Gina Ford has helped thousands of families resolve sleep challenges. In this life-saving new book, she offers gentle, step-by-step plans to tackle a whole range of sleep issues. Whether it’s feeding to sleep, rocking to sleep, night-waking, co-sleeping or dummy attachment, Gina knows how to fix it.
Full of practical, easy-to-implement advice from the UK’s bestselling childcare author, in just seven days The One-Week Baby Sleep Solution will help your baby (and you!) to have a good night’s sleep.
Gina Ford’s Contented Little Baby Book became a runaway bestseller when it was first published in 1999. She continues to be the number one bestselling author of childcare books in the UK. Her advice and methods have been a godsend to tired, stressed parents throughout the world and have helped a generation of children go to bed on time and sleep soundly through the night. She runs a hugely popular website: www.contentedbaby.com
OVER THE YEARS I have worked with many thousands of parents, and have helped them find solutions to the challenges they were having with their babies and toddlers. My first book, The Contented Little Baby Book (published in 1999), was based on my experiences of working with over 300 babies and their families. Since then I have advised thousands more parents through my consultancy work and the Contented Baby website, www.contentedbaby.com, which I set up to help and support parents as they navigated their way through those early months. Through this direct contact I have become familiar with the most common problems new parents experience, and I know how tired and anxious mums and dads can become when their baby is not sleeping well.
Sleep is probably the most misunderstood and confusing aspect of parenthood. The misconception is that for the first few weeks all the baby will do is feed and sleep. While many do, the fact that that there are now literally hundreds of sleep consultants in the United Kingdom is proof that a great many do not. If your newborn or young baby is one of the latter – tense, fretful and difficult to settle – please take heart, as this need not be a reflection of your baby’s future sleep habits.
There is much conflicting advice from childcare experts on how to tackle sleep problems. The majority of experts advise parents with very young babies who are waking up several times a night to wait until the baby is six months old before attempting to resolve the problem. My own personal view is that the longer parents put off trying to resolve excessive night-time waking, the harder it will be to solve problems further down the line.
If your baby has got into a routine of excessive night-time waking or has developed the wrong sleep associations, then the practical advice in this book will help you to instil better sleeping habits in your child. As long as you are prepared to be consistent and persistent, there are many solutions that will help you establish a good sleeping pattern for your child.
Gina
BEFORE TRYING TO implement the plans in this book, it is very important that you have a basic understanding of the different stages of sleep that babies go through. Filmed research shows that all babies come into a light sleep several times a night, some even waking up fully for short spells. When the wakings are not due to genuine hunger, the research shows that the babies who have learned to self-settle will get themselves back to sleep fairly quickly. Babies who have been rocked, patted or fed to get them to sleep are usually unable to settle themselves to sleep without the attentions that they associate with going to sleep.
Once the wrong sleep associations are created it can be very difficult for a baby to sleep for a longer stretch. A baby who is always rocked, fed or given a dummy to get to sleep will be much more likely to continue to wake several times a night, long after the age when he needs a milk feed to get him through the night (see box here for more on this). Because he will naturally come into a light sleep several times a night, he will more than likely need the same comfort to get him back to sleep at each cycle.
SLEEP IS DIVIDED into rapid eye movement (REM) sleep, usually referred to as active (or light) sleep, and non-REM sleep, usually referred to as quiet (or deep) sleep. Unlike adults and older babies, who start out in non-REM sleep, a newborn baby goes straight into REM sleep when he first drifts off. During this active sleep, his breathing becomes irregular, his body may twitch or jerk, his eyelids will flicker and his eyes appear to roll. He may even smile or frown. His body uses more oxygen and energy during this cycle than during non-REM sleep. A baby who has gone full term will spend 50 per cent of his sleep cycle in REM sleep. A premature baby will spend about 80 per cent in REM sleep. The rest of the sleep cycle is spent in non-REM sleep.
During non-REM sleep the baby’s breathing will be slow and regular. There are no eye movements and only the occasional twitch or jerk of the body. This calm sleep cycle allows the baby’s mind and body to recharge, enabling him to cope with his next awake period. Research shows us that this deep sleep is essential for the healthy development of a baby’s mental and physical growth.
