Sleep is serious business. If you have not already done so, please read Blog Posts 1 through 5 that describe how sleep is important and beneficial, from the point of view of the United States of America Department of the Army. A major point, emphasized by the Army, is that more sleep produces more benefits for Soldiers. Also, more sleep produces more benefits for children. Even small amounts of extra sleep help (Blog Post 6). At every age!
Another point made by the army is “The extent to which sleep is undisturbed by arousals and awakenings-sleep continuity [or Sleep Consolidation]-is important because this influences both the duration and depth of sleep, with deeper sleep being more restorative.” and “The restorative value of sleep is determined not only by the duration of the sleep period. But also by the continuity of the sleep period-that is, the extent to which the sleep period is continuous and uninterrupted [Sleep Consolidation]. When sleep is interrupted, the beneficial effects of sleep are reduced.”
The Army is clear about who is in charge: “Planning for sleep is a leader [Parent] competency”
Consolidated sleep means uninterrupted sleep, sleep that is continuous and not disrupted by night awakenings. Slumber broken by awakenings or complete arousals is known as disrupted sleep or sleep fragmentation. Seven hours of consolidated sleep is not the same as seven hours of fragmented sleep. Parents of newborns or sick children who have their sleep interrupted frequently know this very well. The effects of sleep of sleep fragmentation are similar to the effects of reduce total sleep: daytime sleepiness increases and performance measurable decreases. Getting up four times at night, over an eight-hour time in bed, to care for your baby has the same effect as getting only four hours of consolidated sleep.
We all cycle through the night between deep sleep and light sleep. Babies often vocalize with quiet sounds during the light sleep period and then return to a deeper sleep by themselves. In the middle of the night, when your baby quietly vocalizes and you suspect he is not hungry or in distress, consider delaying your response several seconds or minimally soothe in the baby’s crib without always using feeding as a soothing technique. Then your baby learns to fall asleep unassisted in the middle of the night after a normal occurring arousal. For your baby, the ability to return to sleep unassisted is called self-soothing.
To repeat, after your child has fallen asleep at night, your child, while asleep, or after waking, may make non-distress sounds. What are non-distress sounds and why do they occur? I am talking about harmless sounds that all babies make, that do not indicate distress and, if you feel comfortable, can usually be safely ignored. You will hear sounds creating the false impression that your healthy baby has a cold (mucousy, gurgling, nasal congestion) because, for all babies, the nasal passage is narrow and a little fluid their vibrates when breathing through the nose. You will hear quiet wheezing, whistling, and noisy breathing sounds because, for all babies, the muscles lining the airway are not well developed so during inhalation, the airway slightly narrows. You will hear coughing because, for all babies, saliva pools at the back of the mouth and stomach contents normally reflux a little up the esophagus and the cough protects the lungs by clearing the back of the throat. Sneezing, snorting, and rattling sounds are common. Also, there may be some low or feeble sounds that sound like a whimper, or a quiet moan or groan which may or may not indicate distress.
If you go to your baby because you hear a quiet whimper, moan, or groan, and it appears that she is not having difficulty breathing and she appears to be calm without signs of distress such as grimacing, vomiting, or diarrhea, and her forehead does not feel warm or hot, and she showed no signs of illness during the day, it is probably safe to practice watchful waiting. That is, closely watch but do not intervene, even if she appears to be partially or completely awake.
So do you delay your response or respond immediately? In one study, using video cameras in the child’s bedroom, it was observed that often the infants’ self-soothed back to sleep unassisted. At 3 months of age, the average number for parental checks was one or two times each night, but the range was wide (zero to twelve). The average parental delay time was about three minutes. “The children of parents who waited longer to respond to their awakenings at 3 months were more likely to be self-soothers by 12 months of age.”
Hello Dr. Weissbluth – I am the mother of a soon-to-be 6 month old boy who was born 5 weeks preterm. He began sleeping though the night at 3 months. (We have a 7-year old and already closely followed your sleep prescription with great success). We begin the baby’s sleep ritual at 5:00pm and he is asleep in his crib by 5:30/45pm.
His naps are still fragmented throughout the day. Can I do anything more to help him to consolidate his naps? Morning wake up is usually 6:00am. He goes down for an hour nap one hour after waking up. He is usually drowsy again after feeding and playtime about an hour and a half. From there it is a crap shoot as to when and for how long he will nap. Some days he is awake for an hour and then sleeps for an hour. Other days he sleeps in bigger blocks. He is taking about 4 – 5 naps per day. It varies.
Should I be doing something differently to help him organize his naps sooner than later?
Thank you, by the way, for sharing your incredible expertise. Our family is in your debt for the gift of sleep health you have taught us. I made sleep one of the essential keystones to my parenting and chose the absolute best educator with the best approach to follow. We are thankful for you!
Thank you for your kind words. Because your baby was born early, and naps get organized around 4-6 months after the due date, please be patient regarding day sleep. Be optimistic because his night sleep is great, soon his naps will become more regular and perhaps longer. Maybe a pitch black room and/or a whit noise machine will help. On the week-end when your husband is around to care for your older son, focus on your baby’s drowsy signs and ask if the current nap irregularity is due to natural distraction from your older son. Maybe you will see a better nap routine for your baby. Let me know how it goes.