SHARES
Getting a baby to sleep is surely a tough thing to do, we are sure every parent on this planet has tried every trick possible but failed several times. GetDoc spoke to Ms. Sarah Ong, Baby Sleep Consultant and Coach from Sleep Champ Baby to find out the secrets to putting a baby to sleep gently and for a longer period of time (is that possible?) Let’s find out!
Here are some excerpts from the interview. To watch the entire interview and to be part of a community that is dedicated to providing/sharing knowledge on the journey of motherhood, join Journey of MotherHood – GetDoc Community Facebook Group.
GetDoc: Hello Ms. Sarah, thank you for accepting to do this session with us, we would like to start with a brief overview of common issues parents face in the 1st 16 weeks of birth.
Ms Sarah Ong, Sleep Champ Baby
Sarah Ong: It is my pleasure. Sure, we can talk about the common issues first. So, some mums are anxious about starting sleep training for a newborn, right from the day baby is born! For newborns, the first 2 months are something I call nurturing months and I would advise mums to focus on the feeding, especially if you are breastfeeding, make sure the baby feeds right – latches well, feeds well etc because we believe a full baby is a happy baby and a very well-slept progressive baby. So this happens in the first 2 months. But at the end of the 2 months, you begin to see changes in sleep patterns – they sleep earlier, they get tired earlier – the magic time for falling asleep is around 7 pm. And then 3 months onwards you can try to start shaping the good sleeping habits all the way to 4 months and then forward.
GetDoc: When is the best time to start a bedtime routine?
Sarah Ong: 3 months is what I would suggest, some start at 2 months but ideally you can at 3 or 4 months of age. I am not talking about structured timetables or nap times, it is better that you put the baby to sleep as and when you see him or her tired. Wake window at this age is about 90 minutes long, so just be wary of this time period. Just start making a routine – like going to bed at the same time, same place, same way of going to sleep etc so when they start noticing the pattern, they realise that its bedtime and they need to sleep. This way it is easier for both mum and baby.
GetDoc: Babies are said to not being able to differentiate between day and night? How does one handle this?
Sarah Ong: The day-night confusion usually happens in the first 8 weeks. So this is why we start after 2 months. So what you can do is, start exposing them to daytime sounds such as cooking, kids coming back from school, sounds of the TV – all these daytime background noises will help them learn to differentiate between day and night. At night keep it quiet and dark so this will also give them an indication of the time differences. So over time their circadian rhythm which is their internal body clock starts to form from the 9th week onwards. Another thing that can help speed up the process is exposure to indirect sunlight. So in the mornings, open up and ensure your house gets lots of sunlight and this enters the baby’s eyes – the eyes receive this information and sends it to the brain and this slowly becomes a habit. Do this even as the baby is asleep.
GetDoc: How do we handle babies that fall asleep in our arms but immediately start crying the moment we put them on the bed? Are they too dependent on the parent for falling asleep?
Sarah Ong: This is a very common thing, every parent goes through this at least once during the parenting journey. As a mother of a 3.5-month-old myself, I started to put her down on her cot not when she has fallen asleep in my arms but just before she does. Yes, she would cry out initially but with this becoming like a routine, she gets used to it and falls asleep. You could also take the baby in your arms as they cry, and then do this till they fall asleep. Or if it is too much, try it the next day and continue doing this to the point where the baby is used to this and you can pat him/her to sleep. It does take a while, certainly not magical to happen the very first time, it comes with practice and repetition! It takes time, practice, don’t get overstressed, Even though your baby may be older 6 months or 1 year, they can learn to self-sleep, there are different ways to approach this
GetDoc: Is it possible for babies to sleep too much?
Sarah Ong: Yes, newborns do. It is a good practice to not allow one stretch of sleep to go beyond 3 hours during the day. One reason is to help them to get the circadian rhythm to fall into place and the other reason is that they need to be fed every 2-3 hours. So if you are breastfeeding the baby, if you do not feed for like 2 hours the breasts get engorged and it certainly is not pleasant! For older ones, like one lady whose 14-month-old baby slept for 5 hours at a stretch during the day which is way above the maximum I would recommend, 3 hours at one stretch during the day for baby to sleep, so there is a possibility that a baby can oversleep.
GetDoc: So it is ok to wake up a sleeping baby?
Sarah Ong: Well, in the instance I mentioned just now you can but ideally, it is not correct to wake up a sleeping baby.
GetDoc: What do you have to say about carrying baby in a sling/wrap during the day – does this create separation issues later?
Sarah Ong: As babies move from 3 months of age to 5 months, their nap times start coming down to say 20 or 30 minutes. It can be quite frustrating especially when we would have spent so much time in rocking them to sleep. This happens because of the developmental milestones, they start becoming more aware of a lot of things around them. It is perfectly normal for them to sleep that way, just that we must learn to change our expectations about how much they sleep haha. So babywearing is one way I would suggest for aiding the nap to be a bit longer than usual, they sleep better on us. You can use the carrier for daytime naps and put them on their beds for nights because night sleep is longer. This is for younger babies. For babies 6 months and older, you can have them sleep at the same place at home, but if you are outside, the carrier would be useful for a nap on the go.
GetDoc: Are carriers/wraps helpful at all? Please share your experience.
Sarah Ong: Yes, it is definitely helpful since I have been using them for a while now. The type of carrier/wrap doesn’t actually matter, just pick one that works for you – its just a matter of preference. My preference is a carrier.
GetDoc: Is it ok to shorten a baby’s nap time during the day so he can sleep better and longer during the night?
Sarah Ong: If they are oversleeping, yes it would eat into their night sleep quota. But what I usually hear from the parents that come to me, is that their kids are not sleeping enough. So the minimum time babies have to sleep is 2.5 hours during the day – this is for older babies. Newborns sleep about 6 hours.
