How can I help my baby sleep better?

Most experts recommend 14 to 15 hours of sleep per day for babies 3 to 11 months old. Surveys show that most American babies go to bed 1-2 hours later than babies born 20-30 years ago. However, morning awakening times haven't changed in the past few generations. This means that many American babies average 12-13 hours of sleep in a 24-hour period, less than what is needed for adequate rest. A good night's sleep is important for everyone, young and old. In children, poor sleep causes mood changes, impulsivity and attention problems, and poor school performance. We are learning that sleep deprivation is also linked to overweight and obesity. Sleep in babies is important for learning and development, and we're also learning that it plays an important role in the development of vision. Some of the following clues may indicate that a baby may not be well rested:

• The baby sleeps less than 3 hours total during the day.
• The baby doesn't sleep for more than 30 minutes at a time.
• The baby always seems to fall asleep in the car, swing, or stroller, or while being nursed or fed. In fact, the baby seems to have trouble falling asleep outside these particular situations.
• The baby's daytime and nighttime sleep schedule seems irregular.

Just as babies show signs of readiness for a feeding, babies will also show signs of sleepiness, such as:

• crying, fussing, whimpering, and moaning
• rubbing eyes and ears, yawning, dropping held objects, falling down, loss of coordination
• loss of attention, "zoning", sudden loss of interest in play

Babies tend to show sleepy signals for a few minutes about every 90 minutes while they're awake. This doesn't mean a baby must fall asleep every ninety minutes -- but if given the opportunity to fall asleep during this window, a baby usually will. However, if after a few minutes, the opportunity passes, the baby becomes more alert again and won't fall asleep, even if put down to sleep. As with many milestones, it varies from child to child. Most healthy, well-rested infants can "self-soothe" themselves to sleep (or back to sleep) between 5 and 7 months old. By this time, they do not need nighttime feedings to grow and gain weight. (Many babies this age and older will continue to eat at night if offered, but it's not necessary. In fact, many babies have trained themselves to wake up, just because their body expects a feeding!)

Infants who are poor sleepers tend to have difficulty with learning self-soothing. If your baby is having trouble getting back to sleep at night on his own, work on his daytime nap schedule first. Once his daytime sleep pattern is regular, and you are more familiar with his particular "sleepy" signals, it will be easier to work on nighttime sleeping.

There are several different methods. No method is right for every child or every family. Methods which have all been shown to work include:

• The "cold turkey" method. This is also referred to as letting a child "cry it out." A baby is put to bed at his designated bedtime. When he wakes up and cries, parents will check on him for safety, but will otherwise ignore crying until the morning.
• The "minutes" method. A baby is put to bed at his designated bedtime. When he wakes up and cries, parents ignore it for a predetermined length of time (say 10 minutes.) At the 10 minute mark, the parent will go in and check on the baby and reassure him, then leave. The intervals are gradually lengthened farther and farther apart. It is important to keep the interactions brief and boring, without feeding, holding, singing, etc.
• The "distance" method. A baby is put to bed at his designated bedtime. When he wakes up and cries, parents ignore it for a predetermined length of time. The first time they go in to reassure him, they will come up to the crib. The second time, they will come not quite all the way to the crib. This continues until the parents are reassuring him from the hall, and so on.

If you have questions about a sleep-training method, talk to us. This is true of humans of all ages: even adults who are sleep deprived can have trouble falling asleep (or staying asleep). At certain times of day, it's harder to fall asleep than others. For example:

• People of all ages find that it's very hard to fall asleep in the hour or two before one's usual bedtime.
• Travelers who are "jet lagged" find that it's hard to stay up later, or go to bed earlier, while traveling.
• Parents who work night shifts find that it's hard to fall asleep during the day, no matter how tired they are.
• Teenagers, who are often sleep-deprived, tend to stay up late playing Nintendo and Facebooking. The next morning, it practically takes a tractor to drag them out of bed! However, despite getting poor sleep the previous night, teens have trouble falling asleep the next night and repeat the cycle.