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Creating Healthy Sleep Habits

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Once a baby is 3 months old, he no longer has physiological need to be fed during the night. But at 5 months, a fair number of infants are still experiencing problems (or even developing new ones) falling asleep at bedtime or after waking in the middle of the night. Often, well-meaning parents take too active a role in soothing their babies to sleep. The result is a baby who can nod off only with a parent's help and two adults who are absolutely desperate for a good, uninterrupted night's sleep.

Mercifully, most sleep difficulties can be solved relatively easily by following some basic rules. But don't put the task off. Sleep problems become more ingrained as children get older.

Help your baby break the habit of falling asleep only with your assistance. Many new parents assume that rocking, nursing, or singing a baby to sleep is what being a loving mother or father is all about (and these activities can be very pleasurable for both of you). But if you always let your little one nod off in your arms, she will come to expect it. Then, when she awakens during the night, she'll feel helpless and will cry for assistance.

You do not have to eliminate bedtime rituals altogether. You can rock or nurse your baby until she gets drowsy. The point is to put her in her crib while she's still awake, so that the last thing she sees is her mattress-not you. Then when she wakes in the middle of the night, she'll be so accustomed to this familiar sign that she'll probably fall back to sleep.

If your baby is already addicted to your arms, however, she's sure to cry if you put her in her crib awake. You'll have to muster a lot of emotional strength to wean your baby of this habit.

Begin by putting her down and comforting her for about five minutes, then leave the room. If she cries, let her do so for about five minutes, then go back in and soothe her, but don't take her out of the crib. When she's calm, leave the room again. If she begins to cry, wait another five minutes before you return and calm her down always leaving her in the crib. Repeat this procedure until she falls asleep herself. And for the next few weeks, gradually lengthen the time between soothings.

Don't put your baby down with a bottle. Like rocking and nursing, giving your baby a bottle at bedtime creates a dependency: He will get accustomed to sucking and find it difficult to nod off without his bottle or to settle himself back to sleep during normal night awakenings. You may also have to change him regularly during the night, since his diapers will most likely be soaked.

Allowing a baby to fall asleep with a bottle can also cause physiological problems that interfere with his sleep. The extra calories may stimulate his digestive system and throw off his natural body rhythms, causing him to wake from hunger. Ear infections may result if formula pools in your baby's inner ear, as may happen when fluid enters the eustachian tube, which connects the baby's mouth and ear. And baby-bottle mouth can develop once your infant has teeth.

To wean your baby of his bottle-in-bed habit, steadily decrease the amount of milk, formula, or juice in the bedtime bottle and eventually eliminate it. Or replace the fluid entirely with plain water. A child who is getting only water from a bottle will soon give it up altogether, usually in a week or two.

Don't bring your baby into your bed in hopes of solving a sleep problem. Studies show that both adults and children sleep better alone-your movements and arousals are likely to disturb your baby's sleep, and vice versa. More important, teaching your baby to sleep alone is an important part of her learning to separate from you without anxiety.

Some parents, however, prefer the "family bed" concept practiced in other cultures, and that's fine if it's part of your value system and you're willing to forgo the lack of privacy that accompanies it. But experts advise that it's a mistake to bring your baby into your bed solely to solve a sleeping-through-the-night problem; it's more likely to exacerbate the situation.

Do help ease the transition. A fear of being separated from one's parents often begins to surface around 6 months of age and can trigger new sleep problems. So that your little one doesn't feel abandoned when you put him down for the night, spend 10 or 15 minutes with him in the nursery before bedtime so that he comes to identify your presence with the room. This transition time will also give baby a chance to become comfortable with his surroundings. When you do place him in the crib, don't leave post-haste. Instead, spend another 5 minutes talking softly to baby and perhaps gently stroking him, then quietly leave the room before he falls to sleep.

If you try these methods and your baby's sleep problems persist, you should speak to your pediatrician. The great majority of babies have the ability to fall asleep on their own and stay asleep through the night, but in rare cases a disturbance could signal a medical problem.

All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.