Last weeks we've been working on M's sleep. I've talked with many other parents, read books (e.g. this and this) and articles on sleep on the internet (I can recommend Taking Cara Babies material). I'm going to share some tips that have worked for us. Note: this is just exactly what it is - what works for us - and might not be officially correct or scientifically proven (although I have tried to see as much as possible that it would be).
Day-night rhythm
From the beginning, pay good attention to creating a day-night rhythm. Newborns do not yet produce melatonin and can get their days and nights mixed up. That you can notice if they sleep long-long stretches and feed infrequently during the daytime, but wake up often during the night and want to eat.
What to do? Have them sleep in a room with lights and a normal amount of noise during the day. For us, it is relevant that you don't need to whisper when the baby is asleep but that we can carry on with our as-normal-as-possible life.
Furthermore, have the lights off or dim, when needed, at night, use a low voice and keep things 'official' when handling the baby then. You can sing and chat with them as much as possible over the daytime, but the night is meant for sleeping.
Rhythm in general
Whereas in the first weeks, the baby was with us on our laps most of the time, except the night when she slept in her own bed, we have created a more sturdy schedule now. She eats when she wakes up, this is followed by a diaper change, the wake-up time with playing (tummy time, looking at her books, toys, chatting with Mom and Dad). When she shows the first signs of tiredness (with her, mostly yawning), she goes down for a nap.
The maximum awake time at her age (2-4 months) is 1-1,5 h according to different materials. Often she is tired already one hour in. Nap length should be max 2-3 although we belong in a camp of not waking the baby up from naps. If a nap is shorter than 50 min (approximate length of their sleep cycle), you need to get them back to sleep. More of that later.
Choose and stick to specific wake up and night sleep times. We have chosen a wake up time between 6:30 and 7:30 and night sleep time between 19 and 20.
Sleep rituals
Our baby goes to sleep on her own (as much as possible, there can be exceptions of course), she is placed in her sleeping place drowsy but not asleep. In the Netherlands, it is recommended that babies sleep on their backs and that their head faces a different side each time. Our child switches the head position herself very well, but to make sure that it goes well, we also switch around which way she faces in her cosleeper every week.
She has her naps in a stroller (either in the living room or outside, when we go for walks) or in her own bed.
We have chosen the following sleep rituals. At the house, she sleeps swaddled in a muslin cloth (if it is needed that she sleeps downstairs) or in a Puckababy swaddling sleeping bag. She gets a pacifier (we use Bibs). We put on quiet white noise on the background and place a little muslin with my smell by her neck. If the temperature is not cold, I put a little linen tightly over her, reaching her shoulders, for extra tightness. With colder temperatures, she also had a little knitted-by-her-granny blanket, also safely tucked in under her mattress. We stroke over her cheek and nose a couple of times and say a few sentences chosen for sleep time. We leave, keeping an eye on her via a baby monitor with a camera.
Nighttime periods of sleep are different, as one of us sleeps with her in a room, so no camera is used. I personally use white noise as well, my husband doesn't.
At times, of course, she will have her nap when we go out with a stroller or in a sling. She falls asleep in our laps and when we want to, we don't always take her to her own bed. It is our baby and we want to have her close, it is normal. We also talk with friends and family over the video a lot, so they want to see the baby. It is just important that she can fall asleep on her own in her own bed, so we do that several times every day.
What to do when the baby won't sleep?
It can be that they need to eat, burp, have a full diaper. All these things can be fixed quickly.
Did they go over their point of optimal sleep? Follow this order and scale up if it doesn't work (same things can be done when she wakes up from a nap too early): 1. Talk with them. 2.) Stroke them, place a hand on their chest. 3.) Hold them tight. 4.) Hold them tight and rock them. When they calm, place them in their bed again. Repeat the cycle above with sleep rituals. When you place the baby back to their bed and they will start crying, start from point one.
They might have little cramps in their belly or gas that doesn't want to come out. Rocking them might help. But it is more difficult at times...
When our baby doesn't want to calm down at all during the daytime, I put her in a sling and walk around and talk with her. 99% of the time it works. If not, I go back to the first point and check all the basic needs of eating etc. The baby also just might want to be close and feel lonely upstairs, so she can sleep close to us when we are in the living room (in a stroller, preferably).
If nothing works, sleep goes first. A baby who is too tired, can't sleep well either. So do anything to get them to sleep: walk with a stroller, car ride, sling etc.
Safe sleep
Back to sleep! This is a safe manner of sleeping. No sleeping on their belly.
Swaddles have proven to be safe to use if done following the rules (look up good quality information and videos) and until the baby can turn. We swaddle with a muslin cloth only during the daytime and always have an eye on her.
Cosleeping has very specific rules and besides not being comfortable with cosleeping myself, we also do not fulfil one point of the rules (exclusive breastfeeding), so it wouldn't be safe for us anyway.
No soft toys, pillows, extra blankets etc in the baby bed.
