Try a swaddle strap! Traditional swaddling or swaddle sacks (such as the Halo Sleep Sack) did not work on my kids; they would just break out. A swaddle strap worked really well because it has extra pillows over the arms to keep them from wiggling out. I explain the swaddle strap here:
Tag: parenting
-
When to Stop Swaddling Your Baby
Stop swaddling your baby when they can roll over while swaddled. The reason is that the risk of SIDs is increased if babies can roll from the their back to their front while their arms are still contained. In general, when babies sleep on their stomach, the risk of SIDs is increased. So, it is better for them to sleep on their back, though we can’t control their position once they start rolling over. Once babies can roll to their stomach, it is better if they have free arms. Having more arm control must somehow reduce the risk of SIDs.
If you are concerned about how your baby will sleep once you can no longer swaddle them, no worries! You can still use a transitional swaddle. Transitional swaddles allow arm movement but help with baby jerk reflexes that are thought to wake them up. Unfortunately, I don’t have specific data on the efficacy of transitional swaddles but I used them for both of my kids, and they had no issues waking up at night once we stopped swaddling. (I can’t rule out that perhaps they just no longer needed swaddling but my kids rolled over quite early, so they possibly did.) We used the Baby Merlin transitional swaddle and thought it worked great. Here is a link and picture of my son in a Baby Merlin. Even if not absolutely necessary, it works as a sleep sack/blanket as well. My kids seemed to like the coziness.
Swaddling really does help babies sleep better: https://think-parent.com/baby-sleep-hack-how-swaddling-works-according-to-science/. The exact age at which babies no longer need to be swaddled for improved sleep is probably around six months or earlier, definitely by nine months old. The jerk reflex (Moro reflex) that is thought to wake them up is usually gone by six months or sooner. We stopped using a transitional swaddle around nine months old and had no issues with our kids waking up.
Does your baby break out of their swaddle? Try a swaddle strap! Traditional swaddling or swaddle sacks (such at the Halo Sleep Sack) did not work on my kids; they would just break out. A swaddle strap worked really well because it has extra pillows over the arms to keep them from wiggling out. I explain the swaddle strap here:
-
The Best Baby Sleep Hack We Don’t Talk About: Dream Feeding
Dream feeding works! Dream feeding is a useful tool for parents to get a couple of extra hours of sleep with a baby. It is not sleep training per se; it helps parents time their baby’s sleep schedule to better align with their own schedule.
What is dream feeding? This is where you feed a baby while they are still asleep so that they do not wake up for a feeding until later. Surprisingly, it works! For example, you might put your baby down for bed at 8PM. Instead of your baby waking you up at midnight for a feeding, you go in at 10PM (before you go to bed) and feed them without waking them up. Many (if not most) babies can eat while sleeping. Babies have a strong suck reflux if you give them a bottle or nipple. With a full belly, the baby then sleeps until 2AM allowing parents a longer stretch of uninterrupted sleep.
Dream feeding definitely worked for both of my kids. But, according to my reading, it does not work on all babies; some babies may wake up during the dream feed. Once in a while my kids would rouse a bit and then go right back to sleep.
Dream feeding works well with two parents. For example, I would go to bed earlier than my husband (around 9PM). My husband would stay up a bit later (10:30PM) and do a dream feed. I would then get up with our baby around 2:30AM. This way I could get at least a five hour stretch of sleep. Dream feeding is especially helpful once parents are back at work and need to have a more standard schedule.
Dream feeding works well when in tandem with other sleep training tools like independent sleep (The Single Most Important Sleep Training Tip) and stretching the length of time in-between feedings (3 Easy Ways to Wean your Baby from Night Feedings). By stretching the middle of the night feeding by an hour or two (see link above), parents can get almost of full night’s sleep pretty easily when combined with dream feeding.
The hardest part of dream feeding is that you are adding an additional night feeding that you then need to remove later. Dream feeding is the last night feeding that we removed for our kids because it is definitely the easiest of the night feedings. But, eventually, we weaned off the dream feed by gradually reducing the amount of milk until they no longer needed the dream feed. We could have removed the dream feed much earlier but we waited until our kids were about one year old.
I was not able to find any scientific literature that looks specifically at dream feeding. However, one of my favorite scientific studies on infant sleep training included sleep training in the methodology.
I had never heard of dream feeding until I started researching sleep training. It is such an easy sleep training hack that I think more parents should know about!
