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How Do I Get My Infant to Sleep Through the Night?

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This question originally appeared on Quora.

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Answer by Stefanie Wauk, Pediatrician,

This is probably the most common question asked of pediatricians, and each doctor you ask, you'll get a different answer. Basically, you need to find something that works for you, your baby and your family, that you can tolerate doing night after night. What worked for your friends or parents might not work for you, and what worked for your first baby might not work for your second.

There are two main components to healthy sleep. There's the nighttime routine to initiate the sleep, and then how you respond in the middle of the night to nighttime wakenings. Changing how you respond to nighttime wakening is usually called sleep training.

The first thing I'd say though, is to make sure you have realistic expectations:
  • The pediatric definition of 'sleeping through the night' is to sleep uninterrupted from midnight to 6am. It doesn't (usually) mean that they'll sleep from 7pm to 8am without waking.
  • A 1, 2, or 3 month old is not going to sleep through the night, and definitely should not. They need to be fed much more frequently than that.
  • The majority of infants don't sleep through the night.
  • You and your family should discuss why you're trying to sleep train, and whether you're ready for it - is it because you can't tolerate your baby waking in the middle of the night because you absolutely need the sleep, or is it because you feel like he or she "should" be sleeping through the night, and it's something to do? Sleep waking is only an issue if your family can't tolerate it.

As other people mention, a nighttime routine is key. A consistent routine will cue to the baby that it's time for bed and sleep. Nighttime routines can consist of any combination of reading books, bath-time, calm singing, massages or anything else relaxing, just as long as it's consistent each night. ( http://www.babycenter.com/0_esta... )

If you decide to sleep train, talk to the other nighttime caregivers and talk about what you think you can do, and what you aren't willing to do: the 'cry it out' method can be traumatic for both parents and children, and detrimental to the parent/child bond and development of the child. Talk about how far each of you is willing to go. Like I said, this needs to be something you can do night after night, not only during the initial sleep training, but frequently again later when he or she backslides, such as during illnesses or during vacations.

There are literally hundreds of different methods to sleep train, ranging from closing the door and not going back till morning, to sitting by the crib and comforting the infant and helping them drift to sleep. http://www.askdrsears.com/html/7... is a good source for different techniques as well as other helpful tips.

Also remember that the only consistency with babies is change. As soon as you get their sleeping figured out and their sleep is at a point you're happy with, everything will change! Either they'll get sick, you'll go on vacation, someone will come visit, or they'll learn a new developmental milestone that they want to practice in the middle of the night, and you feel like you're back where you started!

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Answer by Linda Geddes, Author of Bumpology: The Myth-Busting Pregnancy Book for Curious Parents-To-Be

The amount of sleep baby needs is inherited to some degree, but research suggests that parents' interactions with their newborn baby can also play a big role in terms of getting them to sleep through the night.
 
Most sleep researchers agree that introducing a consistent bedtime routine such as brushing teeth, taking a bath and reading a story helps babies to fall asleep as does waking them up at the same time each morning and ensuring they get some kind of physical exercise in the daytime. At least one study found that babies exposed to more natural light in the early afternoon slept better at night than those exposed to less.
 
Babies will quickly learn to associate certain cues with sleep, which means that if parents aren't careful they could be teaching their baby bad sleep habits. A review of scientific studies on night waking and other bedtime issues found that some of the most common problems included babies needing to be rocked, held, or a parent to be present in order for them to fall asleep; the baby needing to be fed to sleep; or the baby habitually waking several times during the night. It's easy to see how these associations become set in place - they are often born of desperation and we aren't always thinking rationally in the middle of the night when we're surviving on very little sleep ourselves.

However, trying to prevent bad habits from forming in the first place is generally easier than trying to break them once they've become established. Most experts agree that parents should try to lie babies in their cots while they are still awake so the baby doesn't become reliant on them being present in order to fall asleep. Other evidence-based tips include:
 
·     Encouraging your baby to take a focal feed - a longer than normal breastfeed or a large formula feed - at between 10 PM and midnight
·     Trying to distinguish between genuine crying and fretting in order to reduce the number of times your baby gets picked up during the night. Babies will often fret before settling to sleep and don't always need further attention from their parents
·     Keeping the lights dimmed during night feeds
·     Making night-time as uninteresting as possible for your baby. Night-time is for sleeping.

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