, but they will learn (over time) that this doesn’t mean you’re gone forever. This type of anxiety has been found to be more prominent in infants between 8 and 12 months. See the tips section below for advice on dealing with separation anxiety.
Moving your baby into their own room will impact their sleep, but it’s important to stick with it rather than move them back and confuse them. It may seem like a mean thing to do, but not responding to their every noise and allowing them to self soothe can help to regulate their mood, help improve the quality of their sleep (and yours) and make them calmer and better at concentrating in the future.
Baby sleep problems
Baby sleep problems include:
- Excessive sleepiness or insomnia
Although your little one will sleep a lot, they generally should not sleep more than 19 hours at 0-3 months, or 18 hours at 4-11 months. If your baby is sleeping for an excessive amount of time, it may be due to a growth spurt, teething or illness, but it can also be a sign of an underlying condition (discussed below).
It is possible that things can go in the other direction, and you baby may suffer from infant insomnia, which can also be a sign of teething or illness, or other underlying problems such as colic.
- Disruptive sleep apnoea
Sleep apnoea is particularly prevalent in premature babies. Sleep apnoea is often thought of as a problem that arises as we get older but, although it is rare, it can occur in infants. It affects 84% of infants who weigh less than 2.2 pounds, and 25% who weigh less than 5.5 pounds. Research shows that it also correlates with gestational age – it affects nearly all infants born at 29 weeks or less, 54% born at 30 to 31 weeks and 15% born at 32-33 weeks.
This may be because of airway abnormalities that can cause the airway to collapse, obstructing their breathing. It has been found that infants have both physical and psychological predispositions toward airway obstruction and gas exchange abnormalities.
Signs of sleep apnoea include:
- Pauses in breathing lasting for 20 seconds or more
- Patterns of repeated breathing pauses that last for less than 20 seconds
- Related problems like low oxygen or a slow heartbeat
- Other underlying medical conditions
If your baby is suffering from sleep problems, they may not be environmental or behavioural; it is possible that they have an underlying medical condition, such as a fever, infection of some kind or abnormal reflux.
Sleep problems can also be caused by underlying psychiatric conditions such as mental health conditions, which are difficult to diagnose in infants, but becomes more apparent later in life or ADHD.
A study found that around 25% of children with sleep problems in infancy will later qualify for the diagnosis of ADHD.
Research found that genes can have a big impact on whether children sleep through the night (specifically at night time rather than day time). It is also thought that if a parent suffers from insomnia, it can make their baby more predisposed to it.
- Environmental factors
Infants will wake a lot in the night but won’t always need attention – if you hear them stir, don’t respond straight away as it’s likely they will fall back to sleep. If they continue making noises or crying then they may need feeding, changing or attention.
Self-soothing will help their sleep cycles to link, improving their sleep quality and, in turn, improving their health and development. Of course, it’s important to be there for your child and to make them feel safe, but too much involvement may lead to more disrupted sleep. While it is normal for new parents to be anxious, too much attention will actually stress the child out!
It’s important to keep your baby feeling safe and secure, but too much involvement may hinder their sleep. A reasonable level of emotional availability includes responding sensitively to your baby’s cues, using soothing bedtime routines, not initiating play or too much talking and not becoming impatient or irritable.
Tips on Improving Your Baby’s Sleep
It’s completely understandable that it may be difficult to get your baby to sleep for the recommended amount of time, or to keep things consistent. Some little ones may wake at regular times, fall back to sleep easily and start sleeping through the night at 5 months; others may have sporadic sleep patterns, cry and fuss when they should be sleeping and not sleep through the night until they are past their first year. This does not mean you are any better or worse at being a parent – you’re doing a great job.
The current recommendation from the UK Department of Health, the NICE Guidelines, the NHS and the American Association of Paediatrics is that, the safest place for your baby to sleep for the first six months is in a cot in the same room as you. After that, you may move them to their own room (if possible).
Ways to Create a Comfortable Sleep Environment
To create a comfortable sleep environment, it’s important that your baby isn’t too hot or too cold. The recommended room temperature should be between 16 – 20°C, along with the use of lightweight bedding. Put your hand on their back or neck to feel if they are too warm – they may be clammy or sweaty if they are.
Other things that can create a comfortable environment are keeping it very quiet (but not so quiet that they are unable to cope with the normal noises of life!) or using white noise or lullabies to soothe your baby to sleep. Use these sounds only before bed to help condition your baby to learn the difference between night and day / sleep and awake time.
You also do not want to have any fluorescent light around your baby before bedtime or during night feeds and changes, so a dim nightlight that’s free from blue light will reduce disturbances and help them to sleep better.
You can also use other, natural means to help your baby sleep:
- Aromatherapy: As a baby’s brain is still in development and their sense of smell extremely acute, use ONE DROP ONLY in a burner in a corner of the room, away from the baby’s crib. Orange, lavender or Roman Chamomile essential oils are excellent for children.
- Flower/Vibrational Essences: There are many essences that can be used to help with children – as they are energetic in nature, they impact the infant’s emotional state, rather than his/her physical being (though of course they are connected). A few drops of the essence can be:
Added to baby’s formula; or if being breastfed, mother takes the essence; as it enters her energy field, it will be passed on to the child (who is psychologically and emotionally connected to mum).
Put in mother’s hand and “smoothed” into the baby’s aura with gentle strokes
The beauty of essences is that they do not interfere with any medication or medical treatment, are natural and if not right for the user, they simply have no effect.
- Massage: Massage is an excellent way to both bond with your baby as well as keep them relaxed. Infant massage should be learned from a qualified teacher, as it varies somewhat from working with an adult.
If you would like more information regarding holistic and natural ways to help your baby sleep better, book a free Slip into Sleep session at: https://meetingwithsheila.com
Sources: Bluebell, Sleep Foundation, Nested Bean