-
Baby Sleep Hack: How Swaddling Works (According to Science)
One of my favorite baby sleep hacks is swaddling. With the right tools (discussed in another post), it is actually quite easy. Here I discuss the science and history behind swaddling.
Scientific Studies:
Most (though not all) scientific studies have found that swaddling helps babies sleep. It is great that swaddling is easily studied in the lab! Most of these studies were done in the lab for naps (not overnight sleep). One non-laboratory study giving parents materials on swaddling versus not giving materials to parents was found to be not effective. (There could be many reasons for why that study was not effective.)
Here are some of the benefits for babies of swaddling found in the scientific studies:
- Arouse less, startle less
- Sleep longer
- More likely to return to sleep on their own
- Soothes infants (not as quickly as pacifier but still does)
- Improve motor skills in preterm babies
- Keep them warm
History:
Swaddling was nearly universal before the 18th Century across the world. It very possibly evolved multiple times. In North America, cradle boards (picture here) were used for both sleep and transportation of babies. Swaddling is not as common in really hot and humid areas like Africa. This is likely because it can lead to skin infections in hot and humid areas. Slings are more common in hot climates.
Swaddling fell out of favor in Eastern and Western Europe in the 19th and 20th centuries. Swaddling was seen as putting your baby in prison. A revival is happening now. It is standard practice in the medical community to recommend swaddling, at least in the United States. (Though I would argue that the training methods for swaddling taught by hospitals are extremely out-of-date). Baby slings and carriers (some that look like a lot the cradle board above) are on the market today. Here is an example of baby carrier sold by Osprey.
Osprey Packs_SS24_Poco Plus Child Carrier – Kids_OSPZ18A_OSPZ18B on Vimeo
Safety:
Swaddling is safe when done properly; however, there are some risks. Swaddling can both increase and decrease the risk of SIDs. It can reduce the risk of SIDs if the baby is put on their back while swaddled (before they can roll over). However, it can also increase the risks of SIDS if baby is not placed on their back, or the baby can roll over while swaddled.
Safety risks when swaddling:
- SIDs: can increase SIDs risk if baby not on back or can roll over while swaddled
- hip dysplasia: especially if other risk factors; just swaddle arms and not legs to avoid this
- Increase in respiratory infections (not seen in the US but seen in China and other countries, perhaps because they swaddle more tightly or frequently than in the US).
- Overheating
When to start swaddling:
You can start almost immediately after skin-to-skin contact. Could be issue if start swaddling when baby is older (3+ months) but not a lot of evidence here.
When to stop swaddling:
Stop swaddling when your baby can roll over while swaddled. Most cultures stop between 3 and 12 months. 9 months is when babies outgrow the jerk reflux. If your baby rolls over before 9 months, you can use a transitional swaddle. We used a transitional swaddle for our kids. By 9 months, we stopped using a transitional swaddle and our babies slept through the night just fine.
My favorite reference on swaddling:
Swaddling: A Systematic Review | Pediatrics | American Academy of Pediatrics
-
Which type of baby do you have?
Most babies fall into one of three categories in terms of how they like to fall asleep. This was certainly true for my two kids! Here are the three categories:
Suckers: They fall asleep easily with a pacifier, thumb, bottle, or nipple.
Motion junkies: They fall asleep easily while moving such as in a stroller, car, swing, or while being rocked.
Cuddlers: They like being held to sleep and prefer human contact.
Understanding how your baby prefers to fall asleep is helpful, especially for naps. Naps are more difficult for children (and everyone) because of a less strong sleep drive during the day. You can use this to your advantage for those hard to get but needed naps, especially when you are not at home or not in your normal routine! Independent sleep (without any of the above options) is really important for nighttime but less important for naps. Look here for more on independent sleep: The Single Most Important Sleep Training Tip.
My daughter is a motion junkie. She fell asleep quite easily in the car or stroller. I uses to plan naps around car trips or stroller walks, especially on the weekends. She is five and still falls asleep sometimes in the car. My son is a sucker. He still sucks his thumb at age 3 and loved the pacifier, though we took it away awhile ago. His favorite candy is suckers and he loves drinks with straws. Which type of baby or child do you have? Let me know in the comments.
