SLEEP AND SLEEP PROBLEMS
Treat this important feature as a guide and act as per
your instincts with regard to the needs of your child and the
rest of your family.
We will discuss the following points:
- The duration of sleep differs at different ages and from child to child.
- A few sleepless nights are normal in the first months of your child’s life. After about 3 months of age, most babies settle down to a schedule convenient for you and the family.
- While older children may sleep in a separate room, your young infant will sleep better with you.
- Close relatives, specially the father, should be involved in helping the baby to sleep well.
- Most sleep problems are temporary.
Duration Of Sleep
The duration of sleep varies from child to child. If
your child is joyful and active the whole of the next day, you can be
sure that he had a good sleep the night before. If he is
irritable and not his usual self, he either had inadequate sleep or
has some other emotional or physical problems.
A newborn baby seems to sleep most of the 24 hours of
the day, except when he is hungry, wet or uncomfortable for
some other reason. As he does not yet know the difference
between day and night, he may sleep more during the day and less
at night. While this may not be convenient for the mother,
she will then herself choose to sleep more during the day
while the child sleeps, and learn to feed the baby in a lying
position (safe in breastfed babies) in bed without having to get
up to feed. People at home should support her by
Some babies may demand extra attention. They are rather fussy and can give anxious
moments to an unprepared mother. Most (but not all) babies seem to sleep better
after their morning massage and bath, especially if they are swaddled (wrapped up).
In the second month, the baby is more awake and, after about 6 weeks, may start
responding when you try to
catch his attention. Around 3 months of age, the pattern of
sleep is more likely to change, and most babies sleep for longer
hours at a stretch during the night. They are more awake
during the day and may have a nap for an hour or two in the morning and again in the afternoon. This pattern continues until the
first birthday. They may then have a nap only in the afternoon
until the age of 3, when they may stop having a nap during the day. At this age, most children will sleep for about 10 to 12
hours at night.
Teenagers need 9 to 10 hours of sleep each night. Sleep deprivation can affect
The Difficult First Months
To understand the basis of this statement, you should
have some idea about ‘light sleep’ associated with rapid
eye moments (REM) and ‘deep sleep’, also called non-REM sleep.
A newborn’s sleep period begins with drowsiness,
leading to light sleep, and followed by deep sleep. Rapid movement
of the eyes and dreaming mark light sleep. Up to the age of 3 months, half a baby’s sleep time comprises of light sleep.
Compared to this, toddlers, older children and adults have deep
sleep for upto three-fourths of the total sleep period. So if a small
baby below 3 months sleeps for 16 hours, he has deep sleep for 8
hours. For the other 8 hours, he is in light sleep. Older children
who sleep for 12 hours may have light sleep for only 3 hours. A
baby is likely to wake up more easily from a light sleep. A
mother may put a child passing through this stage of sleep down on
the bed with the impression that he has gone to sleep, but he is
likely to get up soon after and start crying because he has not
yet gone into a state of deep sleep. Therefore, it is important
that we continue to give the child body contact till he crosses
the barrier of light sleep and moves into the realm of deep sleep.
Also, as mentioned earlier, babies are not yet able to distinguish between day and night.
Therefore, they may sleep more during the day but bother Mom more during
And then, in the mother’s womb, all the needs of the
foetus were met promptly. Hunger was satisfied, warmth assured. There were familiar heart sounds to entertain. After he
is born, the baby needs about 3 months to understand that
his demands should be reasonable and that Mom also needs
rest. And so most babies would have their mothers dance to
their tune for the first few months.
The good news is that those mothers who respond promptly to baby’s needs in the first few
rewarded in the long run. As they grow older, babies thus reared
are quieter, calmer and more secure compared to babies who
are left to cry. They start trusting people around them,
which helps in personality development.
The so-called three months’ colic (discussed under Crying) is another problem that bothers
quite a few babies in
their early months.
Once you know about these possible factors that may make life difficult for you and your
baby, you will be able
to cope with such a situation with the right frame of mind. This
may also send signals to other members of the family to give
you a helping hand as often as possible.
Listen to well-wishers’ advice but follow your own instincts. Cry if you feel like. Do not feel
ask for help if required. But have patience. A crying child is
indicating that he needs you. If you fulfill his needs, you will
start understanding him better. You will learn to discriminate
more quickly whether his cry is for a feed or for comfort. In
due course of time, this approach will help you to quickly
pick up the cues that he gives you — even cues related to his readiness in such areas as bladder training, inculcation
of healthy habits or to make him learn to choose between
right and wrong.
