If you mention that you have had a baby, almost everyone will ask you the same thing: how is he sleeping?
Many exhausted parents are anxiously waiting to finally sleep through the night. In the West in particular, therapists, books and articles promise to help families achieve a holy grail: a baby who sleeps in his crib, alone, all night, plus multiple naps during the day.
Even some pediatricians warn that if these goals are not met, children are less likely to get enough sleep to grow and develop.
But this idea of uninterrupted and independent sleep is far from universal and is very different from how infants have slept throughout history.
It is a problem that can generate anxiety and stress for parents and even be dangerous for babies themselves.
“How we sleep in the 21st century is something strange from the point of view of from an evolutionary standpoint, because we didn’t evolve to lie dead for eight hours and wake up in total silence and darkness,” explains Helen Ball, professor of anthropology and director of the Durham Center for Childhood and Sleep at England.
“That affects the way we think about how our babies should sleep.”
(Photo: GETTY IMAGES)Get enough sleep?
It is not new to worry about whether babies get enough sleep. The first scientific guides on the subject date back to 1897, when a Russian scientist recommended in a book that newborns should sleep 19 hours a day.
During the following century the recommended sleep time was reduced, but it continued to exceed the average in practice in 37 minutes, paving the way for decades of concerned parents.
Today experts agree that sleep is crucial for babies and children (and also for adults).
Lack of sleep is associated with cardiometabolic risk factors, more likely to develop attention deficit hyperactivity disorder (ADHD, for its acronyms), to poor cognitive performance and emotional regulation, and to poorer academic achievement and quality of life.
However, many of these possible consequences involve school-age children and not children. babies.
There are correlations, not causality is.
The only way to know if lack of sleep “causes” a disorder such as attention deficit disorder, as several studies have suggested, it would be by conducting controlled and randomized studies.
These are problematic investigations, because they would imply something unethical such as depriving sleep to a group of children for years.
Therefore it is difficult to know if it is lack of sleep that causes ADHD or, on the contrary, if children with this disorder simply sleep less.
Of course, the relationship between sleep and development is likely to be bidirectional.
Short-term randomized controlled trials suggest that children given a task memory fared better when they had taken a nap and that those who were fatigued had more difficulty coping with a stressful episode than those who were rested.
But this does not mean that all babies need to sleep 12 hours uninterrupted by the night and several two-hour naps a day.
“Babies differ in their sleep just like adults,” says Alice Gregory, professor of psychology at Goldsmiths University in London.
The National Sleep Foundation of the United States recommends that babies under 3 months sleep between 14 and 17 hours in a period of 24, but indicates to enter 11 and 19 also It is suitable.
The American Academy of Sleep Medicine, on the other hand, has no recommendations for infants younger than four months. And none of the agencies advise specifically on naps.
“Even experts disagree on infant sleep,” says Gregory.
Adhere to a schedule
There are several pre-established routines to organize naps during the day. For the night, many books and therapists recommend following the rule of sleeping between 7 am and 7 pm.
In newborns, this schedule can be especially difficult to adhere to. That’s because the physiological functions that tell parents that nighttime is the best time to sleep don’t begin to develop until 8-10 weeks in totally healthy babies.
Exposing newborns to light during the day and darkness at night can help these systems work.
In a context global, that the baby goes to bed at 7 pm can be complicated.
In many cultures, little ones can go to bed on the 10: 37 pm in the East Medium, 9: 37 pm in Asia and pm in Italy. They may also wake up later.
Some studies associate going to bed early with better academic performance and a lower risk of obesity. However, this research involves preschoolers and older children, not infants.
It is also unclear whether bedtime alone makes a difference.
Since school and other childhood routines tend to start early, babies who go to bed early tend to sleep more in general, and families who put their children to bed early may prioritize healthy habits in other ways.
It is not easy to break down all these factors.
For some families, the 7am to 7pm routine works. For others, trying to force it can cause their own sleep problems.
“Our data suggest that if the little ones do not go to bed at a biologically non-optimal time, they will not feel ready to sleep and will put up resistance”, say the researchers from a studio in Rhode Island.
In some cultures, such as the Middle East, Babies usually go to bed later, after 10 pm. (Photo: GETTY IMAGES)
And if it turns out that the baby doesn’t need sleep hours in a row per night, putting him to sleep at 7 pm can have unintended consequences, such as interrupted sleep throughout the night or waking up excessively early.
That is why there are theories about two ways of organizing the babies’ routine: a stricter one, based on the needs of the parents, and a more flexible one, based on the demands of the babies.
Some studies suggest that paying more attention to what the latter need has advantages over a strict routine imposed by the parents, such as less anxiety in the parents and a better balance of breastfeeding.