-
The Single Most Important Sleep Training Tip
The single most important tip for sleep training your baby or child is the concept of independent sleep. Most babies struggle to fall asleep on their own. Independent sleep is something babies and children need to learn (and often relearn), and parents can help with this. Independent sleep means the baby falls asleep without the help of parents in terms of rocking, holding, feeding, cuddling, being in the same room, etc. You want your baby to have a full belly at bedtime but you want to separate it from actual bedtime (falling asleep on the bottle or nipples) so that they do not develop a sleep association with feeding and bedtime.
What about pacifiers? It is also probably best not to use pacifiers; it can be okay for some but not for others. For my son, he loved the pacifier, but he would cry if it fell out. We went cold turkey on the pacifier at night so that we did not have to repeatedly go back into his room and give it back to him. Sleep training went much better after we removed the pacifier at night.
How does this relate to sleep training methods? Pretty much all of the sleep training methods I have come across are just different methods for developing the habit of independent sleep in babies and children. Some methods involve crying (cry it out, graduated extinction) and others are more gentle (faded bedtime). We used the graduated extinction method where we put our baby down to bed at bedtime and set a timer for 20 minutes (or however long you feel comfortable with). If our baby was still crying after 20 minutes, we would go back to check on them and make sure nothing was wrong. Eventually (the number of nights can vary), our baby would go down without a fuss (or not much of one). I remember visiting family members and them being impressed by how easily my newborn went down at night. This was because of sleep training!
Does this apply only to bedtime? Independent sleep is most important for bedtime. Once that is established, middle of the night feedings can be removed more easily as the child is much better at going back to sleep on their own. It also makes naps so much better if they go down easily and without a fuss! We would also use independent sleep for naps, but we were less strict about it. We still sometimes used sleep tools (swings, pacifiers, car rides, stroller) for naps. Naps are harder due to a weaker sleep drive during the daytime.
When to start introducing independent sleep? We started introducing it early; essentially at birth. One of my favorite studies on sleep training, recommended starting independent sleep at birth and saw some positive sleep effects as early as 3 weeks (linked below). However, those first few weeks are very difficult for baby sleep; their circadian rhythm is not established and newborns still have the witching hour which peaks around six weeks old. So, those first couple weeks after birth, it can be challenging and you may want to wait a bit to make things easier. I would focus more on a consistent feeding schedule those first couple of weeks after a baby is born.
Does it work forever?: Overtime, your kids will likely regress and go back to crying/meltdowns at bedtime. My three-year old has been doing that lately. We go back to graduated extinction until the phase subsides, usually in a couple of weeks.
-
Why You Should Sleep Train Your Baby
We do not talk enough about the benefits of sleep training! Parents are left alone to figure out sleep training. The parental training classes provided by the hospital did not cover sleep training at all (at least for the classes I took). Despite this, there is a substantial body of evidence in the scientific literature demonstrating the beneficial effects for parents and children of sleep training! Here I will highlight the results from a well-regarded meta-review on this topic (cited below).
- Sleep training works!
The meta-review looked at 52 studies on sleep training. 49 of these 52 studies showed clinically significant results of sleep training. Of the best 11 studies, 9 showed positive effects of sleep training. 82% of kids showed improved sleep. Phone surveys of parents show success rates above 70% for some sleep training methods.
- Sleep training leads to better behavior in babies and children.
It leads to less bedtime resistance and fewer night awakenings. Babies are more predictable; they cry and fuss less.
- No documented negative effects of sleep training in babies or children.
No effect on breastfeeding. No effect on daily fluid intake. A couple of long-term studies have found no long-term negative (or positive) effects of sleep training.
- Sleep training has a rapid and dramatic improvement on parental mental health!
This is perhaps the most important of the reasons! In one study, depression scores dropped 45% in depressed mothers. The positive effects include martial satisfaction and better mood. Surveys demonstrate that parents (~90%) really like education on sleep training and appreciate having someone to discuss baby sleep issues with. Why aren’t we doing more to educate parents? Sleep training may even be as effective treatment for postpartum depression as any other treatment method available!
https://pubmed.ncbi.nlm.nih.gov/17068979
Mindell JA, Kuhn B, Lewin DS, Meltzer LJ, Sadeh A; American Academy of Sleep Medicine. Behavioral treatment of bedtime problems and night wakings in infants and young children. Sleep. 2006 Oct;29(10):1263-76. Erratum in: Sleep. 2006 Nov 1;29(11):1380. PMID: 17068979.