A breastfeeding mother finds it easier to cope with this difficult period. The three months’
colic is less
frequent in breastfed babies compared to those who are artificially fed. The body
contact which breastfeeding automatically provides helps the baby feel more secure in the
arms of the mother. Suckling during breastfeeding also helps in increased production of a
hormone called prolactin,
which has a calming effect on the mother and helps arouse the mothering instinct in her. This hormone is produced in
greater quantity during sleep. So a mother who feeds her baby during sleep is able not only to provide immediate
gratification to the hungry or fretful baby, but help
herself as well by providing more prolactin.
After having made the point that a crying baby should
not be left crying, I must sympathise with mothers who have
to spend sleepless nights in this process. The following guidelines might be found helpful:
- Get into the habit of sleeping while the baby sleeps, as mentioned earlier.
- Do not switch on the lights when the child gets up at night. The idea is to gradually let him learn that
nights are meant for sleeping and not for playing. Feed him in
a supine position if he is hungry. Pat him to sleep if he
is just squirming. Give him body contact if he has moved away from you.
- Do not get up to burp the child. Raise him while you are lying down. Let him lean against you to burp. If he does not oblige, do not worry. Quite a few babies can manage
without burping. If you are still concerned, let him lie on his right side; in this position, the child is more likely to burp on his own.
- If a child has wet his diaper, see if he can remain asleep without it being changed. After the
first few weeks,
quite a few babies can tolerate a wet diaper without getting upset and without
getting diaper rash. If the baby does get annoyed or if the whole bed gets wet, try putting a
double diaper on him. Tie it firmly. This may work. If not, keep such diapers handy which do
not need to be pinned and can be tied easily in the dark. The important
rule is not to spend too much time in changing the diaper so that both you and the baby can go back to sleep as soon as possible.
- All noises do not wake up a child. Many babies sleep quite well with some background
music or human conversation. Of course, sudden loud noises may startle
them, especially if they are in a period of ‘light sleep’.
Where Should Your Child Sleep?
Decide with your husband what will work best for you and your baby. Do not blindly follow the
exhort that children should sleep in a separate room right from an early age.
The baby can sleep next to you in your bed or in a
cradle or in a cot kept in your room or in an adjacent room.
Toddlers can sleep on a mattress in your room or in a bed in an
adjacent room. Older children can sleep in a bed or on a mattress
in an adjacent room.
I believe that a baby who sleeps in his mother’s bed
soon after birth has less sleep problems and behavioural
problems later in life. In the hospital, you should insist that
your baby sleeps next to you and is not kept away in a nursery
with other babies. You can, if you want, ask for a cot that
can remain near your bed. The baby can be placed in it as
per your convenience. Most mothers have been found to sleep
better with the baby in their rooms once they understand that
this helps in bonding with their baby. Of course, you can
always seek help from the nursing staff as and when required.
If allowed, it is, of course, a real boon to have a
close relative in attendance. Most modern hospitals encourage
such an arrangement.
After going home, many mothers have found the following sleeping arrangements quite
practical: The baby sleeps
in your bed until he is one year old. In the second year,
he sleeps on a mattress spread on the floor by the side of
your bed. After he is 3, he sleeps in a separate room, on his
own, or along with his older brother or sister, in separate
Teenaged siblings of the opposite sex should sleep in separate rooms.
The above arrangements are based on the knowledge that children develop separation anxiety
if they are
separated from the mother figure. Between one and a half years and 3
years, they learn that the mother is around somewhere even if
she is not to be seen. Hence, it is important to give enough
body contact to the child in his first year of life, meet his
needs (vocalised mostly by crying) promptly, help him build
trust in you and gradually wean him from your bed to another convenient sleeping arrangement in your room and then to
another room, preferably adjacent to yours.
Once the child is shifted to his room, he can be brought
to your room if he is not feeling well or if he feels
scared for some reason. But he should soon be placed back in his
Ideally, the older child should be taken to his room for sleeping by the mother or the father.
You may read to
him or tell him a story. Many mothers find it helpful to say a
small, simple prayer together. The child is gently lulled to
sleep. Older children are likely to go into a ‘deep sleep’
rather soon and can be left properly covered. Some children are
happier if a dim light is kept switched on all through the night.
If you want the child to go to sleep early, see that he
does not sleep during the day. If he is in the habit of doing
this, take him out during those hours to an interesting place
or a garden for a few days to break his habit of sleeping
during the day.
In your bed, the infant can sleep between you and a
wall. Otherwise, you can get bed-railings that can protect the
child from falling down. For a very small infant, raising the
edge of the mattress by putting a pillow underneath it serves the purpose.
