Redsbaby

15 . May . 24

Newborn & Baby (0 - 18 months)

What to do if your newborn isn't sleeping and how to support your child's sleep

Meet Annie Littlehales, an evidence-based holistic sleep coach, the founder of Nurture & Thrive Sleep, and mum. Annie’s expertise lies in facilitating parents in understanding their child’s unique sleep with clarity and confidence. She supports parents, leaving them feeling reassured, knowledgeable, and empowered which helps to remove the stress that can be felt when dealing with sleep. One Fine Baby and Redsbaby sat down to chat with Annie and gain some insight into how to best approach sleep with your newborn.

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Q: What is your role as a holistic sleep coach?

I'm all about helping parents to understand and support their little ones sleep with alternatives to a sleep training approach or the ‘wait it out’ method. I care about helping parents who feel neither of these are the right fit for them, so I offer a different approach to allow parents to understand and support their newborn’s sleep. I help parents ditch any approaches that offer limiting or one-size-fits-all ideas that may overlook how varied babies and families are. I’m not here to say one is approach is right and one is wrong – either sleep training or ‘wait it out’ approaches could work for particular children and families, but neither approach is going to work for every baby and every family. By offering a framework for understanding sleep, I empower parents to find what works best for their unique baby, family and situation.

Q: Tell us about the most important factor to get right to give your baby a good sleep.

I get asked that question a lot and I wish I could tell you it's just one magical thing but unfortunately, it's not. Sleep is remarkably both complex and simple at the same time, and each parent will have different babies, needs and journeys; so rather than giving you one factor to fixate on, I'm going to give you a framework to help guide your approach. I call it the 6 Truths.

1. Embrace closeness

It is biologically, developmentally, globally, and historically normal that your baby wants to be close to you to sleep, and that they need to be supported during the night. We cannot ignore this, and any approach that has blanket rules to disregard this will be going against this truth.

2. Be mindful of all factors of sleep

Sleep has multiple influences. As a parent, having holistic knowledge about your child’s sleep makes such a difference and will allow you to understand all the different influences on your child’s sleep. It's not just about how they fall asleep, or where; sleep is far more than that. I encourage parents to approach with caution any approach that puts singular intensive focus on just how a baby is falling asleep as this can mean you are asked to completely ignore so many other key influencing factors.

3. Consider how your child falls asleep

This is where it can get a little grey; for some babies the way they fall asleep does have a big impact on how they sleep through the rest of the night. As an evidence-based sleep expert, I don’t ignore that for some babies, going to sleep independently can be a game-changer. This means supporting families to explore different ways for a baby to fall asleep based on the unique baby, knowing that some will be open to independent sleep, some will need this broken down into small gradual steps and some just won’t be okay with this - in fact, this focus can make sleep much harder for some.

4. Be open minded

We must accept that for some babies, the way they fall asleep is not at all linked to what happens with their nights or sleep in general. It’s why many babies will have improved sleep without even focusing on their process of falling asleep, or why some continue to have challenging nights when they are already sleeping independently.

5. Be aware of contextual factors

Number five is that the way babies and children have slept hasn’t in fact changed across history, however, the world we live in sure has. It’s higher pressure, more isolated from support, faster paced, financially tougher and in so many other ways, more challenging. It’s a tricky task understanding and supporting normal sleep and normal parenting in a world that doesn’t always allow that.

6. Remember that rested children and families come in all shapes and sizes

Rested children and families come in all shapes and sizes. There isn't one right way, guide, book or approach. These are all relative.

This framework can be difficult to practice as these truths don’t all harmonise particularly well. The most important factor to look out for is whether an approach asks you to completely ignore any one of these truths.

The most successful approaches consider all of these important truths to find the best way forward for you and your family.

Q: Sometimes your baby might get into a flow, and then all of a sudden, they regress. Why does this happen, and what can be done to remedy it?

There is no evidence to support sleep regressions in the way they are often talked about. Some say that sleep goes wonky for no real reason, while others say it’s due to development at specific ages. While the latter is closer to the truth, let’s talk this through.

Development can cause sleep to go wonky, and this journey is unique to each child. Each child will hit milestones at different times; your babies will roll, walk, and talk at different ages. How their sleep is impacted by their development will also vary. Some will have highly fragmented sleep, some a bit, some will not be impacted at all, and some want to sleep more.

If you find information about sleep regressions or leaps helpful, great. If you find this information stressful, you can ditch these ideas.

Understanding how to move through these periods without panic can be impactful. Developmental changes are beyond our control. The most honest advice parents can receive is that sometimes all you can do is support your child through these difficult periods. Occasionally you will make big impacts, but most of the time it’s about being aware that you don’t have as much control as you may like. This mindset can be the difference between feeling calm and responsive versus stressed and reactive.

Other reasons why a baby’s sleep can go wonky include changes in their needs, shifts in their sleep flow, experiencing different emotions, and other factors.

Knowledge is powerful to understand and support your unique baby’s sleep journey so you can feel clear, calm and confident.

