Whether a good sleeper or a not so good one, your baby can be helped to sleep to potential with some or all of the following sleep enhancers, many of which help re-create some of the comforts of home in the womb:
Cozy sleeping space. A crib is a great modern invention—but in the early weeks many newborns somehow sense its vastness and balk when sentenced to solitude, smack in the center of its mattress, so clearly removed from its distant walls. If your baby seems
uncomfortable in the crib, a cradle, a bassinet, or a baby carriage can be used for the first few months to provide a snugger fit that’s closer to the nine-month-long embrace in the uterus. For added security, swaddle your infant (but not once he or she becomes more active; see page 150), or use a baby sleeping bag.
Controlled temperature. Being too warm or too cold can disturb a baby’s sleep. For tips on keeping baby comfortable in warm and cold weather, see pages 508 and 517.
Soothing movement. In the uterus, babies are most active when their mothers are at rest;
when their mothers are up and on the go, they slow down, lulled by the motion. Out of the womb, movement still has a soothing effect. Rocking, swaying, and patting will help get your baby to sleep.
Soothing sound. For many months, your heartbeat, the gurgling of your tummy, and your voice entertained and comforted your baby. Now sleeping may be difficult without some background noise. Try the hum of a fan, the soft strains of music from a radio or stereo, the tinkling of a music box or musical mobile, or one of those baby soothers that imitate uterine or heartbeat sounds.
A peaceful place. Babies sleep better when they are in a room of their own, not because they’re disturbed by your presence but because you’re more likely to pick them up at the least little whimper—breaking up their sleep unnecessarily. So unless you’re planning on co- sleeping and/or can stop yourself from picking up your baby at any toss or turn, keep baby in his or her own room, if possible. You should, however, be close enough to hear your baby’s cries before they turn into frantic ear-piercing wails—or use an intercom between baby’s room and yours.
Routine. Since your newborn will fall asleep most of the time while nursing or bottle feeding, a bedtime routine might seem unnecessary. But it’s never too early to begin such a routine, and certainly by the age of six months it should top off every evening. The ritual of a warm bath, followed by being dressed in nightclothes, a little quiet playtime on your bed, a singsong story or nursery rhyme from a picture book, can be soothing and soporific for even the youngest babies. The breast or bottle can be last on the agenda for babies who still fall asleep that way, but can come earlier for those who have already learned to doze off on their own.
Adequate daytime rest. Some parents try to solve nighttime sleeping problems by keeping their babies awake during the day, even if the baby wants to sleep. This is a big mistake
(though it’s all right to limit the length of daytime naps a little to maintain the contrast between day and night), because an overtired baby sleeps more fitfully than a well rested one.
Seeing the light of day. Infants exposed to afternoon sunlight tend to have a much better night’s sleep, so try an after-lunch stroll.
Not only are your concerns normal, but your baby’s varied breathing patterns when he snoozes are, too. You will eventually become less panicky about whether he’s going to wake up in the morning, and more comfortable with both you and him sleeping eight hours at a stretch.
Still, you may never totally be able to abandon the habit of checking on your child’s breathing (at least once in a while) until he’s off to college and sleeping in a dorm—out of sight, though not out of mind.
MOVING A SLEEPING BABY TO BED
“I’m a nervous wreck when I try to put my sleeping baby down in her crib. I’m always afraid she’ll wake up—and she usually does.”
She’s finally asleep—after what seems like hours of nursing on sore breasts, rocking in aching arms, lullabying in an increasingly hoarse voice. You rise ever so slowly from the glider and edge
cautiously to the crib, holding your breath and moving only the muscles that are absolutely necessary.
Then, with a silent but fervent prayer, you lift her over the edge of the crib and begin the perilous descent to the mattress below. Finally, you release her, but a split second too soon. She’s down—then she’s up. Turning her head from side to side, sniffing and whimpering softly, then sobbing loudly.