Do not worry that you will smother the baby as he lies
in your bed. This can only happen if the parent(s) are
intoxicated or heavily drugged.
Another reason to have children older than toddlers
sleep separately is to avoid them being unwitting witnesses to
their parents’ conjugal relations. Psychologists report that
children who watch adults having intercourse either can become terrified or can develop undue
curiosity about the same. Moreover, children have to graduate from the parents’
room to another room to prepare themselves for moving into
the outside world.
Support From Others
Graciously accept the help of your husband, mother and mother-in-law, or indeed any good
relative and friend in helping to take care of your baby and relieve you. Let
the child bond with your husband, and with his grandparents. Allow the baby to sleep with a close relative or a
during the day; this will make it easier for the child to sleep
with such a person when the mother is not well or when the
child must be weaned away from the mother during the night.
Most Sleep Problems Are Temporary
Yes, this is true, except perhaps with babies whose
needs for attention in infancy were not met. Children who do not
get attention from their mothers cry themselves hoarse at
first, but finally give up and become withdrawn. People may
feel that the child has settled down, without realising that
instead his personality has been stunted.
Work With Family Routines
Although it is ideal that a child goes to bed early,
this routine may have to be changed if the father comes home from
work late in the evenings and again leaves for work early in
the morning. A child must spend time with his father. In
such a case, it may be essential to make the child sleep during the day or allow him to remain asleep for a longer time
in the morning. The presence of the father definitely helps in prevention as well as in management of
common sleep problems.
Common Sleep Problems
- Getting up too frequently at night
- Night terrors
- Sleep walking
Getting Up Too Frequently At Night
Most problems associated with sleep can be prevented by caring parents who promptly
attend to the needs of the
child during the early months of his life and keep a watch on
the factors that may contribute to sleep disturbances.
Breast milk is digested fast and so a child may demand frequent feeds in the early months.
Parents who do not appreciate this fact may allow the child to cry
unnecessarily. Flies and mosquitoes can be a nuisance. A mosquito net
may be helpful. Extremes of temperature must be taken care
of. If a heater is used in a room, a kettleful of water should
be kept on the boil all through the night to maintain the
humidity of the room. Otherwise, the child’s nasal secretions dry
up, causing discomfort. If the child has a stuffy nose, it
should be cleaned and nose drops used as detailed in Common
Physical discomfort in the form of a wet diaper or
during teething can add to the discomfort. Excessive activity
during the day may also delay the onset of sleep. Any sickness
must be attended to, especially ear infection and itching
associated with eczema or threadworms, which come out from the anus at night and
cause itching over the buttocks. Certain stimulating drugs and caffeine can be responsible for
difficulty in sleeping.
Children who slept well in the early weeks of life may suddenly give the mother sleepless
nights around the age
of 3 weeks, 6 weeks and 3 months. During these periods,
some babies have growth spurts when they need to suckle more often to meet their normal demands of
milk. On such occasions, you should not presume that your milk is not enough and that you
must add artificial milk. This
temporary phase passes as you let the baby suckle more often.
Some mothers give the child a heavy meal at night or a feeding bottle in the hope that he will sleep better.
This is not desirable and often does not work. Outside milk given in
the early months of life can lead to rapid development of infections and allergic diseases. A heavy meal
in the way of the child going to bed soon.
Consult your doctor if you have tried everything and you still feel that your child has problems
sleeping. If he
certifies that the child is normal, do consider the possibility
that your child may need more body contact.
He may need to breastfeed for many more months and may have to sleep longer in your room
compared to other
Any emotional factor at home or school should be
attended to. Don’t allow children to watch violent and scary
movies on television.
These are seen mostly in preschool children. A child has
a scary dream and then he gets up crying. He is fully
awake and appears afraid. He may recount the dream and once reassured, go back to sleep.
The child, again a preschooler, suddenly sits up in bed
crying. He is not fully awake and is not aware of your presence.
He screams as if terrified. He may be sweating and have a
very fast heart rate. No effort on your part calms him down. Fortunately, he settles down after 15
to 30 minutes and
goes back to deep sleep. When he gets up, he does not
remember anything about the whole episode.
This is seen mostly in children of school going age.
While sleep walking, the eyes appear glazed. They may mumble something that may be difficult to comprehend.
Generally, they do not hurt themselves, but care should be taken to prevent injury. Most such children are
and the condition disappears in a couple of months. In rare
cases, it may continue to adulthood. No treatment seems to
help. Homoeopaths claim to be able to treat this condition.
In general, most sleep problems are sorted out by common sense, by listening to the child
and by attending to his needs.
7 March, 2016