Q: What are your thoughts on dummies for sleep?

Dummies can be either be friend or foe rather than there being one clear idea about dummies. A few important considerations are:

1. If you’re breastfeeding, we want to ensure feeding is well established before introducing a dummy

It's important to ensure that breastfeeding is well-established before introducing something different into the mix for a newborn's oral space.

2. Avoid removing the dummy until your child is six months or older

If your child is used to a dummy consistently for sleep the recommendation is to avoid removing the dummy from their sleep routine until they are six months or older. Dummies are known to have some protective impact against SIDS and we know that the first six months are a vulnerable time in this regard.

3. Be aware of why your child finds the dummy so soothing

While it’s completely normal for babies to find sucking soothing, we want to aware if the reason a baby is finding the dummy so soothing is because it’s helping the baby achieve contact with their palate in a way that they cannot do themselves. The ideal position for the oral space in terms of the tongue position when relaxed as it is for sleep is the lips are sealed, the tip of the tongue is sitting just behind the top teeth/gum and the front part of the tongue is sitting against the palate. This is important for different reasons but one is that this is a stimulation point for a key nerve in the body called the Vagus Nerve which is important for many things including regulation which is a critical foundation for sleep. If a baby has any challenges with their oral space that means they cannot achieve this position of their tongue and mouth, then a dummy essentially enables that contact which can support sleep and regulation. We want to be aware of this to be able to support this for the baby in other ways. It’s the same when deciding to stop dummy use, this is critical knowledge to ensure we are doing the very best to understand and support our child’s needs and sleep.

4. Be mindful of your time windows

Dummies can become problematic for some babies and there can be a window of time to shift the dummy between roughly six to nine months but I find it gets much harder and more upsetting after that. I then tend to advise waiting until at least after 2 years of age and often closer to 2.5 years of age where there is language and better comprehension to support this change.

Q: If a mother is anxious do you think the baby can feel that?

We need to approach this issue very sensitively - I am a mum who struggled with postnatal anxiety, and I recognise this is a difficult thing to talk about and know it was so hard feeling like people were saying it was all my fault. All parents who are struggling need compassionate nurturing support. We do know that there is a connection between our regulation and our baby’s regulation. The concept of emotional contagion is real, and it has been researched. We know that the more regulated we can be as mums and dads, the better it is for a child, not just for their sleep but also for the parent’s sleep. This is one of the reasons why the education around sleep is so important, because when parents have this clarity, even when their child’s sleep is tricky, our anxiety levels reduce because we understand what’s going on and why. We feel confident in our actions, know what we can ignore and let go of, and how to detour misinformation and have that reassurance that we are doing all the right things while we support our babies through a tricky stage.

A lot of what I am focused on as a sleep expert is easing the concerns of parents, helping them let go of myths and misinformation, providing reassurance that they have left no stone unturned to support their baby’s sleep while also knowing what normal infant sleep can look like. This involves lots of nurturing of parents on their journey! If a guide says that your baby is meant to have a two-hour nap, and your baby only sleeps for thirty minutes, what does that do to your experience as a parent? We automatically turn our thinking to that of failure, it’s stressful! I can speak from experience – and I still get emotional thinking about this many years on, feeling like a failure isn’t helpful for anyone. I want so much better for every single family.

Q: What does the ideal sleep routine look like?

There isn’t one ideal sleep routine. Many schedules and guides for nap timings, frequency, length, bedtimes, and duration of overnight sleep exist, but are not based on evidence. These guides often don’t account for what the science shows or for the wide variations that are normal between different babies.

The sleep information a parent follows is greatly influenced by the type of person they are. For example, a parent who likes predictability and schedules may prefer methods that provide a step-by-step routine. The challenge here is that even though this can work for some, parents can feel more stressed as they try to follow rigid ideas that make them feel entrapped. If one part of the plan goes wrong, it creates stress and a feeling of failure, plus these schedules and routines are typically not based on evidence.

Other parents who are more ‘go with the flow’ might be happier without schedules and specific routines but might find that some improved rhythms and routines can be helpful for their child’s sleep situation.

It's important to consider who you are as a person when deciding the approach to take with your baby, as it needs to feel comfortable and authentic to you as a parent. It also needs to work for your unique baby and situation. There can be a process of adaptation as parents, which is an important part of great sleep support.

It’s essential to recognise that there isn’t a universally ‘correct’ routine for a baby, and there are wide ranges of norms that will still mean a well-rested child. The evidence about total sleep in a 24-hour period shows there could be an 8-hour difference in optimal sleep between any two babies the same age. This variation shows why prescriptive routines make no sense and make it difficult to name an ‘optimal routine.’ Having great knowledge enables you to support your unique baby’s sleep, free of the misinformation that guides and prescriptive routines offer.

For example, if you’re following a guide that specifies 12 hours of sleep overnight and that isn’t working for your child, this can create stress, worry, and knock your confidence around your child’s sleep. On the other hand, being empowered with good knowledge is freeing.

