- Anything that makes babies feel unsafe or emotionally insecure can disrupt their sleep.
- Illness, discomfort, and pain can cause insomnia in babies.
- Babies can be notoriously bad sleepers, especially at night. It doesn't mean that you or your baby are doing anything wrong.
There are strongly felt and widely expressed opinions about how to get babies to sleep. Many of these opinions contradict and clash with one another—often because they are based on different theoretical frameworks. Some of the common solutions offered for sleep problems in babies are rooted in the model of behaviorism. Korean researchers, E.K. Kang and S.S. Kim, in their 2021 article entitled Behavioural insomnia in infants and young children, have outlined some behavioral approaches to getting babies to sleep better. Sleep training and controlled crying are examples of such behavioral approaches but they don't always work because they might not be getting to the core of the problem. A clue to understanding insomnia in babies is to look at what causes insomnia in adults. A troubled mind, stress, feelings of anxiety, and mood disturbances are often central to adult insomnia. But there are other considerations too, starting with the need for an experience of safety.
1. Babies need to feel mentally and physically safe in order to fall asleep
A baby who is physically ill, uncomfortable, or in pain is not likely to sleep well. This includes allergies, eczema, and infections. It also includes reflux, colic, and a blocked nose. So the first and most important part of addressing sleeplessness in your baby is to have a thorough medical check-up. Treatment options should be considered that alleviate discomfort and suffering. A baby's mind can be troubled by physical distress and by anything that can make her feel scared or insecure. Unfamiliar surroundings—moving house or taking holidays—can also disrupt sleep.
The mother, father, or primary caregiver is the person to whom the baby feels most strongly attached. Her feeling of safety and security rests largely on that person. Babies often have other attachment figures too, but they can be particular about who puts them to sleep—and some babies tend to cry for their mothers at bedtime. The physical and emotional presence of the baby's attachment figures brings a sense of safety and security and allows her to trust and relax in herself enough to fall asleep.
2. Separation anxiety can prevent babies from sleeping
D. Daws and S. Sutton, in their enlightening book, Parent-Infant Psychotherapy for Sleep Problems: Through the Night, have made a substantial contribution to a deeper understanding of why babies sometimes struggle to sleep. There is a link between separation anxiety and sleep, but this does not only refer to the physical separation between the baby and his trusted caregiver. A baby who experiences separation anxiety-related insomnia is usually carrying unconscious baggage linked to the people to whom he is most closely attached. Often an intensely close and connected bond with the mother, father, or another caregiver can be complicated by unresolved, unconscious feelings in the caregiver. For example, a mother who has experienced in the past the death of somebody special might be carrying unresolved grief. Her incomplete mourning process extends to her baby who, in his extreme sensitivity, carries his mother's fear of loss. The result is that he won't let her out of his sight—keeping himself awake and alive and close to his beloved mom.
3. When "through the night" is an unrealistic expectation
There is a lot of pressure on new parents to get their babies sleeping "through the night." The truth is that most babies go through phases. Sometimes they sleep well but often they don't. Development is ongoing and sleep changes occur alongside development. Newborns usually sleep a lot but they wake up at night and they need regular feeding—day and night. Over the first few weeks, they often sleep more and feed less at night, tricking you into thinking you are lucky to have such a "good" baby. At around 4 months of age, as babies become more aware of themselves and the people around them, their sleep often becomes more disturbed. Teething, illnesses, environmental changes, weaning, and starting day care can all influence their sleep in an ongoing way.
4. Your constant attentiveness can make things worse
Although babies need their caregivers (mom, dad, or others) to keep them physically and emotionally safe, they also sometimes need to be left alone with their own thoughts—as long as they aren't very upset and emotionally dysregulated. When your baby moves, squeaks, grunts, and makes noises that are clearly not signs of real distress, it's a good opportunity to let him discover that he can face and manage some small challenges without you. If you consistently respond to your baby each time he appears to be awake, it can make it harder for him to trust in his own ability to slip back into relaxation and (hopefully) sleep.
5. Babies tend to wake up for feeds—especially if they are fed often during the night
Medical circumstances should always take priority. If your baby is sick or not gaining weight according to the clinic and doctor's charts, then you will be feeding her according to medical advice—at night at regular intervals or on demand. During the first few weeks, babies always need to be fed during the night, either on-demand or every three to four hours. But if your baby is over about 6 months and if she is thriving, healthy, and a normal weight, then your doctor or clinic nurse might advise you to let go of some or even all of the nighttime feeds. Some babies seem to need a lot of attention at night and feeding (breast or bottle) is their way of feeling close and connected to their moms, dads, or caregivers. But feeding less often or smaller amounts at night often seems to reduce the amount of night-time awakenings. It can feel like a difficult choice, though, because if your baby isn't given a feed, she might want to stay awake in your arms for much longer than if she was given a feed that satisfied her enough to fall back asleep.
In conclusion, babies are notoriously difficult sleepers so don't be too fixated on a "through the night" sleep. But if your baby is struggling to sleep much of the time, it will be exhausting for you and it can put your sanity at risk. As you look for sleep solutions online, in books, and from doctors, nurses, psychologists, and infant specialists, consider also that babies can carry all kinds of psychological baggage for the special people in their lives. They are like sponges, sensing tension, dark secrets, unhappiness, and deception. They often sense unspoken (or overt) conflict between their parents or depression in family members. Sleep problems might be the first challenge in your parenting journey but it won't be the last. My suggestion to you is to read, listen, consult with trusted professionals, and most importantly, get to know your own baby and find out what works best for her—and for you.
Kang, E.K. & Kim, S.S. 2021. Behavioural insomnia in infants and young children. In Clinical and Experimental Pediatrics. March; 64 (3): 111-115
Daws, D & Sutton, S. (2020). Parent-Infant Psychotherapy for Sleep Problems: Through the Night. Routledge: U.K.