Ready to cry yourself, you pick her up and start all over.
The scenario’s the same in almost every home with an infant. If you’re having trouble keeping a good baby down, wait ten minutes until she’s in deep sleep, then try:
A high mattress. If you were a gorilla, you might be able to set your baby down in a crib with a low mattress without having to scale the rail or, alternatively, drop her the last 6 inches. Since you’re only human, you will find it much easier if you set the mattress at the highest possible level (at least 4 inches from the top of the rail); just be sure to lower it by the time your baby is old enough to sit up. If your crib has the option, lower the side rail before putting baby down to avoid having to bend over a high railing. Or, for the first few weeks, use a crib substitute such as a carriage, bassinet, or cradle, all of which may be easier to lift a baby into and out of. Often these offer the important plus of being rockable, so the rocking motion that started in your arms can continue after you bed baby down.
A little light. Though it’s a good idea to get baby to sleep in a darkened room, be sure there’s enough light (a night-light will do) for you to see your way to the crib without bumping into a dresser or tripping over a toy—which is sure to jar you, and your baby.
Close quarters. The longer the distance between the place where baby falls asleep and the place where you are going to put her down, the more opportunity for her to awaken on the way. So feed or
rock her as close to the cradle or crib as possible.
A seat you can get out of. Always feed or rock your baby in a chair or sofa that you can rise from smoothly, without disturbing her.
The right side. Or the left. Feed or rock baby in whichever arm will allow you to put her in the crib most easily. If she falls asleep prematurely on the wrong arm, gently switch sides and rock or feed some more before attempting to put her down.
Constant contact. When baby is comfortable and secure in your arms, suddenly being dropped into open space, even for an inch or two, startles—and awakens. Cradle baby all the way down, back first, easing your bottom hand out from under just before you reach the mattress. Maintain a hands-on pose for a few moments longer, gently patting if she starts to stir.
A lulling tune. Hypnotize your baby to sleep with a traditional lullaby (she won’t object if you’re off- key) or an improvised one with a monotonous beat (“aah-ah aah-ah ba-by, aah-ah aah-ah ba-by”).
Continue as you carry her to her crib, while you’re putting her down, and for a few moments afterward. If she begins to toss, sing some more, until she’s fully quieted.
CRYING
“We congratulated ourselves in the hospital on having such a good baby. We were home hardly a week when she started howling.”
If one- and two-day-old babies cried as much as they were destined to a couple of weeks later, new parents would doubtless think twice about checking out of the hospital with their newborns. Once they’re safely ensconced at home, babies don’t seem to hesitate to show their true colors, with all doing some crying, and many doing a considerable amount. Crying is, after all, the only way infants have of communicating their needs and feelings—their very first baby talk. Your baby can’t tell you that she’s lonely, hungry, wet, tired, uncomfortable, too warm, too cold, or frustrated any other way.
And though it may seem impossible now, you will soon be able (at least part of the time) to decode your baby’s different cries and know what she’s asking for (see page 123).
Some newborn crying, however, seems entirely unrelated to basic needs. Eighty to 90 percent of all babies, in fact, have daily crying sessions of from fifteen minutes to an hour that are not easily explained. These periodic crying spells, like those associated with colic, a more severe and
persistent form of unexplained crying, most often occur in the evening. It may be that this is the most hectic time of day in the home, with dinner being prepared, parents and siblings coming home from work and school, the family trying to eat, other children, if any, vying for attention; the hustle-bustle may be more than the baby can tolerate. Or it may be that after a busy day of taking in and processing all the sights, sounds, smells, and other stimuli in her environment, a baby just needs to unwind with a good cry.
Some perfectly happy babies seem to need to cry themselves to sleep, possibly because of fatigue.
If your baby cries for a few minutes before nodding off, don’t be concerned. She will eventually outgrow this. What may help is a regular prebedtime ritual and enough rest during the day so she isn’t overtired at night.