Finally, the experts re They recommend not getting too complicated. To know what is ideal for each child, it is best to observe him
“If you see your baby happy during the day, it is most likely that she is fine. If he’s moody and irritable, he might be sleepy,” says Harriet Hiscock, a pediatrician at the Royal Hospital for Children in Melbourne.
Sleeping through the night
As if getting your child to sleep a certain number of hours was not enough, many parents are asked to try to make their sleep “consolidated”.
Therapists and books often indicate that deep and uninterrupted sleep is the best for the development of a baby (not to mention less upsetting for parents).
But even if 12 hours of sleep without waking up were an optimal goal, it is biologically challenging and, if achieved , babies could be put at risk.
( Photo: GETTY IMAGES)All humans wake up between sleep cycles. As adults, it is common for us to get up to go to the bathroom or get a drink of water, and then go back to sleep quickly.
That is the reason why most of us do not remember these awakenings in the morning .
But adult sleep cycles tend to be longer, around 90 minutes. Those of a baby eden last half.
And, unlike adults, babies cannot meet their own needs, so they often wake up completely when they wake up.
This happens when they wake up from hunger, to eat.
For its development, a newborn baby requires a lot of energy . As a result, breast milk is high in sugar, rather than fat.
A higher proportion of fats would satisfy more the baby and would allow him to be more independent, but sugar is digested quickly and requires more frequent feedings.
“Small babies wake up. It is what they do: they wake up and eat”, says Wendy Hall, professor emeritus and sleep researcher at the University of British Columbia, in Canada.
“Over time they develop a longer biological sleep overnight. At three months, it could be 5 or 6 hours at night if all goes well. That is almost a gift”, adds Hall.
Being high in sugars and not having as much fat, breast milk makes babies feel hunger frequently, interrupting your sleep cycle. (Photo: GETTY IMAGES)As they grow , the frequency with which they have to be fed decreases. According to many researchers, at 6 months, if they are healthy and have a normal weight, they do not need to eat at night; not, at least, in terms of nutrition.
But waking up and needing a caregiver for other reasons is still common, especially during the first year of life, when they are most vulnerable and their nervous system is still being immature.
While arousals may still be common among older infants and even young children, it is worth a medical evaluation to rule out any health reasons.
Because it is not Is it so bad to wake up?
Although frustrating for tired parents, there is another reason why babies have evolved to wake up frequently: your own protection.
There is a phase of sleep in which the potential risk of Sudden Infant Death Syndrome (SIDS) is greater: slow-wave sleep . In this phase, babies can suddenly stop breathing.
A healthy baby will wake up, but a baby with risk factors (potentially undetected, such as a brainstem abnormality) may not.
Pressing a baby too early to sleep longer and deeper can consequently increase the risk of SIDS, according to James McKenna, a sleep specialist and anthropologist at the University of Santa Clara, California, United States.
The worst example is putting a baby to sleep on his stomach. While this seems to help them sleep more soundly, it also makes SIDS even 13 times more likely.
After campaigns around the world told parents that put babies to sleep on their backs, SIDS rates plummeted.
“We wanted to promote this idea of early consolidation of sleep: deep and uninterrupted. So we promoted this notion of putting babies on their tummy so they wouldn’t wake up as much. We created the SIDS epidemic,” says McKenna.
While it is a common perception that longer, more consistent periods of sleep help a baby’s development, this is not confirmed by science.
Researcher Jodi Mindell observed 117 infants and toddlers at regular intervals over a period of 18 months in the United States Joined.
“We found that there is no real relationship between sleep and subsequent cognitive development”, explains Mindell, associate director of the Sleep Center at the Children’s Hospital of Philadelphia.
He even found a modest relationship between higher nighttime awakenings and better cognitive performance.
Another study in Canada observed the sleep of more than 350 children aged six s months and one year, as well as their mental and motor skills at 36 months.
There were “no significant associations between sleeping through the night and later mental and psychomotor development,” the authors write.
And the largest longitudinal study conducted in infants who received behavioral interventions to reduce sleep problems, such as nighttime awakenings, found no difference between children’s sleep habits, behavior, emotional regulation, or quality of life at age six.
What sometimes appears is a relationship between lack of sleep and poorer social and emotional development, although that refers to less sleep in general, not whether a baby wakes up frequently.
In any case, the dispute between correlation and causality comes back here. A more restless baby who requires parents to soothe him during the day or at night could simply be the type of child who has more difficulties with emotional regulation.
Sleep regressions
Sleep regression is a concept that is often used to designate periods in which this activity is more chaotic.
They are said to be as frequent as they are supposedly predictable: a sleep consulting website describes a regression at four months, another between eight and 10 months, the next between 11 and 12 and the last one at 18 months.
Most frightening of all, regression at four months is often inaccurately considered permanent.
The problem, sleep researchers say, is that sleep regressions don’t exist, not in the way they are often described.
