“Don’t worry, she’ll outgrow it. Babies sleep through the night when they’re ready.”
Fact? Or fiction?
To clear some of the confusion, it’s helpful to know how the biology of sleep develops. You can check out the post
When Will My Baby Sleep Through the Night?
Most babies will sleep through the night, some with one lingering feeding, by six months of age. The main reason why some babies still wake their parents every night is because a solid night of sleep is not only a matter of development. Sleep is also behavioral.
How is sleep behavioral?
There is a social change that happens at 4 months, when babies become aware that they can interact with the world around them.
If you are the parent of a 4-month old, you’ve probably noticed that baby all of a sudden seems much more alert at this age. Everything catches his attention.
There is a biological change in sleep at 4 months. Your baby will now wake periodically at the end of each sleep cycle, differently to how baby was sleeping as a newborn. Before 4 months, your baby’s waking was connected mostly to hunger. You probably saw longer stretches of sleep develop. Because your baby’s sleep is now different, these wakings are no longer driven by hunger, but by the marking of distinct sleep cycles.
Not every baby will wake his or her parents at 4 months. Some babies will awaken at night and quietly return to sleep. Others wake and let you know they’re awake. You can read more about this here: Sleep Training: Is It a Control Issue? The short of the matter is, a baby who goes into the crib awake at bedtime is much more likely to return to sleep independently–or, as more popularly described, “sleep through the night.”
Object permanence develops around 8 months. Maybe you made it through the changes that happen at 4 months without too much trouble. But now your baby is around 8 months old and sleep has taken a nose dive.
At this age, you can place a blanket over a toy that your baby is playing with. If your baby tries to lift the blanket, your baby has developed the awareness that unseen things still exist.
If you’re helping your baby fall asleep and you don’t happen to notice an increased amount of waking at 4 months, you will almost certainly see a change by 8 to 9 months of age when this concept of object permanence emerges.
These milestones of both biological and social development mean that as your baby grows older, baby becomes increasingly aware of–and dependent on–the cues you provide for sleep.
Choose your own sleep adventure
If your baby is about 4-6 months or older and is waking frequently at night, you can choose what to do.
- Sleep train.
- Bedshare (co-sleep).
- Wait.
Babies are born pattern-seekers. They rely on predictable sequences of events to make sense of the world. They know that if they bat at a toy within reach, the toy will move. When they see a bottle or the breast, they anticipate that a feeding is coming. These are patterns that baby can understand.
The way your baby makes sense of sleep is through the patterns you create. When bedtime always means bouncing on a yoga ball until falling asleep, baby will continue to expect bouncing to fall asleep until you change that pattern.
Whatever pattern you have created, this builds the predictability that baby needs in order to relax and fall asleep. When bedtime and how you handle night wakings have no pattern at all, this is when you see the most disruption to sleep.
Sleep training does not necessarily mean letting your child cry it out. It means making an intentional series of changes to the patterns you have taught your baby. It might be done quickly, it might be done gradually. But sleep training is the only option that changes the pattern baby associates with sleep.
When do babies sleep through the night if you don’t sleep train?
Can babies just figure this out on their own once they’re old enough? Can you just wait it out through all the regressions, growth spurts, and teething episodes?
One of the most frequently cited studies addressing this question involved 60 children between the ages of 15-48 months. 25 of the children had a sleep problem (night waking, bedtime struggle, or both problems) at the start of the study. Three years later, 84% of those children were still experiencing a sleep struggle. [1]Kataria, S., Swanson, M. S., & Trevathan, G. E. (1986). Persistence of sleep disturbances in preschool children. The Journal of Pediatrics, 110(4), 642–646.
What about younger infants still waking at night? Among children who had a sleep problem at 8 months of age, 41% still had difficulty at 3 years of age.[2]Zuckerman, B., Stevenson, J., Bailey, V., & Psych, M. (1987). Sleep Problems in Early Childhood: Continuities, Predictive Factors, and Behavioral Correlates. Pediatrics, 80(5), 664–671.
Even younger? Among a sample of 1741 Canadian children born between 1997-1998, researchers found that those who were sleeping for 6 hours straight at 5 months generally continued to do so. But for little ones who were not sleeping in a 6-hour stretch at 5 months nor at 17 months, 32.9% were still not getting a 6-hour block of sleep at 29 months of age.[3]Touchette, É., Petit, D., Paquet, J., Boivin, M., Japel, C., Tremblay, R. E., & Montplaisir, J. Y. (2005). Factors Associated With Fragmented Sleep at Night Across Early Childhood. Archives of Pediatrics & Adolescent Medicine, 159(3), 242.
Byers et al. observed that among children who had a sleep problem as infants, 21% still had difficulty with sleep at three years old.[4]Byars, K. C., Yolton, K., Rausch, J., Lanphear, B., & Beebe, D. W. (2012). Prevalence, Patterns, and Persistence of Sleep Problems in the First 3 Years of Life. PEDIATRICS, 129(2), e276–e284.
Studies like these are why experts focus on the 4-6 month range as being the pivotal time to create healthy sleep habits.
