I’ve heard a lot of parents confess that they would find this whole parenting gig much simpler if their babies would come with an instruction manual. While I can’t ultimately help with one of those, I can share what science tells us about one of the most contended aspects of parenting: sleep.

First, let’s clear up the term

Just listen in to other parents at coffee group, and it doesn’t take much to see that we all have a slightly different definition of what actually constitutes ‘sleeping through the night’. According to the Moore and Ucko study, sleeping through the night refers to a solid sleep between midnight and 5am; in other words, it implies a stretch of just five hours in a row. However, 80% of parents (and I) disagree.

A study of New Zealand parents found that the average ‘sleeping through the night’ definition was 9.6 hours – plus or minus another three! My own definition also sits at the upper end for babies, consisting of 11 – 12 hours in bed and either no feeds, or just one, depending on age. It’s worth understanding what the scientific literature is referring to in research surrounding sleep and, despite the disparity, there are some solid, evidence-based insights that can help.

Fragmented night sleep

The first thing that the research is relatively unanimous on is the number one cause of sleep deprivation. Contrary to popular opinion it’s not about not being in bed long enough, it’s caused by broken or fragmented sleep. Plagued with lots of wake ups, you’re not getting the restorative, quality sleep required – it’s really more akin to simply taking a series of naps.

With this in mind, some of the most telling research is in what science has to say about fragmented night sleeps and frequent waking, especially in our little people. Studies found that 23% of five month olds did not sleep six hours consecutively, and 32% of these infants still weren’t sleeping a six hour stretch when they reached 29 months – two full years later. That’s a lot of broken nights!

What is causing frequent waking?

A study by professor Evelyne Touchette of 1741 infants set out to look at the factors that contributed to not sleeping six hours in a stretch at 5 months, 17 months and 29 months of age – and some common themes emerged.

In five month olds, the most significant factor contributing to broken sleep was whether the baby was being fed every time they woke up. Of course, we know that newborns need to eat at night, however once past that newborn stage, if your child is gaining weight steadily, we can start to look at other ways to settle them.

Young babies – particularly still five month olds – are active sleepers; they stir frequently and go through lots of sleep cycles during a night. However, leaping up to feed them again at every hint of a noise causes a continual habit that makes it difficult for them to establish that important and restorative six hour block. Feeding can seem a simpler option, especially when it’s otherwise quiet at night and you’re trying to minimise disturbing the rest of the household, however, this research provides insight into why we suggest parents start to learn other methods.

In older babies – 17 and 29 months old – parental presence until sleep onset is the primary factor contributing to frequent night wakings. We’ll note here that this doesn’t mean simply sitting by the cot quietly until your child drifts off; this is unlikely to cause issues. Instead, we’re referring to when parents are present and assisting their child to sleep in some way, whether that’s by feeding, rocking, holding, or patting.

We know that babies can self-settle once they get to this age; they just need to be supported to learn the skill. Supporting the pattern of more frequent night wakings, the research has found that babies older than six months who are assisted to sleep struggle to get into a deeper sleep and tend to wake after 45 minutes or two hourly. On the other hand, if they can self-settle to sleep at the start of the night, they will do a bigger stretch – not waking until at least 11pm or midnight.

Evidence for responding instead of reacting

We often make the distinction between reacting automatically and taking a few moments to meaningfully respond when your baby wakes. A 2017 study by Professor Roberts backs up why. His research found that a small delay between a baby waking and them being fed creates longer stretches of night sleep and less fragmented nights by the time a baby is just five weeks old! The results hold at the other studied age ranges – 5 months, 17 months, and 29 months – too.

Far from advocating a strict ‘cry it out’ method, the study supports the merits of trying other settling techniques first, whether that be giving your baby a cuddle or changing their nappy before offering milk. Another approach is simply to take a moment to get into their room, or talk to them gently first. For this approach to be effective, babies went – on average – just three minutes from the time they woke up to being touched.

As an aside, this same study found that babies started to take, on average, eight minutes longer feeds during the day as they began to have longer stretches of sleep at night – further proving our oft-made point that babies are their own perfect little calorie regulators.

What if you just need to improve your sleep NOW?

Another 2017 study – this time by Dr Jodi Mindell – looked at 134 babies (of various ages) who previously had no bedtime routine; the study had their parents institute one. The results were staggering and heralded successful night-time sleeps within just three days of commencing a consistent, age-appropriate bedtime routine. 

What were the markers of success here? They consisted of:

• Increased sleep onset latency (meaning it took less time for babies to fall asleep);
• Decreased frequency and duration of night-time wakings;
• More consolidated sleep;
• Increased maternal perception of bedtime ease (we could all do with feeling like that time of the day is easier!);
• Greater sleep quality for mums (hooray!); and
• Improved infant mood.

Behavioural interventions bear more fruit

In case you haven’t gathered by this compilation of research already, a 2000 Oxford University study compared the use of prescription medication and behavioural interventions for sleep in under 5s. Prescription drugs – the likes of melatonin or phenergan – were found to produce short-term results, but with no long-term efficacy observed. Behavioural interventions, however, were said to produce both short- and long-term effects.  

We’re often asked by parents for the panacea – the single most effective thing they can do to support their child’s sleep, however there isn’t one strategy that works for all. The study backed us up here, observing that there wasn’t a single most effective behavioural programme to support sleep, but instead the choice should be made based on a family’s individual preferences and circumstances. This is why our approach – and even our online programme – provides choices.

Turning the data into actionable insights

Understanding the research is one (albeit, important) thing, but what I love most about these studies is that they contain clues as to the easy things that you can implement now to have an impact on your child’s sleep that will last at least up until they are 29 months of age.

• Support your child with the space they need to self-settle, especially as they initially nod off to sleep for the night;
• Adopt other settling strategies than rushing to feed;
• Take a moment to get yourself a drink, put on your robe etc. before you rush in there; and
• Introduce an age-appropriate bedtime routine today.

For more tailored support or advice, don’t hesitate to reach out to us directly.

References

Mindell, J. A. (2017). Bedtime routines for young children: A study of impact on sleep and mood. Journal of Pediatric Psychology, 42(4), 361-369.

Moore, T., & Ucko, L. E. (1957). Night waking in early infancy: The role of parental management. Child Development, 28(1), 1-18.

Roberts, R. (2017). Responding vs. reacting: The impact of delayed response on infant sleep. Journal of Infant Behavior, 54(3), 210-218.

Touchette, E., Petit, D., Paquet, J., Boivin, M., Japel, C., Tremblay, R. E., & Montplaisir, J. Y. (2005). Factors associated with fragmented night sleep and frequent waking in infants. Sleep, 28(12), 1441-1448.

Oxford University. (2000). A comparison of prescription medication and behavioral interventions for sleep in children under five years old. Oxford Journal of Child Psychology, 21(3), 223-235.