A Sleep Expert Answers All Your Questions About Baby Sleep

Every baby is different, so every baby and family’s sleep journey is different. We asked Babylist parents to submit their questions about sleep for Dr. Nilong Vyas, a pediatrician, sleep expert and founder of Sleepless in NOLA Sleep Coaching and contributor for SleepFoundation.org, and they had lots of questions. Like, when is it too late to sleep train? Why won’t my baby nap longer than a half hour? And do I really need to stop nursing my baby to sleep?

Read on for Babylist parents’ questions about sleep—and Dr. Vyas’ expert guidance.

Sleep Training

When is it too late to sleep train a baby?

It’s never too late to sleep train a baby because it is not necessarily the baby who’s being trained; it’s the parents. The older a child gets, the harder it can be to undo poor sleep associations, but it’s never too late to start.

How do you get a baby to sleep through the night?

Knowing how to get a baby to sleep through the night is an elusive question and the answer has many factors, which involve addressing the child’s foundational needs. For example, most children who eat adequately during the day, log the appropriate amount of daytime sleep and falls asleep independently will stay asleep through the night when those parameters are met.

It’s unlikely that a child who’s putting themselves to sleep consistently and independently will have difficulty sleeping through the night. If they are doing that and then waking, it may be due to hunger; if it’s not due to hunger, it could be because they are overtired. It’s almost always some combination of one or the other. I recommend that parents look at one of those components. If they’ve been met and the child is still having difficulty, a sleep expert might be able to help.

While attempting to sleep train my eight-month-old, he cries and screams non-stop for two hours. Between check-ins, it only gets louder. Is this a temperament thing or is he scared to be left alone? When we pick him up and rock him, he calms down but he’s definitely catching his breath and really upset.

It may be temperament, but a child thrown into sleep training after many months of being rocked to sleep will persist in crying. Getting him through may take more time and a gradual process. With a little patience, he should get there.

I tried various sleep training methods during months 8-12—now our baby is two-years-old and still waking up in the night. Dad works all day and feels useful going in to soothe during the night. Should we stop using the baby monitor for our two-year-old? Our son goes through phases, but last night he was up four times—as was my husband.

I like the use of the monitor, especially for older kids, because it helps them feel reassured and comforted that someone is watching them and can hear them if they need anything. But practice the use of the monitor with your toddler, so they are not scared of it.

Putting Baby Down

Our son only sleeps in our arms, and the minute we try to put him down, no matter how deep he’s sleeping, those eyes snap open. What do we do? We’ve tried putting him down “drowsy but awake,” but that quickly becomes “awake and screaming” every time.

When falling asleep, getting your child in the drowsy but awake state is essential. He should be more awake than drowsy. That’s where parents get into trouble; they try to get the child mostly asleep to make a quick escape, and it backfires frequently. It’s challenging, but try to allow the child to fall asleep independently every single sleep time you put them down, as well as with overnight wakeups. Give the child space to fall asleep. It is almost easier to ‘do it for them’ and put them to sleep. But, if you’re doing these things for them every time, the child can lose the ability to do it themselves.

I always nurse my seven-month-old for her naps and nighttime sleep and it 100% works to get her to sleep no matter what. Is it okay to nurse my baby to sleep if it’s working for me?

There will be a day when nursing to sleep for naps and bedtime stops working. It’s best to start weaning from that process and allowing your child to fall asleep independently. Also, when a mother nurses an infant to sleep, it increases the likelihood of dental caries and takes away the ability of other caregivers to put the infant to sleep. There also may be a time when it becomes too much on the mother and becomes unsustainable.

Naps

How do you get a baby to nap when they’re tired, but fight sleeping? I try laying my seven-month-old down when he’s tired, but he constantly tries to kneel or pull himself to standing and then falls over in the crib. It seems the only way I can get him to nap is by taking him for a walk in his stroller.

Nap refusal is a common symptom when baby is overtired. To avoid this, take them into the room to initiate the sleep-time routine at least 30 minutes before the child is ready to go to sleep. This way, the baby can wind down, relax and prepare for sleep. The baby will most likely resist the first few days of the change, but staying consistent will help them eventually stop refusing.

What do you do if your baby only naps for 30-40 minutes when at their age, they should be napping for more like 1.5-2 hours? Do you soothe them and help them go back to sleep? Let them hang in their crib? Or get them up?

