by Jessica Martin-Weber
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Ah sleep. Everyone wants it, parents struggle to get it.
We hear all kinds of things about sleep when kids are in the picture. From the start, tiny humans come out with a different set of sleep needs than the people taking care of them and it doesn’t take long to figure out that they seem to require much less sleep for 1,000 times more energy. It’s a mismatch from the get go. So the quest begins for the elusive right amount of sleep for everyone in the family with a balanced routine so the parents and their infants and children can get what they need. Everyone has an opinion and strategy on sleep and even strangers in the grocery store may share with parents their magic tricks for getting babies to sleep through the night (which is only considered 6 hours without waking).
When it comes to sleep and breastfed babies, the advice and myths abound but sleep, like many other aspects of a child, is very much an individual thing. Personality, developmental stages, individual body quirks, etc. can have a major impact on sleep. The fears we typically hear about sleep and the breastfed baby is that for some reason the breastfed baby will wake more often than their formula-fed peers, become dependent on the breast to fall asleep, and have sleep struggles longer. While often formula fed babies may wake less frequently to feed in the early months because formula takes longer and more work to digest, evidence shows that there’s no guarantee that will be the case. Further evidence suggests that formula fed babies and breastfed babies (and their parents!) still get the same total amount of sleep. Plus, by 9 months, all sleep differences between breastfeed babies and formula fed babies have leveled out anyway. With the lowered risk of health issues including diarrhea and ear infections (talk about sleep disrupters!) and the reduced risk of SIDS (sudden infant death syndrome), breastfeeding is still the normal biological way to feed a baby and recommended by experts.
So does breastfeeding mean poor sleep?
8 points you need to know about sleep and the breastfed baby.
Have realistic expectations. Young babies wake frequently, often those wakings are to feed. Frequent wakes are completely normal so adjust your expectations accordingly. Babies have small stomachs, breastmilk is digested quickly because it is exactly what their bodies need, and the part of their brain that regulates sleep hasn’t developed to differentiate between day time sleep and night time sleep or naps and long sleeps. Frequent wakings actually reduces the risk of SIDS, a blessing in disguise.
Breastfeeding helps babies fall asleep. The oxytocin release that comes with breastfeeding is relaxing and naturally makes babies and parents sleepy. It isn’t a bad habit for breastfed babies to fall asleep at the breast and to want to return to the breast to help them settle when they wake in the night, it is normal. Including breastfeeding as part of the consistent bed time routine is a good way to help them get to sleep. If your baby has started solids, just be sure to brush their teeth before breastfeeding so that there aren’t any other food particles on their teeth that could lead to tooth decay. Breastmilk itself is fine for teeth as long as they are clean. Needing to breastfeed to sleep won’t become a lifelong crutch, we promise.
Babies breastfeeding at night helps milk supply. Prolactin levels (milk making hormones) are highest at night which means that babies wanting to breastfeed at night actually work together with those higher prolactin levels to help your body make more milk. A baby that starts sleeping through the night too early could lead to a lower milk supply. It may help to think of your baby waking to feed during the night as protecting your milk supply.
Realistic expectations- again! Research shows that only 43% of babies over 6 months actually regularly sleep 8 hour stretches without waking during the night. That leaves 57% of babies over 6 months that do wake in that time and need help getting back to sleep. By 12 months those numbers flip and 57% of babies over 12 months regularly sleep 8 hour stretches without waking during the night, so 43% of babies are still waking. 72% of babies are making it 6 hour stretches without waking during the night by that age. The expectation that the majority of babies are going to be sleeping through the night by 6-12 months is a myth and causes unnecessary pressure based on unrealistic expectations. If your baby isn’t sleeping through the night, they’re in good company.
Breastfed babies wake for other reasons than to feed. Though they may prefer settling back down to sleep at the breast, they also wake if they’re cold, hot, wet or soiled, scared, were startled, and any other number of reasons. Just like adults. The difference is that adults usually wake and fall back asleep without needing assistance in doing so, a skill that takes some time to develop. Comforting connection that helps your baby feel secure is the best way to help them calm and settle back to sleep.
No matter how they are fed, all babies need a safe sleep space. A firm flat surface (no inclined sleepers) free of blankets, toys, and crib bumpers. Keep in mind that infants up to a year need about 12-16 hours of sleep a day and toddlers need about 11-14 hours a day. That’s a lot of time spent in their sleep space, consider the materials with which your child will be spending a significant portion of their day.
Most breastfed babies aren’t ready to go 8 hours without a feed until after 12 months. Due to stomach size and development, it is normal for them to need a snack and comfort in the middle of the night. Night weaning can actually lead to more wakings if done too early.
Sleep will happen, some day. It may seem like night wakings are lasting forever but most children do eventually settle into the normal sleep patterns we all crave. Even the worst sleepers improve but not everyone ends up with the “sleep through the night” pattern society tells us to expect. My 7yo still often wakes once a night in need of some comfort. Even I have times where I struggle with frequent wakings and have difficulty getting back to sleep. There’s a wide range of normal at all ages.
Keep in mind that there is a wide range of normal and there are a number of factors that can contribute to disrupted sleep for infants and toddlers. Having realistic expectations goes a long way in being patient with the process. If you’re concerned that your child may be exhibiting signs of abnormal sleep, speak with your child’s health care provider about your concerns. Sometimes sleep issues are a sign of something else more serious going on that should be explored by a qualified healthcare professional.
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