Sleep School

When asked about sleep training, Dorothy Waide steers parents away from the rigours of many theories on this topic and instead offers an all-encompassing approach she refers to as ‘parenting to sleep.

Every baby is different and, boy, do I know that. I’ve worked with families and their new babies all around the world, in many different cultures, and all everyone wants is a baby who knows how to sleep.

As with everything in this world, there are many different ideas when it comes to parenting, and they can be diametrically opposed. I believe parents would feel more empowered if they stood back and took the good ideas from both ends of the spectrum and combined them somewhere in the middle.

One of my favourite expressions is ‘parenting is not a quick fix', and learning how to sleep can be a life-long journey – hence another favourite expression of mine is ‘parenting to sleep’. Our parenting should gently teach our babies and children how to find sleep and resettle to sleep, just as our parents taught us, and their parents taught them.

It pays to remember that sleep deprivation is a form of torture. It can have a huge impact on how you are feeling as a parent and plays a part in postnatal depression. To help you through the early baby days, it is important to slow down and have a ‘village’ around you to help, especially if you are a first-time parent.

Firm foundations
The first three months of a baby’s life, commonly referred to as the fourth trimester, are the foundation for working towards good sleeping habits. If you wait until your baby is older to teach them healthy sleep habits, he will have already learnt unhelpful cues from you to fall asleep and resettle. While retraining and changing habits is possible, some of these cues require a lot of external movement from parents, and/or a lot of crying.

Listening to a baby cry is tough, but it's important to understand that crying is a baby’s form of communication. When you go to bed at night, you might read a book, meditate, or chat with your partner. A baby can only cry. As long as your baby is generally happy and content, crying is just part of life.

That said, a baby can cry at different volumes and in different ways so it is important to listen and respond accordingly. Babies are talking to us with their crying, and like us, they are not happy when no one responds. Remember, at bedtime you are not leaving your baby there to just cry it out; you are leaving your baby in bed to give him the opportunity to find his own sleep. You will not get anywhere by leaving a baby – no matter what age they are – to cry for hours. You will achieve healthy sleep habits much faster by giving your baby space and helping them to find their sleep.

I have to confess that my training many years ago taught me to leave a baby to cry to sleep, or to give him large movements (like rocking the bassinet) to help him find his sleep. I’d like to think that we have moved on from this and that we now understand that babies need our support to find their sleep.

Night classes
The first questions I usually hear from parents are: "When can I get my baby into a routine?”, quickly followed by “When will my baby sleep through the night?”.

A baby is actually in a routine as soon as he is born – he wakes; he cries; you respond; you feed, burp and change him; and then he goes back to sleep. The time on the clock doesn't really come into it until baby is much older.

Throughout the night, the main difference between an adult and a baby is that when adults wake in the night, we know how to resettle. Babies do not have the ability to self-soothe until they are between 12 and 16 weeks old, therefore resettling themselves in the night is a very hard task for them to do.

There are two methods that I would recommend for settling and resettling your baby – one way is in your arms, the other way is in your baby’s cot.

1. Settling and resettling in arms
●  Place your baby in his cot while he is still awake. It is important that he familiarises himself with what will become his primary sleeping place.
●  Leave the room – don’t hover like a helicopter.
●  When your baby cries, you can respond immediately by going into his room, or leave him to cry for a few minutes (if you feel comfortable doing so) to see if he can find sleep by himself.
●  If crying continues, pick your baby up from his cot, sit down in a quiet place while holding him in the engulf hold. Be sure not to rock him, talk to him or make eye contact with him.
●  Try your best to remain calm and still, allowing your body and mind to nurture him.
●  Place your sleeping baby back in his cot.

If your baby doesn’t stay asleep and starts to cry again, you'll need to further help him settle into his sleep cycle. Intervene with cupping and shushing. If necessary, you could offer a dummy. As your baby drifts off, replace cupping with patting. Using these techniques, it may take your baby around 20 minutes to find his sleep. While this may seem time-consuming, consider it a worthy investment into your child’s sleep habits.

If your baby wakes after 45 minutes – typically when he will be moving from the first sleep cycle into the next, you may find it easiest to resettle him in your arms (using the above settling techniques) because you can easily feel any slight changes in movement that indicate he is moving into another sleep cycle. You may choose to let your baby sleep the rest of his nap in your arms – a great chance for you to have a rest yourself! Allowing your baby to sleep in your arms isn't a cop-out. On the contrary, it instils a sense of security that makes him feel nurtured and ready to go to sleep.

After he has progressed from a light sleep to a deep sleep, you may transfer him to his cot. Aim to put him into his cot before he wakes to get him used to waking there.

2. Settling and resettling your baby in the cot
●  Place your baby in his cot while he is still awake, as in the settling in arms example.
●  Allow your baby to cry for up to one minute, then intervene by picking him up and burping him.
●  Place him back in his cot and either leave the room, stay in the room with your hand gently on his tummy, or stay in the room but step back from the cot.
●  Let him cry/grizzle for one to five minutes.
●  Comfort him in the cot with cupping and shushing, and a dummy if you choose.
●  If he doesn't respond to the cupping and shushing, step back or stay touching him, and allow him more time (up to five minutes) and then comfort him with cupping and shushing again.
●  Repeat the last two steps for up to 20 minutes until your baby falls asleep.

A good way to comfort your baby is to place one hand firmly on his chest while he is lying on his back. With your other hand, start patting and shushing to reassure him and establish as much contact as possible. Once you sense that your baby is asleep, lighten the patting until you eventually withdraw your hand, continuing with the patting motion as if patting the air. If he stirs, intervene with patting again, very lightly, until he returns to sleep.