As Dr Richard Ferber, one of America’s leading authorities in the field of children’s sleep problems, explains in his book Solve Your Child’s Sleep Problems, non-REM sleep is well developed at birth but has not evolved into the four distinct stages experienced by older children and adults. It is not until around the second month that a sequence of non-REM sleep stages begins to develop. By three months a baby will first enter sleep in stage one of non-REM – a drowsy sleep – then quickly pass into stage two – a light sleep – before reaching stages three and four – very deep sleep. The whole cycle lasts around 40 minutes in babies and for toddlers it is around 60 minutes.
I have observed that it is between the ages of eight and twelve weeks that many parents begin to experience problems with their baby’s daytime sleep, as the different stages of non-REM sleep begin to develop. During the first few weeks, the majority of babies will tend to fall asleep easily – often in their baby seat or in their pram or buggy – and frequently sleep for several hours at a time. Unfortunately, as the baby’s sleep cycle develops into more distinct stages of light and deep sleep, he will often find it more difficult to settle back to sleep after the 40–50-minute sleep cycle if he is used to sleeping in a bright and busy daytime atmosphere. As the day progresses, the baby gets more and more irritable, and by late afternoon he is often very overtired and fights sleep even more. Parents who don’t realise that this fractious behaviour is caused by poor quality daytime sleep resort to feeding, rocking, patting, etc. to help their baby get back to sleep when he has come into his light sleep. What starts out as a daytime sleep problem soon also becomes a night-time problem. A baby who needs assistance to return to sleep when he comes into a light sleep during the day will more likely than not come to need the same help at night. Because all babies will come into a light sleep several times a night once they have developed an adult sequence of sleep cycles, a problem can soon evolve. This can often mean several wakings a night for parents for many months and sometimes even years.
The age that a baby can sleep a longer spell in the night without needing a feed is very individual, but a baby who has gone full term and is gaining a good amount of weight each week can usually start to sleep for one longer spell of four or more hours in the night by the time he reaches one month. As the baby grows he should gradually, over the weeks and months, start to extend the length of time he sleeps, until he is going around ten to twelve hours at night at six months with a sleepy feed around 10/11pm in the evening or perhaps around 5/6am in the morning.
Of course there are many babies who may continue to need feeds in the night until they are a year old if all of their nutritional needs are not being met during the day. The most important thing that I stress to parents is that the aim in the early days should not be to push their baby through the night as quickly as possible without a feed, but to ensure that, as their baby grows, the daytime feeds are increased accordingly, so that the need to feed in the night decreases naturally. It is much better to feed your baby in the night for a little longer, and allow him to self-settle after a feed, than to try to skip feeds by offering a dummy or rocking and patting your baby back to sleep when he wakes in the night.
RESEARCH CONFIRMS WHAT I have always believed: poor quality daytime sleep can affect not only the baby’s mental development but also his ability to sleep well at night. Dr Marc Weissbluth, a leading researcher, paediatrician and founder of the Sleep Disorders Center, Children’s Memorial Hospital, Chicago, and the Northwestern Children’s Practice, says in his book Healthy Sleep Habits, Happy Child: ‘Napping is one of the health habits that sets the stage for good overall sleep.’ He explains that a nap offers a break from stimuli and allows the baby or child to recharge for further activity. Many other experts are in agreement that naps are essential to a baby’s brain development and to helping establish long-term healthy sleep patterns. John Herman, PhD, infant sleep expert and Associate Professor of Psychology and Psychiatry at the University of Texas, says: ‘If activities are being scheduled to the detriment of sleep, it’s a mistake. Parents should remember that everything else in a baby’s life should come after sleeping and eating.’ Charles Schaefer, PhD, an American professor of psychology, supports this research and says: ‘Naps structure the day, shape both the baby’s and the mother’s moods and offer the only opportunity for Mum to relax or accomplish a few tasks.’Although babies do vary in the amount of sleep they require, it is important that you have a clear understanding of how much sleep they need. The total amount of daily sleep your baby or toddler has between 7am and 7pm (depending on when you start your day) will play a big part in how well he sleeps at night. Listed below is an approximate guide to the number of hours of daytime sleep a baby needs:
| Birth to four weeks | 5 to 5½ hours |
| Four to eight weeks | 4 to 4½ hours |
| Eight to twelve weeks | 3½ hours |
| Three to six months | 3 hours |
| Six to twelve months | 2 to 3 hours |
The timing of his naps is also important if overtiredness is to be avoided. Allowing a baby to have too much sleep later in the day is often the reason a baby does not settle well at bedtime. Research shows that the best time for the longest nap of the day is between 12 noon and 2pm, as this coincides with a baby’s natural dip in alertness. A nap at this time will be deeper and more refreshing than a nap that starts later in the day. This further supports my view of the importance of daytime sleep being established at the right time.
