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New Thoughts On Sleep

The AAP goes deep on every new parent’s favorite topic

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Ahhh . . . sleep. Remember sleep? It’s what parents crave most, and what babies and toddlers never seem to do quite enough of. And we’ll read anything we can get our hands on that might help us get more. So when we heard about SLEEP: What Every Parent Needs to Know, the new book by Rachel Y. Moon, MD, FAAP, we were intrigued. We talked to the author about crying it out, crib safety, and when new parents can really expect to get a full night of sleep again.
 
StrollerTraffic: What is the most common question about sleep that you get from parents?
Dr. Moon: "Why isn't my baby sleeping through the night?"

ST: And . . . the answer? Please?

Dr. Moon: Many parents have unrealistic expectations about how long their baby should sleep. For instance, a 2-week old should only sleep 2 to 3 hours at a time, because he needs to eat! A 4-month old should be able to sleep longer, probably about 4 to 5 hours at a time. In addition, "sleeping through the night" really means that the baby can go 5 to 6 hours without waking a parent. (The baby will have multiple little awakenings throughout the night—the key is whether the baby can get herself back to sleep.)
 

ST: Okay, so when is it realistic to expect that a baby can sleep for that wonderful 11- or 12-hour stretch, ALL the way through the night?
Dr. Moon: Somewhere between 6 and 12 months. At 6 months, most babies sleep 13 to 15 hours a day, with 60-70 percent of those sleeping hours occurring at night.
 
ST: How does SLEEP differ from the other sleep bibles out there?
Dr. Moon: SLEEP is a book that is evidence-based. We use what has been shown in studies to work. We do not espouse any particular philosophy on sleep, but try to take a common sense approach to solving sleep and bedtime issues.

ST: That makes sense. Where do you fall on the "cry-it-out-as-long-as-it-takes" to "no-cry" spectrum?
Dr. Moon: I'm definitely somewhere in the middle. I advise that the parent wait for 5 minutes (or as long as s/he can stand it), then go check on the child and reassure him that everything is okay and that it's time to go to sleep. Then leave. Try to double the wait time before you go in again. The first night will be horrible, but each night will successively get better.

ST: Yeah, sleep training is no fun. What are the most important safety considerations for when the infant does finally go down?
Dr. Moon: The baby should be on his back in an empty crib—meaning no blankets, no pillows, and no bumper pads.

ST: Got it. What's your favorite tip for parents of a toddler who used to go to sleep easily, but is going through a sleep-resisting phase?
Dr. Moon: Many times, this is a sign that the toddler is outgrowing her naps. If the child is napping more than once a day, take away a nap. If the child has one nap, maybe it's too late in the day or too long a nap. You can then move up the time of the nap or shorten the nap.

ST: Interesting. And finally, overall, what's the most important thing for parents to do at bedtime?
Dr. Moon: Establish a bedtime routine. This helps everyone to know what to anticipate next, and for the child to get ready for sleep.
 
ST: Sounds good. We're on it.