Meanwhile, hang in there. Though you’ll be drying some tears for the next eighteen years or so,
these probably tearless newborn crying spells are likely to be a thing of the past by the time your baby is three months old. As she becomes a more effective communicator and a more self-reliant
individual, and as you become more proficient at understanding her, she will cry less often, for shorter periods, and will be more easily comforted when she does cry.
A sudden bout of crying, however, in a baby who hasn’t cried a lot before could signal illness or early teething. Check for fever and other signs that baby isn’t well or might be teething, and call the doctor if you note anything out of the ordinary.
COLIC
“My spouse and I haven’t had dinner together since our baby was three weeks old. We have to take turns gulping our food and carrying him around while he cries for hours every evening.”
For the parents of a colicky baby, even a steak dinner becomes fast food, choked down to the
accompaniment of indigestion-provoking screams. That the doctor promises baby will outgrow colic offers little consolation for their misery.
And if misery likes company, parents of colicky babies have plenty of it. It’s estimated that one in five babies have crying spells, usually beginning in late afternoon and sometimes lasting until
bedtime, that are severe enough to be labeled colic. Colic differs from ordinary crying (see previous question) in that the baby seems inconsolable, crying turns to screaming, and the ordeal lasts for three hours, sometimes much longer, occasionally nearly round-the-clock. Most often colicky periods recur daily, though some babies take an occasional night off. Doctors usually diagnose colic based on the
“rules of three”: at least three hours of crying, at least three days a week, lasting for at least three weeks.
The baby with a textbook case of colic pulls his knees up, clenches his fists, and generally increases his activity. He closes his eyes tightly or opens them wide, furrows his brow, even holds his breath briefly. Bowel activity increases and he passes gas. Eating and sleeping patterns are upset by the crying—the baby frantically seeks a nipple only to reject it once sucking is begun, or dozes for a few moments only to awaken screaming. But few infants follow the textbook description exactly. No two babies experience exactly the same pattern and intensity of crying and associated behavior, and no two parents respond in exactly the same way.
Colic generally begins during the second or third week of life (later in preterm infants), and
usually gets as bad as it’s going to get by six weeks. For a while, colic seems as though it will stretch on interminably, but by twelve weeks, it usually begins to diminish, and at three months (again, later in preterm babies) most colicky infants appear miraculously cured—with just a few continuing their problem crying through the fourth or fifth month. The colic may abate suddenly or gradually, with some good and some bad days, until they are all good.
Though these daily screaming periods, whether marathon or of more manageable duration, are usually dubbed “colic,” there is not a clear definition of exactly what colic is or how it differs, if it does, from other types of problem crying. Definitions and differences, however, matter very little to parents who are desperately trying to calm their infant during these prolonged crying spells.
What causes colic remains a mystery. Theories, however, abound. Many of the following now have been totally or partially rejected: Colicky babies cry to exercise their lungs (there is no medical evidence of this); they cry because of gastric discomfort triggered by allergy or sensitivity to
something in their mothers’diets if they are breastfeeding or in their formula if they are bottle-fed (this is only occasionally a cause of colic); they cry because of parental inexperience (colic is no less common in second or subsequent babies, though parents may handle the crying with more aplomb);
colic is hereditary (it does not appear to run in families); colic is more common in babies whose mothers had complications in pregnancy or childbirth (statistics don’t bear this out); exposure to fresh air stirs up colic (in practice, many parents find that fresh air is the only way they can quiet their
crying babies).
The latest research seems to point to a number of potential reasons why colic may occur in some babies:
Overload. For the first few weeks of life, babies are able to block out the extraneous stimuli in their environment, probably so they can focus on sleeping and eating. Once they become more aware of the world around them, they sometimes take in more stimuli than they can handle.