These “regressions” generally have nothing to do with with sleep, but with other forms of development. Learning a new skill, like crawling or walking, is exciting enough for a baby to wake up more during the night. It can also be psychological.
Although babies develop their own sleep preferences and habits as they grow, there is also no evidence that any specific change in sleep is “permanent”.
In one study who compared the sleep of babies in Asian and Western countries, for example, Mindell found that, for the most part, babies wake up less as they get older.
This occurred even in Asian countries, where babies often share beds and are less likely to sleep independently.
Sleep schedules are generally based on one premise: babies should sleep independently as soon as possible, but it can be difficult to achieve.
The neurological immaturity of babies makes them dependent on their caregivers for emotional regulation, which involves relaxing enough to fall asleep.
Mindell is an advocate of use of strategies to help babies fall asleep independently. Still, he says, there’s no reason to think that soothing a baby will hinder his development.
At the opposite extreme from independent sleep, even bed-sharing has a nuanced relationship with development.
Some studies have concluded that there is no a relationship between babies co-sleeping with long-term cognitive and behavioral consequences.
Or even found that bed-sharing has a small beneficial effect on later cognitive outcomes. There are also studies showing that it can reduce the risk of insecure attachment.
Effect in children is unclear to share a bed with their parents. (Photo: GETTY IMAGES)But other research, including a study carried out with almost 4, three-month-old children in Brazil who were evaluated until they were six years old, found that children who shared a bed with their mothers were more likely to have psychiatric disorders.
There is also a relationship between bed-sharing and children being more likely to have trouble sleeping.
These studies, however, have a Big Flaw: Because the researchers didn’t ask parents why babies share a bed, it’s impossible to know if a certain sleeping arrangement “causes” any particular outcome.
If a parent brings a child to bed p Because he does not settle on his own, that could indicate an underlying problem that the child would have no matter where he sleeps.
So, sharing the bed could be an adjacent factor and not a cause.
In fact, investigate orers on a US military base found that children who shared a bed when one of their parents went on active duty were less likely to have psychiatric problems and were considered to be better behaved than children who did not.
This could be the reason why in parts of the world where bed-sharing is the norm, there are no such differences.
One of the only studies designed to account for this difference found that preschool children who began bed-sharing as infants were more self-sufficient and socially independent not only than children who had always slept alone, but also than children who began bed-sharing.
Sleep problems
Parents frequently worry about whether your children’s sleep is not normal.
Almost 40% of fathers of babies out of eight months in a Finnish study, for example, said they thought their children had sleep problems.
But how do researchers define what a “sleep problem” is?
“There is no strict acceptable or quantifiable definition. But the first step is if parents see a problem, it’s a problem where we need to do something about it,” says Hiscock.
But it is also possible that parents think their babies have problems when in fact they behave like any other.
This can exacerbate the problem, increasing anxiety and stress, especially in already tired parents.
Much of what we believe problematic is also governed by our cultural expectations. In one of his studies, Mindell found that parents’ perceptions of their problems differ widely by country.
Only the 10, 1% of those surveyed in Vietnam thought that they had a problem compared to 63,9% in China.
The origin of the myth
In the end, many of our beliefs about how little ones should sleep are based on cultural and ideological values rather than science itself.
For centuries, explains McKenna, it was not only common but necessary for babies to sleep with their families.
Without electricity or heating, and sometimes without a room to share, staying close to the mother was convenient, productive, and made it easier lactation. This is still maintained in various cultures.
“Before the nineteenth century, childhood sleep was not a general concern of new parents”, as anthropologists Jennifer Rosier and Tracy Cassels point out.
“When a child woke up, an awake member of the family or one sleeping next to the baby were ready to react quickly. It was also assumed that babies, like adults, slept and woke up when they needed to”.
Parents’ perception of their children’s sleep may vary depending on the country. One study revealed, for example, that a 63, 9% of parents in China believe that your children have sleep problems. (Photo: GETTY IMAGES)When the Industrial Revolution arrived in the 19th century, the middle class was also empowered and a new emphasis on independence emerged.
Longer working days sparked interest in uninterrupted sleep at night. Urbanization increased the number of parents living far from the support of their families. Physicians, who believed that crowding multiple people together in the same space “poisoned” the air, updated guidelines for mothers and nurses.
New books emphasized the need for stricter schedules and recommended that children sleep alone so that they become independent and strengthened.
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However, this has not been the case everywhere.
“The Japanese believe that American culture pressuring their children to sleep alone at night is almost ruthless,” says one researcher.
In Guatemala, Mayan mothers reacted to American sleep guidelines with “surprise, disapproval, and pity ”.
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Today, many exhausted parents receive information through books and therapists, but many books do not have based on science and the sleep therapy industry is not regulated. After all, anyone can call themselves a sleep expert.
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