Many parents respond to their children too soon when they wake from a nap prematurely. Give the baby time to put themselves back to sleep, especially if they put themselves to sleep initially. If the parent is offering interventions such as rocking, feeding, holding the baby to sleep and then putting them into the crib asleep and sneaking away, the baby will likely wake up when they realize they’re no longer being held. So if, for example, the child needs to be rocked to go to sleep, when they wake prematurely, they’ll need the same intervention, in this case rocking, to go back to sleep. Teaching a child to fall asleep independently will help.

Night Sleep

My baby goes down so easily for naps, but she has trouble falling asleep independently at night. Naps and night sleep happen in the same crib, with the same white noise machine and same sleep sack, and we follow a predictable schedule. We don’t rock or nurse or hold to get her to sleep. We put her down and that’s it. If she fusses we give her a paci but for daytime naps she will fall asleep within three minutes. Putting her to bed can take 30 minutes of going in and giving her the paci. Any ideas why our baby struggles to go to sleep on her own at night?

If naps are easy but nighttime is a struggle, it could be that bedtime is too late. Once children bypass the sleep window, it can be challenging to fall asleep. Recall the times you may have been sleepy but continued doing something fun; often, it’s hard to fall asleep when it’s time. You may have better luck with an earlier bedtime.

Why does my 18-month-old still wake up in the middle of the night and is up for the day at 5 a.m.?

Early morning wake-ups are typically because baby isn’t getting enough daytime sleep. Some 18-month-olds still need two naps. Try adding the nap back into the schedule if they’ve stopped or dropped to one nap.

What is the best approach to getting an almost nine-month-old—who won’t stop night feeding multiple times a night no matter what we try—to sleep for longer stretches at night?

It’s best to consider whether the infant wakes overnight out of hunger or a need for comfort. If he’s hungry, try increasing the amount you feed him during the day. If it’s simply for comfort, work to eliminate the overnight feeds gradually. Using a pacifier can be helpful.

Bedtime Routines

Is it harmful to let my three-year-old cry himself to sleep every night? We have the same routine, he’s tired, he has had a calming bath and book and song and then we say goodnight and leave and it’s screaming for, at minimum, one hour. Consistency does nothing. Should I just lay with him until he falls asleep instead?

A bit of fussing before bedtime is appropriate and can be standard. Still, a child with persistent crying for an hour every night needs an evaluation of the components of the routine, sleep environment and behavioral approaches used at bedtime. You might consider reaching out to a sleep expert who will explore all aspects of the family’s sleep routine and recommend a plan of action to eliminate that behavior.

Time Changes

There’s a time change coming up. How do I adjust my baby to daylight savings?

Daylight Savings Time (DST) can definitely can wreak havoc on your child’s sleep. You will be setting your clocks forward so if it is 7 p.m., the clock should read 8 p.m. There are two ways in which to resolve the issue as it relates to your child’s sleep.

If your child is an early riser, DST is great. Because if they were waking at 5 a.m., now they will be waking at 6! Yay! But if they need to wake up at 7 a.m. to get ready for school, that clock will now say 8 a.m. and they will be late! Below are a couple of options.

• The first option is to do NOTHING. Especially for those early risers, whose wake-time was 5 a.m. and bedtime at 7 p.m., their wake time will be a more tolerable one now, (6 a.m. with a bedtime at 8 p.m.), so you probably don’t want to rock the boat here.
• The second option is to spread the time change across four days, shifting your child’s sleep earlier by 15 minutes a day. If your current schedule is sleeping from 7 p.m.-7 a.m., start with putting baby to bed at 6:45 p.m. and waking them up at 6:45 a.m. This means waking your child up at 6:45 in the morning, as you need them waking up at the new target time, not their old normal time. Continue shifting sleep 15 minutes a day for four days, at which point your child’s post-DST sleep schedule should be the same as their pre-DST sleep schedule (e.g. 7 p.m.–7 a.m). If it’s too difficult to get your child to bed earlier, which is often the case in older kids, then just focus on advancing the wake-up time a bit instead.

I recommend dimming the lights in your child’s bedroom (and throughout the house) and turning off all electronics an hour before bedtime (I recommend this whether it’s daylight savings time or not, but it’s especially important during that process). In the morning, get your child in the light as much as possible. Natural sunlight is best or turn on lights in the house so it’s bright enough to start their ‘wake-up’ clock.

