While some of the tips I’m suggesting require mom and dad to make sacrifices – Like Watching Baby’s Diet – I’m convinced that any effort you make to keep your baby and toddler healthy and happy pay off in the number of hours of sleep you will get. Here are two more tips.

Tip 4. Consistent Napping

Good sleep promotes good sleep. A lot of parents whose children do not sleep well at night mistakenly think it would be a good idea for them to give up naps. Instead, parents should try to institute a consistent nap routine. The baby’s last nap should not be too late in the day either to ensure that it doesn’t interfere with nighttime sleep.

Tip 5. Comfortable Sleep Environment

Wherever your baby sleeps, ensure that it is comfortable. That doesn’t mean adding all sorts of blankets and pillows (which can be dangerous). Instead, it means making sure that your baby is dressed appropriately for the temperature in comfortable pajamas. It may mean using things like white noise to help your baby to sleep. It certainly involves ensuring a smoke free sleep environment, not having smokers sleep in the same room as the baby, and ideally a smoke free home altogether.

I don’t want anyone to think I’m an expert on this topic at all… so consider yourself warned.

When Marc was first home from the hospital, I didn’t think too much of the first night or two. I was used to not getting much sleep but this getting up every three hours wasn’t fun.  After a week I started to think my eyes were about to bleed and about a week after that I’m pretty sure I was sleep walking in and out of meetings at work.  I was drained but in some crazy way I started to get used to it.

After a while I was totally able to function on about four hours of sleep.  We got a routine down – we started by feeding Marc dinner, followed by 20-30 minutes before bath time, followed by getting him ready for bed, and finally a bottle of formula/milk.

Marc would wake up in the middle of the night for a bottle at 2am and 4am until he was 5 months old. Then just at 2am until he was 9 months old.  At that point our doctor started giving us the advice better do it now then later, he was referencing ferberizing. I’m the big softy here I couldn’t do that to him just let him cry.  Thankfully Marc didn’t need much encouragement to start sleeping though the night, I started by giving him half of his normal 6oz of formula with only 4oz then 3oz and then switched him to water alone. That was the trigger that made him no longer wake up.

Fast forward till now 18 months old, We haven’t altered his routine at all.  Of course we had our moments of growth spurts and teething (wow that was the worst). His little colds that kept him up from time to time, but overall we’ve keep it on track.

He now gets his binky only at bedtime (or in the car or when we’re out in public – we’re still working on that one) and he has a few stuffed animals in the crib and his favorite blanket that he snuggles up with (it’s very cute). We do have a play blanket that is different from the sleep blanket mainly to put some cues that play and sleep are different (I’d like to think that helps).

In no way am I solely responsible for this success alone, without my wife I’m pretty sure Marc would still be falling asleep on my chest, like he did when he was first born. (I still kind of miss that too)

There is a lot of information (and opinion) about how to get your infant to sleep through the night. Cry it out/don’t cry it out, rocking/no rocking, co-sleeping/crib sleeping, white noise/no noise, breastfeeding or bottle-feeding. Everyone has an idea about what works. Like I said earlier, there is very little data to support one technique over another.

Auspiciously, there is new data that may help us know what NOT to do. Researchers found 3 things to avoid while helping your baby learn to sleep through the night.

A new study refutes an urban legend: feeding rice cereal keeps babies asleep.

The findings may also help us understand how to improve our home environment to ultimately improve infant/toddler sleep. Researchers in Boston followed over 1600 mothers until their babies were 2 years of age. They evaluated the amount of sleep babies got at 6 months, 1 year, and 2 years of age. Study results included:

No rice cereal before 4 months.  Feeding rice cereal early in infancy doesn’t help babies/toddlers sleep longer. Many parents hear that rice cereal will satiate a baby to the point that they’ll avoid overnight feeds. The study found babies who were fed rice cereal before 4 months of age slept LESS. I recommend no solids until about 6 months of age. Not because rice cereal is necessarily harmful, rather it likely isn’t helpful and what’s the rush? Wait until the baby is able to sit up independently, then give it a go.

No TV. Research (and instincts) tell us television isn’t good for infants & toddlers. In this study, babies who were placed in front of the TV, slept less at age 1 and 2 years of age. The AAP recommends no TV until age 2. Some families find that impossible. Whatever you do, this study may encourage you to wait until your baby is sleeping through the night.

