Infant Sleep

Introduction

Sleep is an essential requirement for human beings. When we don't sleep, our ability to concentrate declines, we experience mood swings, and we may negatively view things.

Sleep benefits children, as the reducing cortisol level and the stimulated production of growth hormones, enable the child to grow. In contrast, enabling sleep.¹

In some cases, sleep deprivation in children leads to irritability, crying, and stress.

It also gives rise to one of the most significant challenges facing new mothers, namely acclimatizing to the rhythm of their newborn. Adapting to the rhythm of their child means becoming mutually acquainted, understanding each other, and redefining one’s habits.

In the early days, when the newborn’s sleep-wake cycle has yet to be established, this lack of rhythm is a significant risk factor for postpartum depression, as it entails a great deal of stress for the new mother.

There is a strong correlation between postpartum depression and the irregular sleep cycle of the newborn, as the stress caused by this results in hormonal imbalances and changes in hypothalamus pituitary adrenal (HPA) axis activity.²

Infant sleep: Reasons for waking up

Parents often ask themselves why their child does not sleep through the night.

Up to the age of 3 - and for many children up to 5 years of age - sleep is very fragmented and differs from adult’s sleep.

The waking phases that occur every 30 or 60 minutes are known as control waking. They are physiologically and naturally intended so that the parents know that the child is alright.

Therefore, it is essential to learn about sleep physiology in babies to avoid having any unrealistic expectations.

Given this, there can be many reasons for sleep disturbance; it may be physiological, organic, emotional, behavior-related, or due to environmental factors.³

A pediatrician can rule out physiological disturbances. These can include heartburn or urinary tract infections, which may cause pain and discomfort when the child urinates for night. Diaper rash and atopic dermatitis can cause a child to wake up if itching badly.

Pediatric osteopaths also have an essential role when it comes to the well-being of a newborn: They can exclude organic causes, such as neck tension caused as a result of birth or the baby’s position in the womb (when the baby adopts the “half-moon” position in the crib, i.e., with their neck drawn up). These experts can also help with colic, vomiting, plagiocephaly, and sleep disturbances in general.

Other reasons maybe emotional in nature. Perhaps the mother is suffering from postpartum depression or pregnant again with another child. Or maybe it is a question of getting used to kindergarten or weaning. The mother’s return to work, family bereavement, and many other circumstances can also play a part in causing sleep disturbances.

Mechanisms and methods for normalizing sleep in childhood

There are various mechanisms for promoting the normalization of sleep in childhood. Some are biological and depend on the nightly production of melatonin and brain development; others on the influence of the external environment and upbringing.

Sleep can be learned from parents. They can support their children in this learning process to gradually achieve a balance.

Having excluded all the mentioned above causes of sleep disturbance, the child’s behavior can be analyzed. Very often, the cause of sleep disturbance lies in the difficulty of returning back to sleep and returning to the phase of deep sleep.

Children seek the conditions that helped them get to sleep, to begin with, and if these conditions are not present, they may not be able to fall asleep again by themselves.

What does it mean for a child to sleep through the night? It does not mean that the child does not wake up until the following day. Waking up is physiological, but the child becomes increasingly capable of falling back to sleep by themselves and thus quickly falling into the deep sleep phase.

How can a child be trained to fall asleep, and when can training start? Over the years, several methods have been tried, some of which have since become outdated or old-fashioned, such as the famous “crying method”⁴, the “controlled crying” method⁵, or the “organized routines” method.⁶ In reality, there is no one method that suits all. It is more a case of considering all the variables above and working with the parents to develop a strategy that suits their parenting style and respects the child’s nature. Even if there is a sound empirical reason that verifies that various methods can improve a child's sleep, they remain a point of discussion, despite studies on their effectiveness and reliability.⁷

Advice to parents in the early months:

1. In the first few months following the birth, physical contact⁸ is essential, so that the baby feels calm and protected: cradle the baby in your arms or a baby sling. Lay the baby in a crib next to the parents’ bed or in a foldaway bed that can be secured directly to your bed. This means your child is always in contact with you and sleeps more soundly.⁹
2. Transmit calmness to your baby: if you are anxious or stressed and put your baby to bed while in that state, this negative energy often results in your baby crying and taking some time to go to sleep.
3. Feeding in the night is necessary for the first few months of life, as the infant’s stomach is still tiny, so the baby needs to feed frequently. Regardless of how you feed your baby, it is essential to satisfy your baby’s needs after feeding them, so that they can sleep for longer and more peacefully. Switch off or dim the lights. Speak quietly and only if it is necessary. Ensure your movements are slow and calm so that your baby does not fully wake up. Sucking relaxes the baby and milk satisfies them, enabling them to sleep for a few more hours.
4. After the fourth month, you can introduce daytime and nighttime bedtime routines. Routines are important for your child; they learn from you exactly what happens at nighttime. This makes them feel calm, enabling them to sleep more peacefully and for longer periods.