Sleep Challenges … Related to Baby

Nap disturbances can be triggered from a variety of sources. The problem might be baby related but it might also be associated with Mom or her diet, waketime activities, or Baby’s sleep environment.  Isolating the cause of your baby’s sleep disturbance is the first step toward fixing the problem.  With that in mind, we begin a 4-part series on sleep challenges.

Here are some potential baby-related contributors to Baby waking early:

1. Baby is hungry because:
   1. He did not take a full feeding at his previous feeding
   2. He needs more milk calories in a 24-hour period – Whether breast or formula feeding, a baby’s growth necessitates more calories. While this does not always signal the start of solids, it may signal a need for more feedings (if breastfeeding) or more ounces (if offering formula).  Hunger can disrupt established nap and nighttime sleep routines.  Check with your baby’s pediatrician for literature relating to the number of ounces a baby needs at each week or month of life.
   3. He is starting a growth spurt – Growth spurts will disrupt Baby’s naptimes for the length of the spurt, which may be one to four days. When a growth spurt takes place, feed as often as your baby needs but try to maintain the feed-wake-sleep cycles as best you can.  The day after the growth spurt ends, your baby will take longer-than-normal naps for a few days.  That is because growth spurts are as exhausting for Baby as for Mom.
   4. He is ready to start solid foods – For the baby who has a well-established nighttime sleep pattern, any abnormal waking at night between five and six months of age or waking early during naps might also signal that more nutrition is required during the day. Babies are highly individual when it comes to showing a readiness for solid foods.  One baby might show signs at four months, while another shows no signs of readiness until six months.  As a general rule, babies usually start between four and six months of age.  Your baby’s pediatrician or family practitioner will direct you based on your child’s unique nutritional needs and readiness cues.
2. Baby is uncomfortable because:
   1. He is getting sick, has a slight fever, is teething, starting an ear infection, etc.
   2. He has an insect bite or a hair twisted around a toe (tourniquet syndrome) – If you have not already, get into the habit of checking your baby all over once a day, including fingers and toes. Certainly look for the bug bites, which will often show up as a red skin bump.  There is also a condition called “toe-tourniquet” syndrome.  A single strand of hair, usually Mom’s, or a fiber from a carpet or blanket where the baby was playing, somehow gets wrapped around a toe or finger.  Although hardly noticeable, it eventually begins to tighten and cut off circulation to the appendage, causing swelling, inflammation, and pain.  The problem is often missed because the baby is wearing a sock or sleeper.
   3. He is too hot or too cold
   4. He has a diaper rash
3. Baby’s tummy is troubling him because:
   1. He has a mild or delayed case of reflux – It is important to understand that reflux symptoms may not be present at birth and may not show up for several weeks. If your baby is troubled by reflux, you can count on it showing up throughout the day, not just at naptime.  If it is a mild case, you can do two things to counter its effects:  Keep the baby upright for a short time following each feeding, and elevate the head of his crib by two inches, allowing gravity to prevent stomach acids from moving back into the baby’s esophagus while he is sleeping.  For more severe cases of reflux, medication will probably be necessary.
   2. He is having an allergic reaction to a new food – Tummy discomfort, diarrhea, even rashes are common symptoms of food allergies and can also affect naps and nighttime sleep. Vomiting, while rare, is a more serious indicator that baby is having a reaction. The bottom line?  Never introduce multiple foods at the same time so you will not have to guess which food caused the reaction, should one occur.
   3. He is struggling with a bowel movement.
   4. He needs a burp.
4. Baby woke up because:
   1. He startled himself (startle reflex).
   2. He rolled over and does not know how to roll back.
   3. He lost his pacifier and cannot resettle without it.
5. Baby is starting a sleep/nap transition because:
   1. He is extending his nighttime sleep, affecting daytime naps – When a baby begins to extend his sleep at night, such as going from 10 to 12 hours, this naturally brings about a reduction in time the baby sleeps during the day. This reduction usually shows up at naptime.  Baby is not adding or subtracting hours of sleep; he is rearranging when his sleep occurs.
   2. His body does not require as much sleep in a 24-hour period, thus impacting naps – While sleep is very important to a baby’s development and overall behavioral performance, there are limits to the amount of sleep a baby needs at each stage of growth. Eventually, he will begin to subtract hours of sleep.  Normally, babies do not subtract hours from nighttime sleep but from daytime sleep.  Correspondingly, this means waketimes are extending and the number of naps decrease during the day.

Excerpt taken from On Becoming Babywise by pediatrician Robert Bucknam, M.D. and Gary Ezzo, M.A.  (2017 6^th Edition).

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