Avoid depression. Postpartum depression was associated with less sleep in babies and toddlers. Nearly 80% of women who give birth have the “baby blues,” but some women go on to suffer from postpartum depression. Prompt diagnosis and help can improve a mother’s enjoyment of the baby, her suffering, and the baby’s sleep. If you’re worried about your mood or sadness, or another mother’s mood, you can get help. Postpartum depression can be treated. Call the doctor for an appointment to discuss. Or talk with your infant’s pediatrician. It’s always okay to ask for help.

Also, two wildcard non-issues: breast-feeding (versus formula) & maternal smoking seemed to have no effect on sleep duration in the 1 and 2 year-olds.

There you go, the anti-advice. Just 3 things to try not to do. All in the never-ending quest for a good night of sleep.

I’m asked almost everyday by some concerned parent whether their child is sleeping enough or too much. That’s not a simple answer and varies from child to child and even from day to day.

For instance, if a child has just learned to walk she will often get more sleep because she’s getting a lot more physical activity than she did just before she began walking. When a child first learns to walk, she toddles from place to place trying out her new skills with a new burst of energy. (Note: don’t put your video camera away after she’s taken those monumental first steps! There are some never-to-be-repeated times right around the corner.)

Once she’s mastered walking, her sleep needs may decrease again. Of course when a child is ill or even fighting off an infection, he might need more sleep. And if a child (or adult) is looking forward to an exciting day ahead, the excitement and anticipationmay naturally result in less sleep the night before.

But back to the question, how much sleep does my baby need? I have general guidelines for the range of normal amount of sleep needed for each age. Keep in mind, this is a general guideline:

Average Number of Hours of Sleep Needed

You may be more exhausted than you have ever been. Whenever people are sleep deprived they are more subject to swings of emotion and to feelings of inadequacy. This, by itself, is enough to cause a blue period (ask any practicing pediatrician).

To make matters worse, research has shown that women with the postpartum blues tend to have babies who cry significantly more than those of their counterparts. It hasn’t been proven whether the fussy, crying babies make moms sadder, or whether the sad moms make the babies less happy – but it seems to me that both are true, and that the crying can become a vicious cycle.

A true grief reaction, at a time of great stress (and insistent noise), in a person who is chronically sleep deprived, all built on a shifting foundation of tremendous hormonal surges – it’s a wonder that postpartum blues aren’t more of a problem. Most of the time, though, the powerful positive feelings that also accompany this time of new beginnings soon displace the sadness.

But if the ride is turbulent, and the oxygen masks should fall from the ceiling of the plane, first put on your own mask, so that you will be able to help your children. If the sky is falling, do the same thing – taking care of yourself is often the first step to being better able to love your baby. This is also a good principle to follow if you are having the best time of your life.

Get as much sleep as possible. If you are breast feeding, you will probably feel sleepy just after nursing. Sleep when the baby sleeps. Once nursing is well established, you may want to give your baby some bottle feedings (ideally of pumped breast milk), both to give Mom a break, and to allow Dad the treat of feeding his baby. If you are bottle feeding from the beginning, share the responsibility, if practical.

Eat delicious, healthy food – hopefully that somebody else prepares!

Get out of the house. Even brief breaks (particularly if it’s time the two of you can spend together) can be very restoring, especially if you get outside.

Clearly, this requires teamwork. Teamwork as a couple, as an extended family, as a community, or as baby care support such as a Doula that you arrange to work with you. An online community can be another source of support and wisdom. We’ve found the online community at DrGreene.com to be a great way for new parents to connect with new and experienced parents when they need it most, right from their own homes, without having to get dressed, go out, or look presentable.

Wherever you turn for teamwork, you don’t need in-laws or anyone else to come in and seem to be bossing you around. On the other hand, little is more valuable than concrete, loving assistance in caring for their baby – on your terms and in your timing.

Would you like someone to change more diapers? To join you in reading baby care books? Do the laundry? Call your pediatrician with questions? Rock the baby to sleep? Run out and buy supplies? Ask.

