Saturday 26 March 2016

Common Infant Sleep Myths....BUSTED!!

Sleep Myths.... Busted!!


I am confident in saying that everyone who has kids has been given “advice” to help them with their children’s sleep.  Whether it is from a neighbor, grandparent, parent, or from their friend whose baby slept 12 hours at night from the second he was born!

I will share a personal story about the circle of advice:  My grandma tended to have a lot of “advice” for her granddaughters as they had children and she liked sharing the information whenever she could.  This was something I loved in a lot of ways because I learned many valuable things from her.  When my son was 6 months old I was visiting her and while we were there she gave him his first taste of baby cereal.  I took a picture because I thought this had to be something for the baby book and I also shared it on Facebook.  Within minutes I received a comment on the picture from my cousin (also my grandma’s granddaughter) that read “Are those mashed potatoes!!!???”  This was a joke of course as she knew it was baby cereal but made me chuckle!  I had been informed a few times that some solids would help him sleep like a dream so this was the best comment ever!

I have received many comments, posts, and messages lately asking questions about common myths that are out there and so I thought this would be a perfect topic to write about!  Please note that if you have used any of these methods or information in your family that is fine!!  I am not here to say if anything is right or wrong to include in your routines but am instead writing about their impacts on sleep!

Sleep Myth #1: Formula-Fed Babies Sleep Better Than Breast-Fed Babies

I hear this one ALL THE TIME!!  The actual statement that “formula fed babies sleep better than breast fed babies” is false.  Studies have shown that although breastfed babies may wake slightly more often and have shorter stretches the total amount of sleep that they get is equal to that of formula fed babies.  The number of wakings and length of stretches have also been shown to become equal to that of formula fed babies later in infancy.

This myth comes from the position that breastmilk is highly digestible causing babies to be hungry more often and that formula is thicker and so babies need to feed less often.  Breastmilk is indeed highly digestible but this does not mean that is causes the need for more feeds.  Formula is digestible as well which is why it is a great option for your baby if you are not nursing.  Being digestible means that the body can use the nutrients to sustain and benefit itself and both breastmilk and formula do this. 

Many moms discontinue breastfeeding and switch or supplement with formula in hopes to improve sleep.  I did this with my first child.  I am not in a position to make a stance that breastfeeding is better than formula feeding or vice versa because I believe that formula was created for our little ones and so is a great option but I will repeat the findings again that breastfed babies and formula fed babies have equal total amounts of sleep and so discontinuing nursing ONLY due to the fact that you want to try and improve sleep may not work.

I am going to go a little deeper into this myth because I am contacted on a weekly basis regarding this information.  There is some indications that formula fed babies get more sleep than breastfed babies as they get older but this is not due to the feeding quality or quantity that the baby is getting. It is instead due to other factors such as the use of feeding as a soothing tool.  Let me explain:

Often times a breastfed mom will use nursing as a feeding tool and a calming tool.  This is totally fine and normal!!  Families who choose to formula feed on the other hand don’t have the same easy access to milk and so often use other calming tools to soothe their baby.  I notice a big difference in my own family with this because when my first child was on formula I would try to rock him, carry him, bounce him, sing to him, play games, etc. if he got upset and it was not close to a feeding time.  Now with my second whom I am nursing I often offer the breast sooner than I offered him a bottle. It is easier at this time but with my first it was easier to wrap him up and walk with him.  Neither way is right or wrong just FYI!!
 What happens in some situations is that formula fed babies are exposed to a wider variety of soothing methods which can sometimes encourage self-soothing at a faster pace and therefore sometimes sleep better than breastfed babies.  Notice how I say “sometimes” because this is not always the case but just one view point!!  When more soothing techniques are used there is a decreased chance of a food to sleep association.

In my experience there are equally the same amount of breastfed babies and formula fed babies whose families contact me for sleep help which shows one is not better or worse than the other for sleep!

Sleep Myth #2: Giving Your Baby Cereal before Bed Will Increase Sleep

This one is similar to supplementing formula although this “advice” is given for breastfed and formula fed babies.  This is not true.  Before we go into it imagine if you went out for a big steak dinner and then had to go to bed 30 minutes later!  This would be very heavy and unsettling in your tummy. It is the same for our little ones.  Going to bed with a heavy stomach can cause more sleep disruptions because they won’t feel well.  Often when working with a family I encourage them to move the feeding earlier so that it does not disrupt sleep!