Q: So what sort of support can we offer our baby to encourage their normal sleep patterns?

I would encourage you to think about rhythms rather than routines. Routines are more boxed in, often specific with times, with little to no middle ground. By thinking of your child’s sleep as a rhythm, there’s more room for variation and change without concern. Developing your knowledge will help you find the confidence to approach sleep more freely.

In these rhythms, we aim to drive consistency with some aspects of their sleep from the outset, such as the morning wake-up time. Children don’t develop circadian rhythm straight away; evidence suggests this starts to ‘come online’ at around two to three months and will mature by roughly age one. In these early days, avoid wide variations with the morning wake-up time. Sometimes it’s about looking for natural rhythms for starting the day or supporting a relatively consistent morning wake time. Getting up and into the light at this point is beneficial.

Your newborn baby may have three to six naps a day, but these can look very different between children. Some will have shorter naps, some will have longer naps. They might be awake between forty-five minutes to two hours in about the first three months. Each baby will be quite different and, along with the support that knowledge provides, you will get to know your baby and what works best for them.

As the day goes on, dimming the lights in the evening and allowing total darkness overnight are great ways to support your newborn baby’s rhythms.

Having some predictable steps as a precursor to nap and bedtime can also be a great way to support your baby’s rhythms. It’s not always easy, but it’s something you can do whenever possible when they are very young, and establish this more into their routines as they get older and are awake for longer periods.

Unpredictability is a normal part of newborn and young infant sleep. Don’t feel like you’re doing something wrong because their sleep is different every single day and night. It can be comforting to hear that unpredictability is normal and you aren’t doing anything wrong. This is where knowledge can help you have clarity and confidence around how to understand and support these rhythms.

Q: What should I dress my baby in when they go to sleep?

There aren’t many precise guidelines about ideal sleeping conditions for an infant – there is no widely agreed on temperature guide or dressing guide. TOG, or Thermal Overall Grade, is used to measure the overall warmth of baby clothing and sleepwear, especially sleep sacks and blankets. A higher TOG rating means more warmth. For example, a 0.5 TOG is light and suitable for warm weather, while a 2.5 TOG is thicker and better for cooler weather. Parents use TOG ratings to dress their baby appropriately for the room temperature, ensuring the baby stays comfortable and safe.

There are many products for sleep that provide guidance around what TOG to use for what temperature, and what to wear underneath. Each baby will also be quite different so there can be a degree of experimentation, always focusing on ensuring they don’t overheat.

I always recommend that whatever your baby is wearing for sleep or indeed whatever they are coming in contact with, is made of natural breathable fabrics.Whether that’s their clothing, bedding or even their pram. Look for prams that are made from breathable fabrics with added ventilation like the Redsbaby ONIX, AERON or NUVO.

An important note on temperature and your baby’s sleep is that ventilation and airflow is very important, particularly when they are alseep in a pram. There is some research to show just how much the temperature can jump up in the pram in warm weather, particularly when a pram is completely covered with something like a muslin or blanket. Avoid completely covering the pram, and keep a close eye on your child’s temperature to avoid risks of overheating.

A good tip when gauging your child’s temperature is to not use their extremities to test. Their hands and feet aren’t good indicators of temperature because their circulatory systems are quite underdeveloped so naturally the extremities don’t have the same blood flow. Their head and chest are the perfect places to test as these areas indicate their core temperature and will more accurately indicate their true body temperature.

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Q: Would you recommend using gadgets such as night lights or white noise to get your baby to sleep?

Although lots of these gadgets are based on personal preference, I personally recommend a few things to assist with sleep. The first is using blackout blinds to keep a baby’s room completely dark overnight, assisting with those sleep rhythms. Then, if you’re going to use a nightlight overnight to allow connection to your baby during feedings and nappy changes, and to help you see what you’re doing, I would suggest using a red or a yellow light as these colours have the least impact on melatonin production and can be more supportive of sleep.

In terms of white noise this is something that is a case-by-case basis, for example, with my eldest child we had a family of cockatoos living in a tree by our house, so we needed to use white noise to partially block out their screeching. If you are choosing to use any sort of sound whether that be music, white noise or brown noise, the recommendations are to keep the volume under fifty decibels (about the sound of a quiet office space) and it’s important to avoid having the machine too close to your baby. An interesting side note is that at around six months your child’s brain starts to develop features that allows them to filter out unimportant noise during light sleep, to keep moving into deeper sleep. The brain is so fascinating!

By adopting an approach that focuses on understanding your child's unique needs with the foundations of great knowledge, you’ll be able to better navigate their sleep and embark on this journey with a greater sense of clarity, calm and confidence.Not only does this place you in a great position to understand and support their sleep but equally, if not sometimes more importantly, to help your parenting journey be less stressful, less confusing and less overwhelming. Parenting with these burdens can be emotionally and physically exhausting! I hope some of these tips help to reassure you, and give you some confidence when navigating this journey.