Most parents will be familiar with waking in the middle of the night to the sound of their child crying. Dr Mahmoud ElHalik, Head of Neonatal Intensive Care Unit, Consultant Neonatologist and Head of Health Informatics Unit at Latifa Women and Children Hospital, DHA, says that during the first three months, feeding the baby should take priority over sleep, so interruptions during the night are perfectly ordinary and should be expected.
Here, Dr ElHalik reveals exactly what parents should know about their babies and their sleeping habits.
How often do babies tend to wake up during the night and what are the main reasons?
Every newborn is slightly different in terms of how much sleep they need. For newborns up to three months old, the recommendation for sleep is between 14 and 17 hours a day, although this can vary to between 11 and 19 hours and sometimes they sleep for three to four hours at a time.
Babies do not know the difference between day and night. They wake up for their feeds and then go back to sleep. This demand for food should be encouraged and a baby should not be allowed in the first three months to sleep more than four hours without feeding.
As they grow up, babies will adjust by themselves to the frequency of feeding and accordingly the time of sleep. She or he might feed almost every two hours especially with breastfeeding, and possibly a little less often when on bottle-feed.
By three to six months, many babies are able to sleep for a stretch of six hours and infants between four and 11 months old need between 10 and 18 hours sleep each day.
You cannot spoil a newborn. If your baby calms down when you pick him up, they needed to be picked up.
What causes unexplained crying?
The most common reason babies cry is because they are hungry. They stop crying at the onset of feeding. By the end of the feeding, they tend to be happy.
The second reason babies cry is when they need sleep. They need their parent to put them in a comfortable position, such as swaddled and on their back.
Some babies cry because of a bloated stomach from overfeeding. Unlike gas, too much milk can cause discomfort that lasts a short time.
Another issue can be caffeine. It is a stimulant that can cause increased crying and trouble falling asleep. Breastfeeding mothers need to limit their caffeine intake.
Being too hot or too cold can also make a baby cry as well as clothing that is too tight. A dirty diaper can also cause pain and burning, making the baby to cry.
During the early months colic is one of the most common causes of crying. All babies have some normal fussy crying every day. When this occurs over three hours per day, it is called colic. When they are not crying, they are happy. As rule of thumb is always burp your baby after feeding.
A more serious issue for babies is pain. Painful causes include an earache, mouth ulcers, or a raw diaper rash. These babies cry a lot and are not happy when they are not crying. They need to see a doctor to make a diagnosis. Fever in this age group is serious until proven otherwise.
How important is consistency when establishing a sleep routine for a baby?
Babies are not usually capable of being on a fairly consistent schedule until they’re four to six months old. Accordingly, it is not the time to work on imposing a rigid routine. For newborns, it should be very clear for the parents that it is best that sleeps and feedings are on demand. However, developing some caregiving routines around sleeping and feeding times will set the basis for establishing a schedule later on. For example, when you see that your baby is getting sleepy, sing them a cradlesong, and then put him or her to bed. Over time, the cradlesong will become a cue for sleeping; babies find comfort in being able to anticipate what will happen next.
What advice would you have for parents who are worried they are indulging their baby too much by constantly being attentive during the night?
You cannot spoil a newborn. If your baby calms down when you pick him up, they needed to be picked up.
However, more importantly, the baby has to gain confidence that you will respond to their needs. In fact, during first six months of life, one of the baby’s primary needs is to develop a sense of trust that you will take care of them.
Always remember that by three to six months, babies typically develop regular sleep patterns and can rest until dawn. As your baby’s brain matures over these first few months, you will probably see a sleep pattern start to emerge with longer and stretched hours of sleep.
Do not wait until your baby is overtired to put them to bed. An overtired baby has more trouble falling and staying asleep.
Dr ElHalik’s 6 tips for parents
As early as six to eight weeks old, parents can start their baby’s bedtime routine. A baby’s routine can be any combination of regular bedtime activities such as:
1. Play active games during the day and quiet games in the evening, which won’t make the baby too excited just before bedtime.
2. Keep activities
the same and in the same pattern and order every night.
3. Make every activity calm and quiet, especially towards
the evening.
4. Bathing right before bedtime will calm the baby.
5. Save your baby’s favourite activity such as a cradlesong for last, and do it in the bedroom. This will help the baby look forward to bedtime and associate sleep space with things they enjoy.
6. Always make nighttime conditions in the baby’s bedroom consistent. If they wake up in the middle of the night, sounds and lights in the room should be the same as when they fell asleep.