Maintain the temperature well. 18 degrees has been recommended, but sadly we can't get it as low ourselves at this time of year. I've been reading myself into TOG-ratings to know how to dress her optimally.
No smoking by anyone at or outside the house.
UPDATE
We've been trying to teach M to fall asleep on her own for about 12 weeks. We've changed several things.
- Baby sleeps in her own room in her own bed (we moved her there about 3 weeks ago when it turned out that it's a much cooler room), except when the nap needs to be on the go for getting out for a walk, going to meet friends etc. She has started napping worse in the stroller and needs specific circumstances for it to happen (her view being blocked, walk timed for a naptime exactly etc). She doesn´t fall asleep downstairs any more, except when we use our last resort, the carrier.
- We have stopped swaddling because she's attempting to roll over (also when swaddled). We use linen with a tight fit and a sleeping bag from Fedde&Kees to make the transition to a normal sleeping bag. It's only the third day that we use these products and it's early to say, but so far so good. Less crying before naps, less windmilling with arms, less rocking.
- We have a short sleep ritual before going down for naps: we go upstairs, turn the white noise on, close the curtain, she goes in a sleeping bag, we sit in the chair and cuddle for 2-3 minutes, I put her to bed. She sleeps next to her Bert the Bunny (legs touch her head, this is safe, as it doesn't reach her nose and mouth and she can't move so much yet).
- The nighttime ritual is a little bit different. After her top-up bottle, we play a tiny bit, calmly, then we say good night to toys, cats, to the other parent, her playpen and stroller. We head upstairs. When we enter the room, again, we turn on the white noise and close the curtains, she gets a new diaper, goes in a sleeping bag. We sit for a few minutes in the chair, we sing to her and put her to bed.
- How to get her to fall asleep? We are aiming at putting her to bed and her just falling asleep on her own. It happens, but very infrequently still during the daytime. We do as little as possible: first, sit and wait, then do "ssssh", then hold a hand on her chest and stroke between her eyes on her nose. The last couple of days, this has been enough (and it's important to stop before she falls asleep while you do it so it doesn't become another sleep association). If not, we gently rock her back and forth in bed, then pick her up and hold, then rock her holding her.
- We struggle with crying before going to bed, it seems to be improving now but still occurs when she is too tired. We also struggle with waking up after one sleep cycle of 45 minutes and not being able to self-settle. Then I try to get her back to sleep with as little help as possible. I sincerely hope that this should teach her to connect her sleep cycles on her own.
- Another difficulty is getting her back to sleep in the early morning hours after feeds or if she wakes up too early. If she wakes up before 6:30, we try to get her back to sleep and treat this as a night wake up. If it doesn't work, one can create a sleep bridge about 1 hour after waking up to get the baby back to schedule. This is a 10-15 minute catnap after which you feed the baby again and go on with the day.
UPDATE (21-12)
- We have gone through some big changes regarding M's sleep. She had 2 naps most of the days now (if needed, a short powernap is added between 15 and 17). We are experimenting with just placing her in bed after her sleep ritual, handing her the pacifier and leaving. We have seen that she can fall asleep on her own after some wiggling and making noises for 5-45 minutes. At times, we need to help her to fall asleep though, which means holding a hand on her chest or forehead.
- We are not rocking her anymore, walking her to sleep in a carrier etc.
- She sleeps in a standing or moving baby carriage! It was just a win when she started to do that after the 4th-month sleep regression passed.
- We stopped using the Fedde&Kees sleeping bag and switched to a normal one about a month ago. We are still using the tightly fit linen from them though. I think that without this, she would be rolling, crawling etc in bed and that would be making things much harder.
- We usually don't cover her eyes with a muslin cloth anymore.
- We are not entering her room when she is not crying franticly, as she can usually fall asleep on her own without us intervening.
- At the moment, we don't wake her up from naps, except that she can't sleep past 17 (soon we need to move that to 16, I think). I do need to wake her up in the morning for breastfeeding at 6:45 when I need to leave during the work week.
- Our next goals are fully independent sleep (preferably from 19 to 7) and weaning the pacifier.
UPDATE 04-10-21
I see that it has been 10 months since I last updated this sleep blog.
- M started sleeping 12 hours in a row when she was 9 months. She doesn't get any milk or water in this period.
- She was doing very well with no crying at night until about 2 months ago when she was sick. Since then, it is a gamble - she might or might not cry once/twice at night and require us to go there and stroking/holding her and giving her the paci back.
- We have stopped using white noise and Fedde and Kees blanket and sleeping bag. Now she just sleeps in her crib in her own dark room. We just place her in her bed, we leave and she goes to sleep (maybe after some chatting).
- We stopped using the baby monitor in the spring, now we only do it when we are out of the house (across the street, back yard etc) by calling each other.
- We have transitioned to one nap (in August) and she sleeps 12:00/30-14:30 and 19-7.
- She doesn't nap very well on the go, but if it is needed she can sleep in a moving stroller and in the car.
- We are still teaching her not to use the paci for the sleep times at all.