The best time for introducing new solids into your babies diet is lunch time or at least 60-90 minutes before they are going down to sleep.  This eliminates the chance of something not sitting right with them and affecting sleep.

Sleep Myth #3: Feeding Your Baby to Sleep Will Spoil Them

Although formula fed moms hear this one as well it is commonly directed at breastfeeding moms.  You may hear that feeding your baby to sleep or holding them to sleep will spoil them.  This is simply not true.  The act of feeding and/or holding your baby is not spoiling them!

The statement that “ALWAYS feeding your baby to sleep can cause sleep disturbances” on the other hand can be true in some ways.  If your baby falls asleep feeding and then needs this feeding very frequently during the night or any time they need to be put to sleep then this could mean that a sleep association has been created.  If this is causing a problem in your family then you can look at options for making changes but if it is working fine then don’t fix what isn’t broken!

I will make a note for the breastfeeding moms reading that nursing your baby to sleep is actually very normal and natural during the early weeks of your baby’s life.  This helps to build your supply and nursing/breastmilk triggers the release of cholecystokinin (CCK) which is a hormone that leaves your baby feeling a sedated sensation and a feeling of relaxation which encourages sleep.  As your baby matures the effects of CCK decrease and this is why it becomes harder and harder to simply nurse your baby to sleep.  Instead they will be awake after the feeding or need alternative methods of soothing. If you are nursing and are noticing that your baby is not falling asleep as easily at the breast please note that this has nothing to do with your milk supply or milk quality but instead is a normal physical process within your baby!

Sleep Myth #4: Babies Should Be Sleeping Through the Night by “X” Months

First of all, I put an “x” instead of a number because I have heard and read all sorts of numbers.  Some resources and people say 3 months while others say 16 months.  The biggest misconception about sleeping through the night is how different sources word the statement!  Being “capable” of sleeping through the night does not mean being “ready” to sleep through the night.  For example, a 6 month old may be capable of sleeping through the night but they might not be ready! 

Every baby, parent & family is unique and this means that there is no right or wrong time for a baby to sleep through the night! Sleeping through the night depends on a number of different factors each individual to each family.  If you are wondering when your baby “should” be sleeping through the night consider the following:
  • Does your little one have developmental readiness for sleeping through the night?  We want to make sure that they are reaching their developmental goals such as weight gain, reaching milestones, and age appropriateness.  Your family health care provider can let you know how they are doing!!
  • Are they getting sufficient calorie intake during the day?  If not, then they may be hungry at night!
  • Do they have the ability to self-soothe?  If not, you can work on this when you are ready.  Start with allowing them time to soothe during the day while they are playing.  Then work on sleep times by helping them soothe themselves.  A baby who can self-soothe has a better chance of sleeping through the night.
  • What is your baby’s temperament or personality?  An easy going baby may begin sleeping through the night faster than a more sensitive baby.  This doesn’t make one baby a “better” sleeper than another.
  • What is the parental readiness?  This is a big one.  If you want to keep the feeds during the night because you enjoy them and like the time together then keep them!  Some families enjoy this time together.  If your older baby is beginning to get irritable and not themselves during the day due to lack of sleep then you can reassess and look at a solution.  If you are tired, frustrated and resentful then you may want to encourage self-soothing skills earlier.
  • What are your family sleep goals?  Establishing goals, needs, and wants allows you to look at your situation in a unique manner and decide on a plan of action that is most beneficial to your family.  Don’t let a book or the internet tell you when your baby “should” be sleeping through the night.

Sleep Myth #5: Every Waking At Night Is Hunger Related.

This is a tough one because I am not just a sleep consultant but also a mom!  I know how tired you feel in the middle of the night and so who wants to try other soothing techniques when you know a feed will put them back to sleep!!

Besides the fact of what you do to put them back to sleep it is a myth that every night waking is hunger related….kind of.  If your young baby is only waking up once or twice a night then there is a good chance that this is hunger related.  But, if your baby is waking up numerous times then I would confidently say that not all of the wakings are due to hunger.

Babies can wake during the night for many reasons including teething, too cold, too hot, habit, craving closeness, room environment and lack of self-soothing skills.  Typically, feeding your baby cures all of the above suggested reasons for waking but as a baby gets older (8-9+ months) if they are still waking frequently I may begin to look at other reasons for the waking and address them with what works best for your family!

Sleep Myth #6: Teaching Your Baby How To Self-Soothe Means “Crying It Out”

Myth #5 states that waking could be due to lack of self-soothing skills and I know when many of you read that you cringe.  That is because there is such a negative feeling towards the phrase “self-soothe” now because it has somehow got confused with “crying it out.”

