Rock-a-bye Baby, Sleep Through the Night

The key is feeding your infant fewer times

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HealthDay Reporter

FRIDAY, Jan. 24, 2003 (HealthDayNews) -- Want to know how to get your infant to sleep through the night?

Don't be so quick to feed your baby when he or she cries out, a new study says.

Researchers had nearly 600 mothers in England keep a diary about their infants' sleeping and eating patterns during the first 12 weeks of life.

The researchers found that babies who were fed more than 11 times during a 24-hour period were three times as likely as babies who were fed fewer times to wake repeatedly during the night.

"It's possible to predict babies who will be sleeping through the night at 12 weeks of age by measuring how many feeds they have at one week of age," says Ian St. James-Roberts, lead author of the study and a professor of child psychology at the University of London.

The next step was figuring out how to break the pattern.

The researchers identified 134 babies who were fed more than 11 times in a 24-hour period and therefore "at risk" of driving their parents to exhaustion by waking up at night.

Those babies were divided into two groups. One group was put on a behavioral program; the other wasn't.

The behavioral program taught parents to begin teaching their child from birth that day and night are different. Parents were instructed to do things such as keeping their baby active and playing during the day, making sure the sleeping area was dark and quiet, and not letting them fall asleep wherever they happened to be or while feeding.

After three weeks of age, as long as the child was gaining weight satisfactorily, mothers were taught to delay or avoid feeding the infant when he or she woke up at night.

Instead, the mothers would change the diaper or do some other activity to break the association with waking up at night and getting fed, St. James-Roberts says.

Eighty-two percent of the babies on the behavioral program slept through the night at 12 weeks, compared with 61 percent of babies not on the program, the study found.

Whether the babies were breast-fed or bottle-fed made little difference, the researchers note.

Their study appears in the Jan. 22 issue of the Archives of Disease in Childhood.

Dr. George Cohen, a pediatrician and editor-in-chief of the American Academy of Pediatrics' "Guide to Your Child's Sleep," says encouraging mothers to delay feeding their baby at night to promote sleep is "perfectly reasonable."

"If you can settle him down without a feeding, with just soothing murmuring, rubbing his tummy or patting his head to calm him down, the academy goes along with that," Cohen says. "If it works, good for you."

But the fact is, it's unreasonable to expect a baby who's just a few weeks old to sleep more than five or six hours at a stretch, he says. And sometimes, the baby will demand nothing less than being fed.

"You may just have to live with [being woken up at night] for awhile," Cohen says. "Sometimes feeding a baby is the only thing that works."

About two-thirds of babies in industrialized nations sleep through the night by the time they're 12 weeks old, according to the study.

Parents commonly take babies who don't sleep through the night by this age to the pediatrician for advice.

Among cultures, there's a wide range of beliefs about how often an infant should be fed, ranging from regular, four-hour intervals to on demand, St. James-Roberts says.

"We're not talking about normal or abnormal," St. James-Roberts says. "The issue is what do you want? If your purpose is to have your baby sleep through the night at 12 weeks of age, then this study gives you some information to help you achieve that purpose."

St. James-Roberts stresses his study doesn't mean to imply that mothers who feed their baby 11 times or more are overfeeding them. However, feeding the child fewer times during a 24-hour period will improve their sleep habits, he says.

"There has been some misunderstanding that we are talking about babies being overfed or not feeding babies when they're infants," he says."It's not about any of those things. It's simply about the number of feeds."

The American Academy of Pediatrics' guidelines for breast-feeding say feeding, especially breast-feeding, an infant eight to 12 times a day is perfectly normal. They also recommend feeding an infant on demand.

However, Cohen says new parents sometimes have a hard time figuring out what "on demand" means.

"When the baby is crying, are you sure you know what the baby's demanding?" Cohen says. "When a baby cries, the first thing some parents do is stick a bottle or a breast or a pacifier in their mouth, which may teach the baby that crying is the only way to get that."

More information

To read the American Academy of Pediatrics' guidelines for breast-feeding, click here. LaLeche League also has information about feeding infants.

SOURCES: Ian St. James-Roberts, Ph.D., professor, child psychology, University of London, England; George Cohen, M.D. pediatrician and editor-in-chief, American Academy of Pediatrics' "Guide to Your Child's Sleep"; Jan. 22, 2003, Archives of Disease in Childhood

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