Alternatively, you can roll him onto his side so that he is facing away from you. Place one hand firmly over his shoulder and his arm (not his waist) to engulf him and start cupping him on his back and shushing him. This is called engulfing in the cot. Continue cupping and shushing him until he falls asleep, and then gently roll him onto his back while keeping your hand on his chest. If you are confident that he is asleep at this stage, you can remove your hand and quietly leave the room.

When it comes to resettling in the cot, it is important to respond immediately when you hear your baby stir, as it is easier to resettle him before he wakes too much. Eventually you will need to step back and allow him the ability to do this on his own.

Making it through the night
When will your baby sleep through the night? The simple answer is, I don’t know. When I worked overseas, families would tell me that they had interviewed others before me who guaranteed their babies would be sleeping through by six weeks. I find this hard to understand as babies are not born with behaviour guarantees. In my experience, it is not common for babies to sleep through at such a young age.

You may be one of those lucky people whose newborn baby does sleep right through the night. Enjoy it, as you never know whether it will continue or not. Most of the time, babies will need to be fed throughout the night, however, I would never wake a sleeping baby to feed them after the evening feed – they are capable of waking for a feed on their own!

The evening routine is very important. This is when I feed, bath, feed again, and then put baby to bed. Some parents find that the bath stimulates their baby, making them more wakeful. In this scenario, you could look at how long your baby has been up for. Usually a baby who is more wakeful after a bath is actually over-tired, rather than over-stimulated.

If your baby wakes after going down to sleep for the night, I would attempt to resettle before offering a feed, as usually babies wake for reassurance. This can be tricky to assess, but I feel it's important to only feed a baby at night for hunger, not for comfort. You won't be able to resettle a hungry baby without feeding them, and a baby will let you know whether they just needed that extra bit of reassurance, or if they really are hungry.

Years ago I would have suggested that it was normal for babies to sleep through by about 16 weeks, but there is plenty of research these days to suggest a much wider range of ‘normal’.

Make your own normal
While some babies easily sleep through the night, others need to be taught how. People are all different, and babies are no exception. Some of us are laid back and some of us are anxious, and this affects our parenting styles and baby's behaviour.

It is important to bear in mind that while there is no right or wrong way of caring for a baby, there are certainly harder and easier ways. Looking after and caring for babies takes T.A.C.T: time, acceptance, consistency and touch.

Life isn’t predictable so you can’t plan for 100% consistency in everything you do, but if you aim for 80% consistency you'll be doing great. It is important to work within your boundaries, not to what other people tell you to do; the reality is that most people can’t remember clearly back to their own experiences with babies! This is your time to learn to parent, and like learning anything new, you will make mistakes – but we learn most effectively by these mistakes, so don’t be too hard on yourself. At the end of the day, ‘baby whisperers’ like myself can offer you support and guidance, but you are your baby’s expert.

BEWARE THE QUICK FIX
Many professionals advocate large movements such as driving, walking, rocking, swinging, swaying –even putting a cord down on the floor and pushing the buggy back and forth over it until baby goes to sleep. These techniques might work well if you can find the right movement, however, your baby will probably not settle in the cot without a lot of crying, because the cot doesn't replicate any of these movements.

Small movements, like patting and cupping, can be done while you are holding your baby, and also while he is lying in the cot. 

SLEEP TIPS
■ A good daytime routine, with some flexibility, will help your baby to sleep well at night.
■ Babies need two essential nutrients: food and sleep, and the two go hand in hand. Without food, babies won’t sleep well, and without sleep, they won’t eat well.
■ It is important that your baby sleeps in a dark room in order to release more melatonin, the sleep hormone that controls our sleep and wake cycle. Invest in blackout blinds and eliminate any other sources of light.
■ Holding or feeding your baby before they sleep isn't a negative sleep cue if it is done in a way that it won’t become an issue. Keep any movements small and manageable and ensure they can be replicated in the cot. Large movements are the hardest habits to break when they are used to settle or resettle a baby. 

DOROTHY’S DICTIONARY
settling: helping your baby transition from being awake to being asleep.

resettling: helping your baby get back to sleep when he stirs and wakes midway through a nap (when he really should be still sleeping).

the ‘engulf’ hold: This hold provides as much body contact as possible, giving baby the sense of being contained, as if in the womb. Hold your baby so that his head is resting on the upper region of your non-dominant arm. For mothers, this ensures that baby is not too close to the breast, so as not to draw baby to feeding again. Draw your baby in close so that you are pressed tummy to tummy with his face nestled just below the top of your shoulder. Wrap your non-dominant arm across your baby's shoulders and take hold of their upper arm and shoulder to firmly support him. Your other hand will be on his bottom with his legs tucked up into your body and supported by your forearm.

For this technique to be effective, there should be no eye contact or direct communication between you and your baby. Allow your body to do the nurturing.

shushing: Shushing is a long, low sound resembling air being released from a tyre. It should be loud enough for baby to hear over his cry.

cupping and patting: Cupping or patting your baby’s bottom or lower body mimics your baby’s heartbeat and reassures your baby of your presence. Cupping is a stronger action and is done with a cupped palm, incorporating both cupping and a short but gentle thrust forward of baby’s body. Patting is a repetitive rhythmic and firm action done with your palm flat. 

Dorothy Waide is a baby consultant and member of the OHbaby! panel of experts. She recently published a book, You Simply Can’t Spoil a Newborn, available wherever good books are sold. Visit her at babyhelp.co.nz or ask her a question on our website here.

Photography: Sam Mothersole, sammothersole.co.nz • Micah wears Merino Kids