Unfortunately self-soothing is a learned skill and so our little one’s are not born with it.  That is O.K. though!  When everyone is ready you can begin guiding them on the right path.

Learning how to self-soothe does not mean letting your baby cry it out.  Is there such thing as a cry it out, or extinction, method…yes!  This method has worked for some families who have wanted to try it.  There are also many other methods for helping your little one learn to self soothe! 

There are gentler methods that involve holding your baby until they fall asleep, methods where you sit with them and sing/hum/pat/etc. until they fall asleep, methods where you sit in the room and have intermittent reinforcement, methods where you occasionally leave the room (this is different than gradual extinction where you occasionally re-enter the room), methods where you occasionally re-enter the room after leaving, and then full extinction methods!  There are lots of methods!!  On top of all the different methods there are hundreds of ways we can modify them so they fit your family! 

Helping your little one learn how to self-soothe needs to be a process that fits your baby’s needs, your needs, and everyone else in the family’s needs as well!!  It is not a one shoe fits all!

Sleep Myth #7: It’s Never Too Early to Put Your Baby on a Schedule

Sleep schedules can work for many families but there is an appropriate time to begin following a set schedule.  When a baby is born they have a very immature circadian rhythm which is their internal body clock that allows for schedule to happen.  It does not begin to mature until around 4 months when their body begins to produce hormones responsible for being awake and going to sleep! Before this age it is nearly impossible to get their body on a schedule because you will not be able to impact their internal body clock a whole lot. 

Prior to 4 months what you can do is use light and other stimulation to help your baby identify night versus day.  For example, during the night feeds keep stimulation to an absolute minimum (no lights, no talking, limited eye contact, etc.) but during the day have them in a bright environment with things going on around them.  This begins to help set the stage for their body clock to become established.  This is a big job for their bodies!

You may begin to notice more of a schedule emerging, or consistency in timing of sleep, around the 4th month but it may not be “clock work” until closer to the 6th month.  Don’t worry about focusing on a schedule during the early months!  Instead, have your goal as making sure your little one is getting enough quality sleep.  To see sleep recommendations click here.

Sleep Myth #8: If You Keep Your Baby Up More During the Day They Will Sleep Better At Night

I have come across a few situations where young children are not napping during the day in hopes of being able to sleep more at night.  Unfortunately this is a huge myth because the complete opposite will occur!  These cases are easy because we work on re-establishing naps!
In my experience, the number one cause of sleep disturbances is overtiredness!  This causes infants to resist naps, take short naps, resist bedtimes, wake frequently during the night, and wake early in the morning!

In most sleep resources the statement “sleep begets sleep” will be in bold!  This is because it is true.  Good sleep during the day helps lead to good sleep at night and vice versa!

Make their naps a priority!

Sleep Myth #9: Keeping Your Baby Up Later At Night Will Make Them Sleep Later In The Morning!

Awe man I wish this one was true!  As I stated above being overtired leads to the majority of sleep disturbances in infants and children!  They don’t have the ability to crash quite the same as adults do and so instead of having a restful sleep they have a restless sleep which is not beneficial for anyone!

The saying “early to bed, early to rise” is also a myth!  Putting your little one down early allows them to enjoy deep, restorative sleep, because they are well rested from a good day!  If they get that deep, restorative sleep at the beginning of the night and are not restless then they have a better chance of sleeping longer in the morning to continue that blissful sleep!  When overtired they will most likely wake during those early morning hours when sleep is in a lighter state!

Sleep Myth #10: Never Wake a Sleeping Baby

I have been told this many times when people are giving me that lovely “advice” we talked about earlier.  Since having kids and becoming educated on sleep however I have learned that this statement is not always true. There are some times when waking a sleeping baby is beneficial.  For example, when my daughter was a newborn I woke her at the 3 hour mark during the day to feed her and then put her back down.  Sometimes, it seemed like she slept through the feed but I knew this would help her differentiate between daytime and nighttime (I never woke her at night).

  Time when waking them is a positive thing include waking them for calorie intake, waking them from a nap to make room for additional naps and waking them from their last nap at a time that allows for an appropriate bedtime (remember earlier is better!)

Every baby is unique and you begin to know your baby very soon after they are born.  If you know your child does better with a certain nap interval or you know their schedule well then follow their cues and your intuition!  Don’t be scared to wake them though if what you are doing is leading to great sleep!!

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