How To Get Sleep When Baby Won’t Sleep

Recently, I received a question from an expectant parent on the subject of baby sleep. I love sleep questions. Of all parenting issues, baby and child sleep is the most difficult to deal with. Yet, at the same time, it is one of the most studied issues and there is a tremendous amount of guidance to draw from. So what does my dear reader want to know? Here’s the plea:

My husband and I are expecting our first child in a few months, so we’re doing our research & reading what to expect for the year ahead. We have read from multiple sources that ‘rooming in’ is something we should consider. We love this idea: keeping a bassinet by the bed for easy feedings and to keep an eye on Little One. But we’ve also heard from parents Who’ve Been There, that it helps to split up the night into shifts, and move the ‘active’ parent’s station to the nursery, so they can feed and soothe the baby, change diapers, etc during their ‘shift’ without disturbing the other partner’s sleep. This also seems a very wise approach, as I am a Cranky Hellbeast when I haven’t had enough sleep.

I know a significant amount of sleep loss is inevitable, but I’m already imagining a 4 hour sleep block promised by the shift approach. Does it make sense to plan for one over the other, or should we just see how it goes when Babe arrives? Would love your input on the health benefits and concerns for each approach.

Signed,

Already somewhat sleepless in Seattle.

Where is the Baby Sleeping?

The question here hinges on the proximity of the baby at night. The amount of work, ease, and sleep you can capture in the first months of a baby’s life depends largely on how close they are to your bed and how freaked out you are about their safety.

Some parents choose to bed-share with a baby. It’s a controversial practice considering the danger that a baby might become trapped between parents, tangled in blankets or covered by pillows. Bed-sharing can, and has, led to infant suffocation deaths, and it is roundly condemned by the American Academy of Pediatrics (AAP).

Those who decide to practice bed-sharing, however, usually try to get as close as they can to safe sleep practices recommended by the AAP: Minimal bedding (bottom sheet only) on a firm mattress, no blankets, pillows, or toys near, with baby placed to sleep on their back. For additional safety the bed will often be occupied by one parent during the night and parents will not go to sleep under the influence of drugs or alcohol.

Some couples extend the distance by use of co-sleeping bed extensions that attach to a mattress. These co-sleeping beds allow a baby to have their own protected sleeping area while also being close for night feedings. The benefit is that both parents can occupy the bed without worrying about trapping the baby between bodies or under covers.

Does Having the Baby Farther Away Make Sense?

Our expectant questioner above is looking at yet more distance. Either in the room in a bassinet or in a nursery separated from sleepers. Both are fine, but upfront, it should be noted that the AAP recommends that babies share a room with parents for the first 6-months, or if possible, up to a year. That’s because AAP research shows that SIDS deaths decrease by as much as 50-percent when a baby room shares.

That might be enough for some people to make the decision to keep a baby in the bedroom at night. But there are some incredibly salient and important issues our parent-to-be has raised. I’ll address them one at a time:

• Ease of Feeding: Sure, It’s more simple to take a few steps and pop a breast in the kids mouth than to walk down a hallway. But honestly, it depends on how inconvenient a few extra steps are to you. And that convenience is practically erased when bottles need to be prepped.Yes, the closer a baby is, the easier it will be to feed them. But only in circumstances where a mother is breastfeeding exclusively. If dads are taking on a night feeding with breastmilk and a bottle it will be no more convenient for them if the baby is in the room or out of it.
• Keeping an Eye on Them: It’s super simple to check on a room-sharing baby. You pop up, walk over to the bassinet, squint into the dim and listen for their little breaths. If they cry, fuss, or engage in any kind of weird behavior, it’s easy to find out what’s going on.Having a child in the other room makes it slightly more complicated to keep tabs on them. But only in the sense that monitoring the distant baby requires baby monitoring gear. Now, there are plenty of companies offering solutions to keeping tabs on your baby. These range from HD night vision cameras to smart wearables, like socks and diapers, that claim to offer accurate data about heart rate, respiration, blood oxygen levels, and the presence of poop.

