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Sleep in Babies & Children

by Dr. Mandar V. Bichu
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The Laurel- and- Hardy- fans go into raptures while describing the funny and ultimately futile attempts of the comic duo to put their kids to sleep in their masterpiece short-film ‘Brats’. If you haven’t seen it yet, please do- at least that will put your troubled mind at peace by making you realize that you are not the only parents facing difficulty in making their kids fall asleep! Coaxing, cajoling, cooing, cavorting- so many different ways are adopted by the parents to make their children sleep and not always, these methods are successful!

Describing their baby’s/ kid’s awful sleep patterns with bloodshot, sleep-deprived eyes is a peculiar parental problem for which there is no simple solution. But let me give you a few bright ideas to tackle this difficult problem.

Counting the hours of sleep

The average sleep time differs according to the individual’s age and as always these figures serve as mere guidelines rather than absolute truths! To put it simply, sleep is a very individual trait and the average sleep required to refresh the body and mind differs greatly from person to person.

The rough estimates of sleep- hours according to age will be:

AgeAverage Total SleepAverage Night-sleep
1st Month17-18 hours3-4 hours
1-3 Months16-17 hours4-5 hours
3-6 Months15-16 hours8-10 hours
6-12 Months14-15 hours10-11 hours
1-3 years12-13 hours11-12 hours
3-6 years10-12 hours10-11 hours
6-12 years10 hours10 hours
Teens8-9 hours8-9 hours
   

So this chart will make it clear that in the first three months, even though the sleep period is more; the most of it is day-sleep. The night sleep period starts increasing only after that age.

The reasons for ‘Not Sleeping’:

  • The different Day-Night sleep rhythm: The main reason why the mother (and even the father!) starts to feel the sleep deficit in the first few months of baby’s life is the sleep cycle in a baby is so different from the adult sleep cycle. Taking over from their inside- the-womb-sleep schedule, , the babies in the first few months of life sleep a lot but they usually do it in the day-time, rather than in the night- when the other mere mortals like Ma and Pa sleep!

But just when you start feeling that your night awakenings would never cease, at about three months of age, the baby usually decides that enough is enough and it is ready to follow the adult pattern of night sleeping and provide some respite to parents!

  • Light Sleep: The sleep cycle consists of various stages like drowsiness, light sleep (also called as REM or Rapid Eye Movement sleep) and deep sleep (Non-REM sleep). In the first three months, almost half the sleeping hours consist of light sleep and that’s why with slightest of stimulus the baby might wake up and demand your attention!
  • Frequent Need Of Feeds: In the first six months, the babies sleep in short naps each lasting 3-4 hours, since they need frequent feeds. Later as the diet pattern changes towards more solid foods, the need for frequent feeds decreases and the sleep- period increases.
  • Loneliness: After six months, the babies start to feel ‘Separation anxiety’ and that emotional factor can often interfere with sleep till almost the pre-school stage. Many toddlers and preschoolers keep on fighting off sleep just to make sure that they don’t lose out on the family fun!
  • Other factors: Colic, cold (nasal block), wet nappy, too cold or too hot surroundings and uncomfortable clothing or bedding are often the factors causing sleeping troubles in infancy.

Physical exertion, a heavy a night-meal, a scary movie or school-pressure can cause sleeping difficulties at older ages.

Effects of less sleep:

At younger ages the lack of sleep may manifest as hyperactivity, irritability or fretfulness. Later on in life, it can cause decreased attentiveness, decreased short-tem memory, delayed response and inconsistent performance at school, college or work.

Strategies to improve sleep patterns:

  • Mental preparation: From the beginning be mentally prepared to face some (or many!) sleepless nights. Take it as an inevitable price for becoming parents! At the same time, rest assured that these problems are temporary!
  • Establish a sleep routine: Maintain a consistent sleeping time-schedule for the family and stick to it. When the baby is young, it would be better if the mother adapts and grabs sleep according the ‘sleep packets’ of her baby- rather than hoping to change her baby’s pattern to her own normal pattern.
  • Winding down period: Before the actual sleep time, start to prepare the baby/ kid for sleep. The younger the age, the more will be this preparatory stage. Giving a good warm bath, tucking them into comfortable clothes, bed and blanket, lying down besides them (telling a bed-time story or cooing a lullaby), putting on dim lights and soothing music- these are some good preparatory suggestions.

Don’t excite them or encourage any play-activity.

  • Don’t use a feeding bottle or a sweetened pacifier: as a sleeping device. It can lead to serious tooth decay. Delaying the dinner-time solid meal often avoids the need for late night feeds in infants and at later ages, such late night-feeds are plain unnecessary.

Where should they sleep?

This is a contentious issue and this decision should be made by parents after discussing their own attitudes towards it. Western parents mostly prefer separate beds and bedrooms for their children whereas Indian/ Asian parents often prefer to sleep with their children.

In his book ‘Guide to Child Care’, veteran Indian paediatrician Dr. R.K. Anand says:

‘After going home, many mothers find following arrangements quite practical: The baby sleeps in your bed till 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 three, he sleeps in a separate room on his own or along with his older brother or sister in separate beds. Teen-aged siblings of opposite sex should sleep in separate rooms.”

Which position is better for sleeping?

The scientifically recommended position for infant’s sleeping is supine or lying on the back.

The prone position (lying on tummy) or lateral position(lying on the side) has been associated with Sudden Infant Death Syndrome (SIDS)- mostly because of the possible interference with breathing in those sleeping positions.

What are the other sleep-related problems?

Apart from inability to fall asleep or frequently getting up during the sleep, there are certain specific sleep-related problems like nightmares, night terrors and night walking (Somnambulism).

Nightmares are terrifying dreams which happen in REM (light) sleep stage. The child (usually a preschooler) wakes up with fright after the bad dream and can remember the details. After reassuring he can go back to sleep in most cases.

Night Terrors happen in Non-REM deep sleep stage. The child (usually a preschooler) suddenly sits up in his bed and appears terrified. He might scream or make thrashing movements. He is sweating and his heart is beating fast. He cannot be reassured but mostly settles down on his own after about half an hour and goes back to deep sleep. Later he doesn’t remember a thing about the episode.

Night Walking takes place in Non-REM deep sleep stage and usually happens in school age children. The child gets out of his bed and starts walking in deep sleep- with glazed eyes and incomprehensible speech.

Thankfully most these sleep problems are temporary and self-limited but if they seem to be persistent or prolonged then specialist’s opinion might be needed.

Video:

Watch our Right Parenting expert Dr. Sridhar Kalyanasundaram’s informative video on helpful tips for better sleep in babies and young children.

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