Parents can help infants sleep through the night

Source: Contemporary Pediatrics May 2005

Commentary by Michael G. Burke, MD

Results of a questionnaire indicate that what parents do at bedtime and when their infant awakens during the night strongly influences the likelihood that the infant will sleep six consecutive hours.  The parental questionnaire, as well as interviews, were part of a longitudinal study investigators conducted in 1,750 Canadian infants.

At 5 months of age, almost one quarter of the children were not sleeping six consecutive hours at night.  At 17 months, 7% fit this description; at 29 months, 10%.  For babies 5 months old, sleeping less than six consecutive hours at night was strongly associated with how parents reacted when the child awoke during the night.  Children who were fed when they awakened were 2.6 times more likely to sleep poorly than those who were not fed.  Similarly, poor sleeping was 1.7 times greater in children who were rocked to sleep or brought into the parents’ bed when they awakened rather than being comforted in their own bed.  Children with a “difficult” temperament (as perceived by the mother) also were more likely to be poor sleepers.  In addition, breastfeeding and cosleeping (sharing a room or bed with parents or siblings) were strongly associated with sleeping less than six consecutive hours a night at 5 months of age.

At 17 and 29 months of age, putting the child to bed when he (or she) was already asleep or staying with the child until he fell asleep were the factors most strongly associated with sleeping less than six consecutive hours.  Feeding or rocking the child after he woke up at night or bringing him into the parents’ bed instead of letting the child cry or comforting the child in his or her bed also were important factors at these ages.  At 17 months, the infant’s “difficult” temperament and cosleeping also were associated with poor sleeping.  (Parents of 29-month-olds were not asked about these two variables.)  Investigators found strong relationship between the child’s sleeping behavior and gender, health status, prematurity, immigrant status, use of transitional object, income, day-care setting, or the mothers depression or feelings of efficacy and overprotectiveness (Touchette E et al: Arch Pediatr Adolesc Med 2005;159:242).

Commentary: Here’s evidence to help you broker bedtime peace in the homes of many young children.  The authors’ work seems to support the so-called Ferber method, described by Richard Ferber in his book, Solve Your Child’s Sleep Problems.

Some good general rules of thumb:

  1. After 3 months of age, try to stop all night time feedings.
  2. Put children to bed awake or when they are sleepy, but not when they are fully asleep.
  3. An awakened child should be comforted in their own bed.  Do not rock them back to sleep or bring into the parents’ bed.
  4. Expect some regression at 9 months.  Continue to stick to a healthy routine.
  5. A few nights of crying and difficulty adjusting to the above advice will pay off huge dividends, not only in your child’s sleep but yours as well!
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