Sleep Regressions

My 19-month-old has generally slept through the night since six months. He would sleep almost 12 hours on the dot most nights. Recently, it’s been 5 a.m. wake ups every day. No routine changed. What could be causing this?

A lot of changes are happening in a 19-month old’s development! Additionally, at around 15-20 months, toddlers can transition their nap timings and may start to resist naps. Many parents will then begin to skip naps altogether because of this. Toddlers can then become fatigued which often causes early wake-ups. Hunger also causes premature early a.m. wake-ups. Toddlers can also get picky with eating because they’re easily distracted. Parents assume the child is not hungry at mealtimes, so the child wakes prematurely because they’re hungry. Another potential reason for early wakeups is getting to bed too late. So, add the nap back into the schedule if missed, ensure ingestion of enough calories during the day, and have an appropriate bedtime.

Breaking Sleep Habits

My 18-month-old has slept with me since birth but will not sleep in his crib or independently. How can I break this cycle? I would love him to sleep in his own crib and to be able to put himself to sleep without me and my husband’s assistance. He is able to sleep in the crib for an hour or two once asleep but will wake up and sleep with us the rest of the night. He takes one nap for two hours and we hold him the entire time. Where do we begin?

Breaking the associations of falling asleep with a parent will need some time, patience, and, most of all, consistency. Start slowly by working on the child falling asleep independently while the parent is still in the room but without holding to sleep and gradually eliminate the associations. There may be some tears (on both sides), but patience and consistency with the message will prove victorious on the sleep front. Teaching your child to fall asleep independently will allow for healthier sleep habits throughout their childhood into adulthood.

Room Sharing

What are the psychological effects of sharing a room with newborns?

Sleeping in the same room with your newborn can have beneficial psychological effects for both the parent and child. The American Academy of Pediatrics (AAP) recommends that parents sleep in the same room (but not the same bed) as baby for the first six months—it can help decrease the likelihood of SIDS by as much as 50%.

For some parents who suffer from anxiety, having a noisy newborn close by in their bassinet can disrupt the parents’s sleep patterns. In that case, having a co-parent sleep in the same room with the newborn while the mom gets some uninterrupted sleep elsewhere until the next feed can help with milk production and postpartum depression. The parent can return to the room once they are better rested.

Health and Development

My baby waves her head back and forth a lot while in the crib? Why and what can I do to reduce this?

Some kids move their heads back and forth while trying to fall asleep as self-soothing. It can be appropriate behavior.

Can my PTSD night terrors have been passed down to my baby in womb?

No. Generally, night terrors for babies and toddlers result from insufficient sleep during the daytime or nighttime. But inadequate sleep habits can be ‘passed down’ as traits because if the parent does not have good sleep habits, those habits may not be enforced in the home.

Parent Sleep

How and when will I get proper sleep in the first few weeks of the baby’s life?

Using support from your network and other caregivers, if possible, is paramount for parents to recover and get much-needed rest after delivery. However, the first few weeks of a baby’s life are the most beautiful yet stressful for parents. When possible, finding time for the mother to rest and eat sufficiently is essential.

When Should You Hire a Sleep Consultant or Ask for Help?

Our 18-month-old son is waking up around 4 a.m. every morning, calling our names and asking for a “baba” (bottle). We adhere to every possible recommendation received about sleep routine/training and feel like we’ve tried just about everything to try to get him to sleep later—can a sleep coach actually help us and if so, how? They seem to be pretty expensive and while us all being well rested is priceless, I’m having trouble making the move and hiring one.

Many parents find themselves in this predicament, and often mothers take it upon themselves to solve the problem. Additionally, there is a lot of guilt surrounding the thought, ‘I’ve failed in getting my child to sleep well when every other child sleeps perfectly.’ That thought process can stall the search for help. No one expects you to know how to fix your car’s transmission, but it’s expected that every sleep problem must be tackled through Mom groups on Facebook and Dr. Google. Getting a sleep coach is no different because we need professionals to assist us with difficult things. I highly recommend seeking help; the money is worth it because the extra sleep benefits the entire family. You become a better parent and version of yourself, and the child becomes much happier.