Difficulty in Settling Baby at Bedtime

Important to a baby's wellbeing is developing a sleep-time routine (as discussed in Caregiving Routines → Sleep-time). In general, the predictability of your calm interactions as you prepare Baby for sleep provide him with a feeling of warmth and security. However, difficulties can arise. Research has shown that up to 80% of sleep difficulties from the early age of 7 months up to 2 years originate in the first 3 months of life. There are factors associated with this such as:

• The lack of a consistent bedtime routine
• Overtiredness
• Over-stimulating environment
• Feeding Baby to sleep
• Parents 'over-interacting' with their baby
• Infant temperament
• Premature birth and associated stress.

Lack of a consistent bedtime routine brings about uncertainty in babies. Babies need routineness, which provides predictability (discussed in Shaping the Day). In turn, this develops their sense of security and needs to be maintained as they grow through their early childhood years. Importantly routineness to both day and night-time sleep patterns improves infants' ability to settle and will continue to benefit their development throughout childhood.

Overtiredness causes babies to have difficulty settling for sleep, which causes more likelihood of them having interrupted sleep patterns. As discussed in Caregiving Routines → Sleep-time, it is important to anticipate Baby's tiredness and to read his 'tired' signals before grumpiness sets in.

Over-stimulating environment does not induce the calm that babies need for sleep e.g. toys in the crib/cot and over-hanging mobiles can be visually stimulating, so instead of going to bed for rest babies can become over-stimulated by what is around them in their bed-space. For Baby's safety, toys in the crib/cot are not recommended.

Feeding Baby to sleep as a settling method for bedtime can become problematic in later months. For newborns, it is very natural for them to fall asleep while feeding as they are in your secure arms, being loved and nourished. Yet, for some babies a pattern of falling asleep on the breast or bottle and then to be put into bed can develop into a dependency, where they associate feeding with sleeping. As part of developing a sleeping routine where Baby falls asleep in bed but you want to give him a 'top up' feed, allow him to suck just until he is drowsy. Then gradually remove the breast/bottle.  Of course, Baby may protest with a cry so this may take a little getting used to. Don't forget to incorporate his favourite bedtime lullaby as you put him to bed!

Parents' 'over-interacting' with their baby can also be associated with sleep difficulties. With all of the best of loving intentions to care for their baby, parents' over-fussing at bedtime can often develop into the baby becoming dependent on Mum/Dad to fall asleep. Problems can begin with parents rocking the baby to sleep or giving him a 'comfort' feed, then putting him into bed only to find that Baby wakes distressed shortly after. This is because the last thing he remembers is being in the secure arms of Mum or Dad and when he wakes he wonders where they've gone. Parents then find themselves needing to resettle the baby and in doing so, use the same method such as rocking him back to sleep. So what happens is that the baby learns to associate the secure presence of the parent with falling asleep. As a result, bedtime interactions can turn into a vicious cycle of parent versus baby. I have put together a 'flow chart' to illustrate how this situation can happen.

Infant temperament (as discussed in Bonding and Beyond) could also play a part in babies' sleep problems. As far as research findings go, there is no 'fixed' decision about the role of infant temperament affecting sleep. What we do know is that some infants can be soothed more easily than others. Babies who are described as reactive or fussy are more difficult to console when upset than babies who are 'easy going'. Such difficulty can flow over into trying to establish a sleeping routine, which can challenge parents and affect their level of stress.

Premature babies may have additional stressors that cause them to be unsettled sleepers in the early weeks of bringing them home. Babies who have spent some time in a neo-natal intensive care unit (NICU) have been in a disruptive environment and may have experienced invasive medical procedure and discomfort. Gradually over the months the baby's sense of security develops when provided with parents' consistent loving care.