You have just done something magnificent in creating a new life. It’s normal and fine for parenthood to be an unfolding process. It doesn’t have to feel great right now to feel great in the future. You might feel like smiling all the time. You might not. But, take time to smile at your baby even if you don’t feel like it. Smiling may make you feel a little better, and your baby a lot better – which in turn will help you. You might also try laughing until it is funny. Seriously, try laughing out loud until you get tickled! If you have a hard time doing it, grab your partner by both hands, look into each others eyes, and laugh. Soon you won’t be able to stop.

This is an excerpt from: From First Kicks to First Steps: Nurturing Your Babys Development from Pregnancy Through the First Year of Life, McGraw-Hill, 2004, Pp. 200-201

To reduce crying in irritable babies and to prolong sleep in babies who seem to wake up all the time, parents in many parts of the world swaddle their babies when putting them down to sleep. This custom of wrapping babies snugly in light cloths or sheets has been used for centuries. Researchers at the Pediatric Sleep Unit of the University Children’s Hospital in Brussels, Belgium decided to use their modern sleep lab to measure the effect of swaddling on sleep. They were particularly interested because swaddling while sleeping on the back has been said to reduce the risk of SIDS. Up to 30 percent of babies are still placed face down to sleep, despite a massive education campaign. One of the main reasons parents give for this dangerous choice is that their babies cry more on their backs and don’t sleep as well. If swaddling babies sleeping on their backs reduces crying and improves sleep, it might help promote sleeping on the back, further reducing SIDS, while making life more pleasant for babies and their parents. What did the researchers find?

The somewhat surprising results were published in the May 2005 Pediatrics. The babies in the study ranged from 6 weeks to 16 weeks old. The study started at 9 p.m. Half of the babies were placed on their backs and allowed to fall asleep without swaddling. Then at 1:01 a.m., whether they were awake or asleep, they were “tidily wrapped” in a small bed sheet to prevent them from moving their arms or legs, and returned to their backs for the rest of the night. The other half of the babies were swaddled at the beginning of the night, and unrestrained at 1:01 a.m. Throughout the night, all the babies were carefully monitored with EEGs (measuring brain activity), EKGs (heart activity), electrooculograms (eye movements), electromyograms (muscle activity), plethysmography (breathing movements), actigraphs (overall movement), thermistors (air flow from the mouth and nose), pulsoximeters (oxygen saturation in the blood), and rectal probes (core body temperature). All of this detailed information was collected and collated on computerized polygraphed recorders for a total of 16 babies.

On average, the babies did indeed sleep significantly better for the half of the night that they were swaddled. The swaddled babies spent significantly more total time asleep. They had fewer spontaneous awakenings. When the swaddled babies did wake up (which we all do, several times each night), they fell back asleep in an average of only 30 seconds (ranging between 0 and 7 minutes). The heart rates of the swaddled infants were also more responsive (a good thing!). There was no change in core temperature or oxygen saturation.

Nevertheless, the swaddled babies awakened more easily to outside noises! While the babies were dreaming (REM sleep), the researchers played 3-sec bursts of white noise at increasingly loud volumes to see what it took to get the babies to open their eyes. The babies awoke at significantly lower volumes when they were swaddled than when they were unrestrained. The swaddled babies awoke at an average volume similar to a moderately loud conversation. Their heart rates and blood pressures responded at even lower volumes. Perhaps this increased responsiveness to the outside environment makes SIDS less likely.

With only 16 babies, and only 4 hours each of swaddling time, the study was too small and too brief to make general recommendations about ongoing sleep habits. But the possibility of promoting both better sleep and increased responsiveness is exciting. And this high-tech, 21 st century evidence seems to support and explain generations of parenting wisdom.

The same “Back to Sleep” campaign that has dramatically decreased the rate of SIDS has also resulted in an increasing number of babies with flat skull areas, usually on one side of the back of the head. The benefits of sleeping on the back far outweigh the often-preventable short-term cosmetic issues.

The AAP has issued July 2003 recommendations for preventing these flat areas (plagiocephaly or positional skull deformities) while still sleeping on the back. The ideas are simple.

First, try to decrease the amount of time that babies spend on their backs or leaning on the backs of their heads when they are awake. Building the habit of “Tummy Time” is one great way to do this.

Second, try to alternate which side of the head is down when babies sleep. This may often be accomplished by changing which way a babies would look to see the door when they sleep.

If a change in skull shape occurs, this will usually improve on its own, or with minor treatment, once the baby is sitting on his own through much of the day and beyond the highest risk period for SIDS.