Bombarded all day long with sensations (new sounds, sights, and smells), they can reach the early evening hours at sensory overload—overstimulated and overwhelmed. The result in babies who are particularly sensitive to stimuli (in some cases because they’re extra alert): lots of crying, and sometimes colic. Fortunately, once babies acquire the ability to tune out the environment before overload occurs (usually by three months, occasionally not until five), bouts of colic end. In the meantime, if you think this might be the cause of your baby’s colic, the try-everything approach (rocking, bouncing, driving, swinging, singing) may actually make things worse. Instead, watch how your baby responds to certain stimuli and steer clear of the offending ones (if baby cries harder when you rub or massage him, limit that kind of touching during colic; instead, try swinging him in a swing once he’s old enough; see page 335).
Immature digestion. Another theory is that a baby’s immature digestive tract contracts violently when gas is passed, causing pain and, not surprisingly, lots of crying. When gas seems to be pulling the colic trigger, there are medications that may help (see page 190).
Reflux. Recent research has found that one common cause of colic is reflux. This form of reflux irritates the esophagus (much like heartburn in an adult), causing discomfort and crying. If reflux seems to be the cause of the colic in your baby, some of the treatment tips on page 558 may help.
Environment. One factor that does seem to contribute to an increase in colicky behavior, though the reason for it isn’t clear, is tobacco smoke in the home. And the more smokers in a household, the greater the likelihood of colic and the worse the colic will be.
Milk supply problems. Insufficient milk or other breastfeeding problems is another possible cause of colic. Milk supply often diminishes in the early evening, just the time when the baby starts
crying. If this is the cause of your baby’s colic, improved breastfeeding technique or supplementation with pumped milk usually corrects the problem.
Parental tension. The theory that babies are colicky because their parents are tense is a more controversial one. Though many experts believe it’s more likely that it’s the baby’s crying that makes a parent tense, some insist that a parent who is very anxious may unconsciously
communicate this to the baby, making him cry. It may be that although parental anxiety doesn’t cause colic, it can make it worse.
What’s reassuring about colic is that babies who have these crying spells do not seem to be any
the worse for the wear (though the same can’t always be said for their parents), either emotionally or physically—they thrive, usually gaining as well as or better than babies who cry very little, and display no more behavioral problems than other children later on. Children who cry vigorously as infants appear, in fact, more likely to be vigorous and active problem solvers as toddlers than those with limp cries. And most reassuring of all is the certainty that the condition won’t last forever. In the meantime, the tips on the following pages should help you deal with the problem. (See page 738 if you have an older child who’s having trouble coping with baby’s colic.)
SURVIVING COLIC
“This is our first baby and she cries all the time. What are we doing wrong?”
Relax. You’re not guilty. The theory that a baby’s colic is somehow the fault of the parents just hasn’t held up. And, in fact, your baby would probably be doing just as much crying if you were doing
everything right (which, of course, no human parent does, even with the benefit of experience). Colic, the latest research indicates, has to do with baby’s development and not yours.
The “rightest” thing you can do is to try to cope with your baby’s crying as calmly and rationally as possible, since your tenseness will only compound your baby’s. Keeping your cool in the face of colicky fire isn’t easy, but knowing that you’re not at fault can help. So can the tips you’ll find in the next answer.
“Sometimes when I’m rocking the baby through his third hour of colic, and he won’t stop screaming, I have this terrible urge to throw him out the window. Of course I don’t—but what kind of parent am I to even think such a thing?”
You’re a perfectly normal one. Even those otherwise qualified for sainthood couldn’t survive the agony and frustration of living with a baby who won’t stop crying without experiencing some feelings of anger—even fleeting animosity—toward him. And though few would admit it freely, many parents of chronic criers regularly have to fight off the same kinds of horrifying impulses you’ve been feeling.
(If you find such feelings are more than momentary, and/or if you’re afraid that you might really hurt your baby, get help immediately.)
The colic carry. Some colicky babies are soothed by the pressure applied to their abdomen when they are carried in this position.