Bedsharing is a whole topic on its own, but similar persistent trends are found here too. In a group of almost 500 Swiss children part of a study lasting an impressive 27 years, bedsharing increased from 6 months to 4 years of age, with about 38% of kids sharing their parents’ bed at least once a week at 4 years old. These kids weren’t in a great hurry to return to staying in their own beds all night: at 8 years of age, 21.2% of all kids were still crawling into a parent’s bed.[5]Jenni, O. G., Zinggeler Fuhrer, H., Iglowstein, I., Molinari, L., Largo, R. H., Fuhrer, H. Z., … Largo, R. H. (2005). A longitudinal study of bed sharing and sleep problems among Swiss children in the first 10 years of life. Pediatrics, 115(1 Suppl), 233–240.
Does that mean it’s the parents’ fault if a child isn’t sleeping through the night?
Not necessarily. Besides, parenting is hard enough without a heavy dose of guilt thrown in.
Most professionals recognize that sleep problems go both ways–a child who is having more difficulty sleeping is more likely to have a parent who is more highly involved with his sleep, and vice versa. A parent who is more involved is going to have a child with more interrupted sleep.
Behavioral sleep problems are common, affecting about 20-30% of children.[6]Vriend, J., & Corkum, P. (2011). Clinical management of behavioral insomnia of childhood. Psychology Research and Behavior Management, 4, 69–79. These are children who have no physical reason why they couldn’t sleep better. Other causes of continued night waking in children, such as sleep apnea or sleep-related movement disorders, are important to diagnose–but much more rare.[7]Meltzer, L. J., Johnson, C., Crosette, J., Ramos, M., & Mindell, J. A. (2010). Prevalence of Diagnosed Sleep Disorders in Pediatric Primary Care Practices. PEDIATRICS, 125(6), e1410–e1418.
Is it possible that your child “just isn’t a good sleeper”? Nope. There’s always a reason. For the majority of little ones with a sleep problem, achieving healthy sleep is a matter of changing your child’s habits.
It’s important for sleep problems, whatever their nature, to be addressed. The benefits of sleep are essential for virtually every aspect good health–not to mention, sleeping is pleasant! Conversely, the cost of lost sleep is much more significant than many realize. At a time when children are experiencing rapid brain growth, sleep is essential for learning, memory,[8]Gomez, R. L., Newman-Smith, K. C., Breslin, J. H., & Bootzin, R. R. (2011). Learning, Memory, and Sleep in Children. Sleep Medicine Clinics, 6(1), 45–57. language,[9]Simon, K. N. S., Werchan, D., Goldstein, M. R., Sweeney, L., Bootzin, R. R., Nadel, L., & Gómez, R. L. (2017). Sleep confers a benefit for retention of statistical language learning in 6.5 month old infants. Brain and Language, 167, 3–12. https://doi.org/10.1016/j.bandl.2016.05.002 and age-appropriate higher-level thinking.[10]Tham, E. K., Schneider, N., & Broekman, B. F. (2017). Infant sleep and its relation with cognition and growth: a narrative review. Nature and Science of Sleep, 9, 135–149. https://doi.org/10.2147/NSS.S125992 Evidence points toward poor quality sleep at 12 months of age connecting to poorer attention and greater behavioral problems at 3-4 years of age.[11]Sadeh, A., De Marcas, G., Guri, Y., Berger, A., Tikotzky, L., & Bar-Haim, Y. (2015). Infant Sleep Predicts Attention Regulation and Behavior Problems at 3–4 Years of Age. Developmental Neuropsychology, 40(3), 122–137. https://doi.org/10.1080/87565641.2014.973498
What’s the bottom line?
Don’t assume sleep issues will fix themselves. They don’t just disappear on their own. Even into elementary school ages, kids who experience sleep problems often continue to have trouble–sometimes without their parents even being aware of the sleep difficulty their child is having.[12]Fricke-Oerkermann, L., Plück, J., Schredl, M., Heinz, K., Mitschke, A., Wiater, A., & Lehmkuhl, G. (2007). Prevalence and course of sleep problems in childhood. Sleep, 30(10), 1371–1377.
Build healthy sleep habits early on. This is why professional organizations, like the American Academy of Pediatrics, and the American Academy of Sleep Medicine, recommend creating good sleep habits as baby grows, including putting baby down awake.
Consider your situation carefully. Is your child getting enough rest, falling asleep easily (whether with or without your help), and waking refreshed in the morning? Are YOU getting enough rest? Is everyone in the home happy with your sleep situation? If you can honestly answer yes to all of these questions, you may not need to change anything right now.
Is sleep a huge challenge in your home? Do you find yourself struggling to stay awake at the wheel? Are sleep issues causing stress and anxiety for you? If your answer is yes, then please don’t wait for things to improve on their own. Your health and safety, as well as your child’s, are far too valuable to put off fixing your sleep. If you’d like some one-on-one help creating a sleep plan for your family, contact me!
Sweet dreams!
Interested in reading some of the research on your own? (You rock!) Here you go:
Prevalence, Patterns, and Persistence of Sleep Problems in the First 3 Years of Life
Night Waking, Sleep-Wake Organization, and Self-Soothing in the First Year of Life
I'm ready for a good night's sleep
References