During the first week or two most newborns will only manage to stay awake for an hour or so at a time, and most of this time is taken up with feeding and changing. Between the second and fourth week they will usually be managing to stay awake properly for one to one and a half hours, although some very wakeful babies may manage to stay awake for up to two hours. The important thing to remember during the very early days is never to let your baby stay awake longer than two hours. If a baby stays awake longer than two hours he will often become overtired and fight sleep when you try to put him down for a nap. Overtiredness is one of the main causes of very young babies not settling well at nap times, and care should be taken that this does not happen (for more on overtiredness, see here).
By the time babies reach two months, providing they’re sleeping well at night, it is likely that they will manage to stay awake nearer to two hours before needing their morning nap. A typical pattern may be that when they first wake in the morning, they will stay awake for a full two hours, then after the first nap of the day they may only manage to stay awake for one and a half hours. The important thing is to watch for your baby’s cues as to when he is sleepy (see box below) and ensure that he is well fed and settled in his bed before he becomes overtired.
By the time they reach six-seven months, the majority of babies can stay awake for between two and two and a half hours, provided they’re sleeping well in the night. If you are starting your day at 7am, your baby should be woken from his morning nap no later than 10am if you want him to sleep for a longer time at midday, even if this means he has a slightly shorter morning nap.
Between nine and twelve months most babies will cut right back on their morning nap, cutting it out altogether somewhere between 12 and 15 months. In my previous books I have said that the morning nap is usually dropped between 12 and 18 months, but over the last ten years I have noticed a huge link between the morning nap and early-morning waking and night-waking problems with toddlers. The link being that nearly all who slept well during the first year but then went on to experience sleeping problems were still having a morning nap. I now recommend that parents should gradually push the morning nap to later and reduce it somewhere between nine and twelve months, therefore preparing to drop it somewhere between 12 and 15 months. (See the box below for a detailed plan on how to eliminate the morning nap.)
If your baby is over nine months and showing signs of waking earlier, not being ready for his morning nap, or reducing his lunchtime nap (all signs that a change in sleeping needs is imminent), I would suggest the following tips to help him gradually drop his morning nap altogether:
A baby under one month is usually ready for this nap one to one and a half hours after the time he wakes from his morning nap, but by the time he reaches two to three months he can usually make it to two hours. Ideally, this should be the longest nap of the day, as research shows that a nap between 12 noon and 2pm coincides with the baby’s natural dip in alertness.
Depending on how well the baby has slept at his morning nap, this nap usually lasts between two and two and a half hours, gradually reducing to around two hours by the time the baby is six months old. At around one year this longer nap may be cut back to one and a half hours if the baby is still having a full 45-minute nap in the morning, although it may lengthen again to two hours if the morning nap is cut right back or dropped altogether. At one year the length of the lunchtime nap is determined by how well the baby is sleeping at night. Some babies who are sleeping twelve hours at night will continue to need two hours’ sleep at lunchtime, while others, if they are waking earlier in the morning, will need to have their lunchtime nap cut back.
The majority of babies will continue to need a nap in the middle of the day until they are at least two years of age, with the length of the nap again depending on how well they’re sleeping at night. Babies who are starting to wake earlier in the morning or are starting to wake in the middle of the night may need to have their lunchtime nap cut down or cut out altogether. This can happen anywhere between 18 months and 3 years of age, depending on the child’s individual needs.