Sleep regression
Sleep regression is a term used at any point in a child’s life when sleep routines are not optimal for their age. Image Credit: Shutterstock

It’s a shock to the system, that’s what it is. When you’ve finally laid down a routine that sees your baby sleep peacefully through the night, allowing you rest too. When you stop feeling like you are running at 20 per cent. When you’ve just settled for the night and you hear that familiar wail – the baby is awake. Welcome to parenthood, where sleep regression is just another fact such as the night is dark or sugar is sweet.

Cecile de Scally, Lead Parent Educator at UAE-based Malaak Mama and Baby Care, explains: “Sleep regression is a term used at any point in a child’s life when sleep routines are not optimal for their age. This occurs commonly the first time around four to six months of age and is often linked to a higher need for calories.

“For expatriate families, they will often experience these with travelling or following visitors, with illness and anytime a child is out of routine.”

Not everyone calls the bumps in sleeping pattern a backward slide though. Claudine Gillard, of UAE-based firm Sweet Dreams Sleep Consulting, says the terms ‘regression’ is used incorrectly when it comes to analysing a baby’s naps. “So, there is only one official ‘sleep regression’. And that's around 16 weeks. It's actually a progression of sleep. And that's for the development of sleep from baby sleep to adult sleep.

“Baby sleep comprises two sleep cycles, which are light and deep. Adult sleep comprises four sleep cycles, which basically includes REM (rapid eye movement sleep) and non REM sleep. The key difference is that it's a stage of maturity. And that's why it's a progression. All other sleep regressions is not actually accurately described.

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“These are stages of maturity that children reach and during that time, their sleep is affected … but it's not as though children wake up one day and their sleep is in any way worse than it previously was.”

When can you expect to see these changes in pattern?

Sophie Jones, Sleep Consultant at Babies and Beyond, says: “Sleep regressions are a very common part of development for babies and toddlers. They can occur at many different stages of growth, but typically happen when:

  • a new skill has been learnt,
  • sleeping patterns are shifting,
  • during development of a baby’s circadian rhythm, or
  • if they are experiencing separation anxiety.”

Julia Youll, Public health Practitioner at Nightingale Dubai, adds: “Travel in different time zones, teething and sickness may all cause sleep regression, as well as reaching different developmental milestones such as sitting and crawling.”

At which age is sleep regression most common?

The most common ages for sleep regression are, explains Jones:

  • 4 months,
  • 6 months,
  • 8 months,
  • 12 months,
  • 18 months, and
  • 2 years.

Malin Ghavami, Lead midwife/Head Nurse at Nightingale Dubai, says: “Sleep regression comes and goes in phases for babies and toddlers, it is usually related to food-regimes and stomach-issues for the younger babies as well as going through stages where they grow more than average and want/need more milk than usual. It can also be because of over stimulation and the baby is simply over tired.”

How long does it typically take to reverse this regression?

“They may last around one or two weeks. The usual signs are: more restless or wakeful, fussy, fighting naps, taking longer to settle at night, increased crying at sleep times ,” Jones adds.

Growing good sleeping habits

Begin young, says Youll. “In the early days try occasionally putting your baby down awake at nap times. They may surprise you by dozing off. The art of falling asleep independently is a skill that develops over time.”

Happy associations help too. “It is important to work on positive sleep associations where the baby feels safe and secure going to sleep/ bed. Make sure the room is not too warm and that the light is not too bright,” she says.

Ghavami suggests play as a way to create a cosy vibe in a spot. “Play and spend time in the place where the baby will sleep while taking nap and/or at night, make this space to a friendly environment and not only the place where they are left alone for sleep,” she says.

“From four months you can begin to encourage naps in the same environment as night sleep. Putting a baby down to bed awake and patting to sleep can be a great transition from being rocked or held to sleep,” Jones explains.

Consistency is the key, especially if there are different carers/nursery workers,” Youll adds.

