Newborns Who Confuse Night and Day
Selene Mize
St. Kilda, Dunedin, New Zealand
From: NEW BEGINNINGS, Vol. 12 No. 1, January-February 1995, pp. 14-15
We provide articles from our publications from previous years
for reference for our Leaders and members. Readers are cautioned to
remember that research and medical information change over time.
Few things are as challenging
to new parents as being awakened every half hour or so all night long
by a baby who finally settles in at 5:00 or 6:00 AM, then sleeps solidly
(or at least with minimal interruption) until noon. My daughter, Rachel,
began this pattern the second day after her birth and stuck to it persistently.
We were still in the hospital, and the hospital routine imposed on us
meant it was virtually impossible for me to sleep with Rachel during
the morning. I had greater flexibility once at home, but my mother was
visiting from the US, and my husband was taking parental leave from
his job. I really wanted to be awake during the day to spend time with
them. The result was incredible exhaustion! I searched through books
on nighttime parenting, but found little help. Now after years of experience
and further reading, I have a few thoughts to offer parents who might
find themselves in a similar situation.
The first question that
must be asked is whether there is really a problem. First-time parents
who hear stories told by friends and family or consult popular "how
to" child-rearing books often believe that their baby will sleep round-the-clock
in the early weeks, waking after 8:00 PM for feeds only. Babies, though,
have not read the same books or heard the same stories. Midnight is
often their preferred bedtime—not the 7:00 PM many a parent might prefer.
There is also great variability
in babies. At one month of age, some normal babies sleep as much as
nineteen hours total, while others sleep as few as twelve. If the problem
is one of unrealistic expectations, the simple answer is to revise them.
Good-natured acceptance of this situation goes a long way.
A problem exists only if
the baby needs continual attention during the mother's usual sleep period
(continual attention being more than frequent breastfeeds, an occasional
nappy change, and some quiet cuddling. A baby needing these things at
night is normal and not confusing night and day). An awake baby may
not require much attention if placed in a secure and interesting place
(e.g., in bed between sleeping parents with a low light on and a few
soft toys or an interesting ceiling). So long as the baby is safe and
happy, there is no reason for the parents to remain awake.
Even when the baby needs
continual attention during the mother's usual sleep period, it may be
easier for the mother to adjust her sleeping habits than to attempt
to change the baby's. If the baby is an only child, the mother might
be able to take the phone off the hook, put a sign on the front door,
and sleep blissfully until noon or whenever the baby decides to wake.
But sometimes a change in the mother's schedule isn't possible. For
example, an older sibling who wakes at 6:30 AM each morning will make
a long lie-in for the mother difficult. A working mother whose maternity
leave expires before baby is sleeping more soundly may find it impossible
to nap.
The next step then, is to
consider whether any reason for the baby's schedule can be identified.
Is the mother drinking too much coffee, tea, cola, or other substances
containing caffeine? Caffeine is a stimulant which passes into breast
milk. The easiest way to test the possibility that caffeine is affecting
the baby is for the mother to cut down on (or better yet, totally avoid)
caffeine for several days and see if any changes occur. If caffeine
seems to be the cause of the problem, it may not be necessary to abstain
totally. Experiment--avoiding caffeine after about 4 PM may be enough
to do the trick.
Food allergies also may
be involved. Rachel had "colicky" crying fits for seven months. These
were ultimately attributed to her sensitivity to foods that I was eating
and passing through my breast milk. Evening is the most painful time
and morning the most comfortable for many infants with colic. Perhaps
this is because the mother does not eat during the night. Our second
child, Helen, also suffered from severe food allergies, but we were
much better informed after her arrival and were able to control her
colic a few weeks after it appeared. Both children had the tendency
to prefer sleeping during the morning. If food allergies are suspected,
talk to your La Leche League Leader about eliminating some of the most
likely allergens from your diet. Supplements such as vitamins or fluoride
may also interfere with a baby's ability to sleep.
Another possible cause of
a troublesome sleeping pattern may be the parents' schedule. Children
quickly learn to adjust their schedules to maximize time with their
loved ones. If the mother is absent during part of the day, or present
but preoccupied with other concerns (such as getting older children
off to school), the baby may decide that this is an excellent time for
a nap. More focused attention on the baby during the day may help to
change the pattern. Overstimulation is another possible cause to consider.
Some sensitive babies may shut out a loud and boisterous daytime atmosphere
by sleeping through it. If this is the case, create a predictable, low-stress
environment for the infant during the day. A parent or day care provider
who allows an infant to sleep the day away can expect a baby who hasn't
much interest in sleeping at night.
If no cause for the pattern
can be found and remedied, try easing the baby into a new schedule.
The basic approach is to clearly distinguish between night and day;
make day as interesting as possible and night as peaceful and relaxing
as possible. To clearly distinguish between night and day, parents may
need to exaggerate their normal behavior. Clothing, sleeping place,
lighting, and noise level can be altered. At nighttime, for example,
baby may always be dressed in a nightgown and nursed lying down in a
dark or dimly lit room (use towels over the windows if necessary when
days are longer). Be sure that baby is not overdressed or the environment
too warm. One study indicated that babies that disturbed their parents
in the middle of the night were significantly more heavily wrapped in
significantly warmer rooms. This suggests that an above-normal body
temperature may lead to wakefulness. During the day, the baby might
wear a one-piece stretch suit and be nursed in a chair in a brightly
lit and noisy living room.
Even more important than
these physical factors is the parents' behavior. During the day, the
parents might talk directly to the baby and play with him or her. At
night, there could be lullaby singing and quiet cuddling rather than
direct eye contact, chatting, or vigorous play. (This might be difficult
to manage: Helen smiled for the first time in the middle of the night,
and my determination to be low-key disappeared.) Nighttime parenting
books give advice which may be helpful in making a baby sleepy, such
as a consistent bedtime routine.
The goal during the day
is to stimulate the baby so that he or she doesn't want to sleep, rather
than trying to force the baby to stay awake. In addition to play, cool
air on the face (as in a walk outside) may discourage sleep, as may
frequent nursing or a bath. Tine Thevenin, author of The Family Bed,
suggests that carrying the baby around a lot during the day may stimulate
and keep him or her awake. This approach may work for some babies, but
others may be lulled to sleep by being carried. (If so, it might be
a strategy to try at night.) Babies are very different, and an approach
must be tailor-made to the individual baby.
If the baby is upset by
attempts to change his or her sleeping schedule, re-evaluate your desire
to do so. Most children will settle down dramatically by the age of
three months regardless of what parents do or don't do. The most important
thing is to accept babies as they are. It may help to remember that
a significant number of adults love to stay up at night and sleep in
late the next morning. Why should babies be any different?
REFERENCES
Sears, William MD. NIGHTTIME
PARENTING. La Leche League International. Franklin Park, IL USA. 1983.
Thevenin, Tine. The Family
Bed: An Age-old Concept in Child Rearing (2nd ed.). Avery Publishing
Group. Wayne, NJ. 1977.
Wailoo, M.P. et al. Disturbed
nights and 3-4 month old infants: the effects of feeding and thermal
environment. Arch Dis Child 1990; 65:499-501.
Last updated Friday, September 29, 2006 by njb.
Page last edited Sun Oct 14 09:30:16 UTC 2007.
