Sleep deprivation – top tips for parents!
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Mandy Gurney
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Former Director of the Sleep Clinic at the NHS St Charles hospital in London and Director of Millpond Sleep clinic. She also works as an NHS Sleep educator to health professionals across the UK.
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Baby Sleeping

Newborn Sleep and SIDS

It's useful to know the basics guidelines on sleep and naps for newborn babies, and also how to make sure they are safe when they go to sleep. This includes advice on co-sleeping, sleeping in a cot, SIDS (Sudden Infant Death Syndrome) as well as simple things like room temperature.
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In Short
Newborns sleep around 16 hours in 24 evenly spread between day and night - and need feeding around the clock.

Prepare them for longer night time sleeps by distinguishing between day and night - i.e. lots of light through the day.

Don't co-sleep with your baby unless you're familiar with the risks, as outlined below. Then only after the age of around 3 months.

The safest place for your baby to sleep is in a cot, up next to your bed.

The main cause of SIDS is smoking - even on your clothes will impact on your baby's health.

The temperature in your baby's bedroom should be around 18 degrees.

Safest is a cot, next to the bed.

The main cause of SIDS is smoking - even on your clothes will impact on your baby's health.

Temperature in your baby's bedroom around 18 degrees

The pattern of baby sleep and naps in the first year

It’s helpful to understand the general patterns of sleep and naps in the first year. Then you can check whether you and your baby are on the right track.

Your baby’s pattern of sleep changes a lot during their first year.

They will have spent a lot of time asleep in the womb and most of this sleep would have been REM or dream sleep.

In the early days after birth, your baby will then spend about half of their sleeping time in REM sleep and the other half in non-REM sleep.

By about three months of age, your baby will probably be able to sleep a lot better, and even getting the bulk of it at night-time.

Newborns sleep around 16 hours in a 24 hour period but initially this is split evenly between day and night, so is pretty exhausting for new parents.

During your baby’s first 12 weeks he will become increasingly wakeful with longer periods of being alert and awake.

As their need for sleep goes down they can begin to pack their sleep into the night time.

You can help this more ‘diurnal’ behaviour (diurnal animals, like us, are awake during daylight and asleep in the night) by taking your baby out in the daylight. If they get lots of light in their eyes, just by being outside, this will help to regulate their body clock.

The idea is to help them distinguish between night and day. Having a bedtime routine at the same time every evening will also help to regulate your baby’s body clock and help them to understand this is night time.

Their naps through the day shouldn’t have this bedtime routine, they can just go to sleep without pyjamas, bath etc, so they start to realise daytime naps are different.

About three-quarters of 3-month-old babies can sleep for six to seven-hour chunks, maybe have a feed, and then go back to sleep again.

By six months of age many babies can sleep through the night without needing a feed, but don’t stop them if you and your baby are happy with night time feeding.

By six months of age, babies can, in theory, sleep for 10-12 hours at night with less sleep in the day.

By about nine months old, most babies are only really needing two naps in the day. This means they can just have a late morning nap, and afternoon nap, and then sleeping for 11-12 hours at night. It’s a good idea at this point not to let them nap if possible after around 3.30pm, so they have a long stretch of being awake before night-time.

By about twelve months they will drop down to one nap a day, and have most of their sleep at night.

Where should my baby sleep?

It’s your choice whether your baby sleeps in a crib, a Moses basket or a cot, or with you, but you need to be aware of the pros and cons of each.

Most guidelines suggest there are risks for very young babies (up to 3 months) sharing a bed with their parents, and that the safest option is to have a cot, right up next to your bed, so you can reach them to comfort them or breastfeed easily.

You certainly should not sleep with your baby if you smoke, drink or take drugs (illegal or legal) that might make you tired or sleep heavily, e.g. even things like painkillers or antihistamines. You should never fall asleep with your baby on a sofa or armchair since the risk of rolling onto them is very high.

After 3 months it’s generally thought to be fine for your baby to sleep with you, given you don’t do any of the things listed above – and we talk about that more below.

How do I position my baby in the cot?

When you’re putting your baby down for a sleep in a cot it’s really important that you put your baby on its feet right to the bottom of the cot and the baby needs to be lying on its back. A lot of parents feel that the baby should perhaps be lying on its side or lying on its tummy. But babies are safer if they’re sleeping on their back and you don’t have to worry about the risk of vomiting. We do know that if a baby sleeps on its back with its feet right to the bottom of the cot it does significantly reduce the risk of Sudden Infant Death Syndrome otherwise known as SIDS or cot death.

What is SIDS?

SIDS stands for Sudden Infant Death Syndrome and that’s a term that’s used to describe the sudden death of a child or a young baby where we’re unable to identify what the underlying cause of death has been. Around 300 babies in the UK die from SIDS each year, so it is quite rare, but it generally happens in babies under 3 months old.

What causes SIDS?