De Scally says: “It is best to start from around two weeks of age and use two techniques; for day routines. HAT and EASY; along with ‘hands on’ to establish a flexible baby-led routine. ‘HAT’ is the amount of time a child is awake in one time before they need to sleep; and is guided by the age and their cues. ‘EASY’ is commonly used to describe an eat play sleep routine although I do like to add in a small feed before sleep for smaller babies.”

Is guilt keeping you awake?

There is a lot to understand around sleep but it is important for parents to know, says De Scally:

  • Sleep is a basic need and you should not feel guilty by ensuring you and your child have enough.
  • Sleep is dynamic and changes as your child grows.
  • Sleep can be corrected but it does take commitment and hard work.
  • It is never too early to start ‘good habits’; rather than need to correct poor sleep routines later.

How can you get a child to sleep without the breast or bottle?

While it’s a common side-effect of exhausted parent meeting insistent infant, be warned that this is one habit that’ll come back to bite you later. “Going to sleep whilst feeding is common at the beginning, soothing for all and generally unavoidable, but sometimes over- rocking or other associations may create a habit difficult to break later,” says Youll.

For young babies (over two-weeks-old), says Ghavami, try this to encourage self-sleeping practices:

Use a pacifier (one of the preventative measures when it comes to Sudden Infant death Syndrome, or SIDS).

Swaddle: This is another great way of making the baby more comfortable on his/her own in the bed, it makes them feel less exposed and alone.

Meanwhile, de Scally recommends a technique she calls ‘hands-on’ She explains: “This is not about crying, although your child may cry to settle themselves a little.

Ensure you create the right environment, which includes:

  • Safety is the most important factor: SAFE - Supine (flat)-Alone on a Firm Mattress in an Empty Crib (older children are safe with a lovey). No cot bumpers. No duvets or pillows.
  • Cool not cold- a comfortable room temperature.
  • A dull light in the day and dark at night.
  • Use white noise, which is helpful to calm your younger child, and a lullaby for the older child.

Swaddle is a must in a younger baby (zip up, allowing their hips to be free) or in an older child a snuggle toy often referred to as a lovey).

Ensure the child is well fed and satiated before sleeping. (Always brush teeth or rinse their mouth with water if appropriate).

Place them in bed when they are drowsy but not asleep.

In a small baby - rock or pat to sleep in bed (not in your arms).

In an older child - you can stroke or hold hands and reassure.

This will take around 20 minutes but requires you being consistent and persistent.”

Gillard also calls for well-timed comfort. She explains: “Make sure that you're not overcompensating and providing comfort at the wrong time. What I mean is, be certain that your baby's awake or that they need you before you go in and provide additional support and comfort to get back to sleep. Because babies are quite noisy in their sleep, they have what's called noisy transitions, and they might not actually be awake. But if parents go in to a half-awake child, he or she, inevitably that child will wake up.”

Co-sleeping
Is co-sleeping inevitable?

What about co-sleeping? Is that a good idea?

Co-sleeping is used to describe sleeping

1. In the same room

2. In the same bed

“As per SIDS committee recommendations, a baby should sleep in their parents room till six months of age; however, no baby should mattress share,” says de Scally.

Claudine Gillard, of UAE-based firm Sweet Dreams Sleep Consulting, admits to co-sleeping with her son, but the confession comes with a warning note. “I co-slept with my son. He was two-and-a-half-years old and I didn't know any better. And we thought that was a solution to sleeping better and sleeping more. Nothing could be further from the truth, to be honest with you.

“Co-sleeping needs to be done safely … it can be a very dangerous activity,” she says.

Ghavami adds: “Co-sleeping is not advised for the first year in babies 'life, as this is the time when the risk for SIDS is relevant, the risk of both suffocating and overheating increasing while co-sleeping, a good option is to get a side bed-cot attached to the parents bed (preferably on the mother's side, especially if she is breastfeeding).”

When is it time to reconsider co-sleeping ?

If you choose to co-sleep after four months or at any age, it is completely personal choice and there can be many benefits for both parent and child. However, if sleep is being disrupted or it is affecting other areas such as mood, behaviour, nutrition, then it is maybe time for change, says Jones.


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