At 3 months of age when they start their short naps, 2.5 hours daytime sleep should be sufficient for the babies.
GetDoc: Is that a 2.5-hour sleep at a single stretch?
Sarah Ong: No, this 2.5 hours is broken down into multiple short naps. Total of 2.5 hours is good enough for them.
GetDoc: When should you stop swaddling?
Sarah Ong: I highly recommend swaddling for newborns as part of their going to sleep routine because they get startled and wake up easily. Having their arms secure helps them to not get startled so easily and they sleep better. That said, there are babies that hate being swaddled, no matter what. My 2nd baby hated swaddling and so now for my 3rd kid, we use a different swaddle, it is pretty easy to use – zip up swaddles and arms go up which is more natural, so you could use swaddles like this if you are having a problem with the regular one. You can stop swaddling when they start to roll and lie on their tummies, this developmental milestone happens around 4 months, some cross it earlier.
GetDoc: Which is the best sleeping position for baby?
Sarah Ong: The recommended position (by AAP) is to put your baby to sleep on their backs, so as to reduce the risk of SIDS (Sudden Infant Death Syndrome). It is better to be on a preventative mindset. I know babies that sleep better on their tummies but from a safety perspective, it is better to make them lie on their backs and put them to sleep.
GetDoc: You just mentioned SIDS, can you tell us a bit more about it?
Sarah Ong: SIDS is real, we have safe sleep guidelines to prevent SIDS. As a parent, co-sleeping is fine, but make sure the bed is firm and ensure there is no such thing as a comforter that will possibly cover the baby’s face. I do not have the statistics for SIDS cases in Malaysia, perhaps it is not studied here but globally it does occur.
GetDoc: What should be done in the case of babies that like to nurse/breastfeed to sleep?
Sarah Ong: It may sound easy to say just wean them off but when the baby has the habit of falling asleep while nursing, it does take time to wean. Babies tend to expect you to do this everytime they feel sleepy. I would suggest you start doing this for night time sleep and not during naptime since naps are low-pressure sleep times. You can start by feeding the baby and then either hold or cuddle the baby to sleep. Keep doing this for 3-4 nights and the baby slowly understands that she no longer can nurse to sleep.
GetDoc: How should you wake up babies that are around a month old, is there any sure-shot method for this?
Sarah Ong: So this is still near about a month old, if your baby is swaddled, the first thing to do is to unswaddle the baby because the sudden loss of heat might make the baby wake up slowly, some resort to undressing the baby to make them wake up. But you can put the baby to breast, and coax them or talk to them to wake them up, just keep trying. Find out what works for your baby.
GetDoc: How do you train a baby that wakes up daily at 4 or 5 am to drink milk, is there a way to make baby sleep longer?
Sarah Ong: Assuming the baby is 4-5 months old, it is common for them to wake up early at times like 4 or 5 am and drink milk. As long as they are fed and are able to go back to sleep, I don’t think its a habit. Mornings are colder right, so as the warmth decreases it becomes easier for kids to wake up at even the slightest noise. We would love for them to sleep longer but it is common for babies to wake up early, don’t worry you are not alone 🙂 This is not a habit, try to see if they can settle without feeding, this does differ from one baby to another. By right, if the baby is breastfed, she must go back to sleep. Sometimes nap times also affect when baby rises in the morning.
GetDoc: Does the sleeping position of the baby affect her growth? In Chinese culture, we say that if we put the baby to sleep on their backs, their heads would become flat, is this true?
Sarah Ong: It is true. What we can do is, during the first 16 weeks, give tummy time during the day, it is very important. You can do this every day, the goal here is to give 10 minutes of tummy time after each waking. If the baby is just born, you can let them be on their tummies for a few seconds since their neck muscles aren’t so well-developed. At night, they are going to be sleeping on their back but not like 24 hours so it is ok. Ensure they are on their tummies daily, this will help in strengthening their neck muscles as well. Tummy time is overlooked a lot in our country.
GetDoc: How early should you start giving tummy time?
Sarah Ong: As early as possible.
GetDoc: How does a parent differentiate between the cries of my baby for various reasons – hot, they cry; hungry- cry, poo – cry…?
Sarah Ong: This might be tough for a first-time mum. So yes you need to figure this out – they may be hungry or they may have “wind” in their tummies. You must burp the baby after a feed. Check whether they have pooped or it is a wet diaper. So if you have checked all this and they are still crying then this is what I do. I subscribe to the philosophy put forth in the book Wear Baby. The baby may have emotional stress or trauma, yes babies do have feelings and they need to cry. No, it is not like what we get stressed about like finance or other things. Their stress is more of a new environment, change of caregiver, milestones etc They seem to be more fussy than usual. So it takes a while to understand the cues.
GetDoc: What should a parent do if the baby gives sleep cues but it isn’t actually time for bed?
Sarah Ong: I wouldn’t be actually checking for sleep time routines during the first 16 weeks after birth. During this period, it is better to look for cues for sleepiness and make them sleep. Yawning not necessarily indicates sleepiness. But rubbing eyes, yanking etc are most likely signs of sleepiness as opposed to just yawning. Another early sign of sleepiness is when the baby doesn’t want to engage with you no matter how much you try to play with them, they just turn away. For older babies, you can go for a structured routine. Healthy sleep habits such as time of nap, wake up times, etc are important for a good foundation.
Want to learn how to make your baby go from a light sleeper to a great sleeper? Enroll in Ms Sarah Ong’s Easy Peasy Sleepy time online class and help your baby sleep peacefully while you too get your special time for yourself! Join today!
by Hridya
A biochemist by education who could never put what she studied to good use, finally found GetDoc as a medium to do what she loved - bring information to people using a forum that is dedicated to all things medical. View all articles by Hridya.