There are a number of different factors which have been identified which seem to increase the risk of SIDS, but by far the most significant factor is smoking. The risk to the baby begins with smoking during pregnancy and being around other people who are smoking when you’re pregnant and that goes on throughout the baby’s life. So if you smoke near your baby or other people smoke near your baby or in the house that will increase the risk. The best thing that you can do for your baby’s safety is not to smoke at all and not to let other people smoke around your baby. It’s also important to remember that cigarette smoke can stay on your clothes so even if you go into the garden and smoke that smoke will stay on your clothes so when you go back in and hold your baby your baby will be exposed to that smoke from your clothes.

Is Co-Sleeping OK?

Some people like to share their bed with their baby, but there are a few important points to think about if that’s what you choose to do. You need to make sure you’ve got a firm mattress. Don’t ever consider sleeping together on a sofa or a water bed. Don’t use a pillow. Make sure the bedding is nice and light. Don’t have a toddler in the bed at the same time because of the risk of a toddler rolling over on to the baby.

To reduce the risk of cot death you should never sleep with your baby in your bed if either you or your partner are smokers if you’ve been drinking alcohol or taking any medication that might make you drowsy. And never leave a baby in your bed on its own.

What’s the right temperature for my baby at night?

The optimum temperature for a room that a baby is sleeping in is about 18 degrees, which is a lot cooler than most people imagine!

What’s the best bedding to use?

It’s a good idea to use natural fibres like cotton or wool. Light cellular cotton blankets are a particularly good idea. You can add or reduce the layers as you want to make them cooler or warmer. It’s not a good idea to use a pillow for a baby and small babies shouldn’t use a duvet either.

Make sure that the mattress you’re using in the baby’s cot, Moses basket or crib is the right one designed to fit that Moses basket, cot or crib. It’s important you don’t have any gaps around the edges, and no tears or emerging stuffing in the mattress.

Note


Sleep Training NHS staff since 2007

If you or your colleagues want to know more about children’s sleep and how you can help the families you are working with, Millpond Sleep Clinic run one-day Sleep Workshops aimed at health care professionals.

These highly engaging sessions are based on proven research and years of experience and are suitable for all staff working directly with the families of babies through to school aged children.

The workshop is fully certified and approved by The CPD Certification Service.

If you would like to find out more about the sleep workshops please contact Millpond direct on:

Tel: 020 8444 0040

Or website: http://millpondsleepclinic.com/accredited-sleep-workshops/

References and Recommended Reading

Teach Your Child To Sleep, Millpond / Hamlyn, Revised 2016.

Sleep Faring, Jim Horne / Oxford, 2006.

Take Charge of Your Child’s Sleep, Judy Owens and Jodi Mindell / Marlowe and Co, 2005.

Healthy Sleep Habits, Happy Children, Dr Marc Weissbluth / Vermilion, 2010.

Sleeping Better, A Guide to Improving Sleep for Children with Special Needs V Mark Durand / Brookes Revised Edition 2014.

Outcomes at six years of age for children with infant sleep problems: Longitudinal community-based study Anna M.H. Price, Melissa Wake, Harriet Hiscock et al, Sleep Medicine 13 (2012) 991–998.

Short Nighttime Sleep Duration and Hyperactivity Trajectories in Early Childhood,Tourchette et al. Pediatrics.2009.

Sleep and Depression in Postpartum Women: A Population-Based Study; Dorheim SK et al, Sleep 2009; 32(7): 847-855.

Fragmented maternal sleep is more strongly correlated with depressive symptoms than infant temperament at three months postpartum. Goyal D, Gay C, Lee K, authors Arch Women’s Ment Health. 2009;12:229–37.

Sleep problems in young infants and maternal mental and physical health, Jordana K Bayer, Harriet Hiscock, Anne Hampton and Melissa Wake, Journal of Paediatrics and Child Health, vol 43, issue 1-2, January/February 2007.

Longitudinal analysis of sleep in relation to BMI and body fat in children: the FLAME study. BMJ 2011.

Short sleep duration is associated with increased markers in European adolescents.

International journal of Obesity (2011) 35, 1308-1317 M Garaulet et al.

Sleep and the epidemic of obesity in children and adults; E Van Cauter & K Knutson, 2008.

The use of Melatonin in children with Neurodevelopmental Disorders and impaired Sleep: a randomised, double-blind, placebo-controlled, parallel study (MENDS),Re Appleton, AP Jones, C Gamble, PR Williamson, L Wiggs, P Montgomery, A Sutcliffe, C Barker and P Gringras. Health Technology Assessment 2012; Vol. 16: No. 40 DOI: 10.3310/hta16400

Kids’ behavior impacted by lack of sleep, Jase Donaldson, Insight Journal, Feb 13 2006.

What affects the age of first sleeping through the night? S M Adams, D R Jones, A Esmail and E A Mitchell, Journal of Paediatrics and Child Health, vol 40, issue 3, March 2004.

Behavioral Treatment of Bedtime Problems and Night Wakings in Infants and Young Children; An American Academy of Sleep Medicine Review, Jodi A. Mindell, et al SLEEP, Vol. 29, No. 10, 2006.

References are reviewed on a regular basis and are updated when applicable

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