The Problem with “Smart” Monitors

There’s a hitch in smart monitor claims, though. There is no national regulatory body that ensures the accuracy of the data they collect. The only way that oversight would occur is if the monitors were marketed as medical devices. Then, the devices would be tested by an independent third party and approved by the FDA. Currently, they are not, and so should not be used by parents to make any kind of health decisions about their baby. At most, they should be used for entertainment. In other words, if you find it interesting or comforting to watch your baby’s heart rate and breathing, then a smart monitor is a good way to pass sleepless hours. However, if you’re hoping a smart monitor will save your child from SIDS there is no evidence to suggest they are effective.

So that would suggest that room-sharing is the safer way to go. But what does it do to a parent’s ability to sleep?

How to Get Shut-eye Yourself

One of my favorite sleep experts is nurse practitioner Maile Moore from Boston Children’s Hospital Sleep Center. The last time we spoke she blew my mind on a couple of important aspects of infant sleep:

1. Infants have no concept of night or day. It’s up to us to get them acclimatized to the 24 hour clock and when it’s appropriate to be asleep and be awake.
2. Infant sleep cycles are wild. Until around 4-months of age infants have fantastically short 45-minute sleep cycles with wakeful transitions. You read that right. 45. Minutes.

Those two facts have a tendency to lure parents into a sleepless hell that goes something like this: The baby starts fussing after a 45-minute snooze. A parent intervenes thinking their child needs food or comfort. The baby then becomes accustomed to parental intervention to fall back asleep.

The whole thing becomes a vicious feedback loop. The parent loses sleep, and their baby never develops the important ability to self-soothe.

So, any room sharing situation should incorporate two important parental behaviors. First, parents need to double down on sleep hygiene. All screens should be off and lights dimmed or extinguished at least an hour before sleep is expected. The room should be dark. A fan or white noise should be available and the temperature should be between 60 to 70 degrees.

Second, parents need to get in the habit of taking a beat before reacting to infant fussiness. It might seem incredibly painful, but it will help to wait a minute or two to see if a baby can get themselves back to sleep after some restless fussiness. Infants need some time to practice self-soothing. If fussiness becomes full-blown crying or it’s clear that a baby is experiencing some kind of discomfort, parents are free to step in. By about three or four months, babies should have developed the self-soothing skills necessary to string together enough sleep cycles to get through the night without incident.

What About Teamwork?

A couple should divide nightwork in a way that makes sense for their own household. There is no such thing as a division of labor that acts as a panacea for night troubles. Some couples prefer to trade night feedings and interventions one for one. Some couples prefer to split infant interventions into pre-midnight and post-midnight shifts. Others divide the night shifts by days. Some give mothers weekends off.

Whatever couples choose will depend on how a baby is being fed and the parents’ schedules. It’s a good idea to consider the division before the kid arrives (kudos to our question-asker for being ahead of the game). Honesty is key and the discussion should be undertaken with the intention that everyone is supported within the context of a healthy, fed baby.

Importantly, even if a baby is going to be exclusively breastfed, without any pump-expressed milk and bottles, fathers can still be hugely helpful. Mothers might have some disrupted sleep but dads can ease the burden by keeping breastfeeding stations (a comfy chair, table, and lamp) clean and stocked with blankets, reading material, and snacks. When a baby is between feedings they can take on primary care duties, keeping the kid wakeful for daytime hours while mom gets some shut-eye.

The name of the game is collaboration. But personally, I recommend splitting the night in half and adding pump expressed milk and bottle feedings to give dads a shift. Not only does this increase the uninterrupted sleep for both parents, it allows dad to get some crucial cuddles and care that will boost his oxytocin and make him feel more bonded to his kid.

The Final Answer

Look, you will still lose sleep regardless. So be prepared. That said, I tend to defer to AAP recommendations. It might be best to room-share with your kid. As long as you give them a chance to learn how to self-soothe, practice good sleep hygiene and act like the badass team you are, you’re unlikely to fail.