An Australian study published in 2001 found that 10 to 15 percent of mothers experienced postpartum depression in the first year after birth.
However, for mothers of infants with sleep problems, this rate skyrocketed to include up to 45 percent of mothers.
Research published in the Royal Australasian College of Physicians’ Journal of Paediatrics and Child Health found that as many as 20 percent of Western parents reported infant crying to be a problem. The study set out to identify the management strategies that parents found most helpful.
Helpful management and educational strategies
Talking about the baby, learning about the baby, and having the baby examined by a health care provider were ranked as the most helpful strategies by parents.
Parents also reported the following educational techniques to be helpful:
- Sleep cycles explained
- Putting a baby to bed awake
- Settling techniques explained
- Infant crying patterns explained
- Infant sleeping patterns explained
- Using a sleep diary to record sleeping, waking, feeding, and crying
A note on medication
Interestingly, although 76 percent of mothers tried giving their baby medication, including over-the-counter colic remedies and anti-reflux drugs, the vast majority reported them to be unhelpful.
Settling techniques include recognizing your baby's tired signs, developing a consistent approach to settling to sleep, and the encouragement of self-soothing.
Signs your baby is ready for sleep include:
- Rubbing eyes
- Looking away
The process of allowing infants to learn to fall asleep by themselves has been found to be effective in research studies.
Teaching your baby to self-soothe is generally carried out from around four to six months of age.
A consistent approach is important here. Typically, you pat or rock your baby until he or she is quiet, but not yet asleep, and then leave the room.
If your baby starts crying, return after five or 10 minutes and attempt to resettle her. Repeat the process until your baby falls asleep.
It's a good idea to develop regular habits and bedtime routines so your baby can more easily learn when it's time for sleep.
Help your baby prepare for sleep by:
- Talking softly
- Dimming the lights
- Reading or singing
Infant sleep and crying patterns
Being aware of typical sleep and crying patterns can help you avoid unrealistic expectations.
Newborn crying typically peaks at just under two-and-a-half hours of crying per day at around six weeks of age and begins to decline by 12 to 16 weeks.
According to a study published in the Journal of Pediatrics, most infants aren't sleeping through the night until they are two or three months old.
Furthermore, it isn't until the age of five months that most infants are sleeping at the same time as their parents.
A Finnish study found that only a third of babies under six months old got at least six hours of uninterrupted sleep at night. The good news is this rose to 72 percent by nine to 12 months of age.
The benefits of a baby sleep diary
Keeping a sleep diary can help measure the total amount of sleep your baby is getting over a 24-hour period. It can also help both parents and caregivers evaluate the effectiveness of settling techniques.
Sleep diaries can also help solve sleep problems; for example, a diary may show that your baby sleeps better after longer periods of being awake between periods of sleep.
A special note on premature babies and twins
When it comes to improving the sleep of twins, try to follow the same techniques for both. Include both babies in the bedtime routine and put both babies to bed at the same time. If one wakes to be fed, consider waking the other for a feeding, too.
Bear in mind that the American Academy of Pediatrics does not recommend crib-sharing.
The authors of a proof of concept trial suggested that premature babies may be more likely to experience issues with sleep due to the medical procedures, handling, and noise associated with neonatal intensive care units.
Researchers found that clustered care and skin to skin contact promoted sleep in premature babies. Neonatal positioners were also found to improve sleep efficiency in premature babies with feeding difficulties.
My experience with sleep training
Our daughter's sleep got progressively worse from about six months of age. By this time, it was taking at least two or three hours for her to fall asleep at night, and she woke frequently during the night.
We decided to give sleep training a try. After researching a few different websites we decided that we would let our baby "cry it out." The first night was a disaster, with both my daughter and my wife ending up in tears. My wife found it too difficult to hear our daughter cry without going into the room to comfort her.
We decided that we couldn't follow such a method, so we went back to comforting our daughter to sleep. After a few weeks, this took its toll on everyone's health. My wife and I were exhausted, and our daughter who was usually so expressive and active would become increasingly quiet during the day and frequently "zoned out."
At this point, we knew we had to do something — even though we were still uncomfortable with the idea of letting our daughter cry.
We found the book The Happy Sleeper by Heather Turgeon and Julie Wright to be extremely helpful. One method advocated by the authors is to allow your baby five minutes of crying time before you enter the room. When you enter the room, you do so for only a few seconds so your baby knows he or she isn't alone. You are told not to physically comfort your baby, but instead, to say something like, "It's time for sleep. Mommy and daddy are just outside. We love you. Goodnight!"
The idea is to allow your baby time to self-soothe (something frequent interruptions can prevent).
After agreeing that we would commit to the methods promoted by Turgeon and Wright, we began.
The first night was the hardest. It took over two hours for our daughter to finally fall asleep (with one of us going into the room to reassure her every five minutes). She then woke shortly after midnight and took about two hours to fall back to sleep (again, with one of us entering the room for reassurance every five minutes).
The second night was much easier. Our daughter fell asleep in half the time and was awake for only a couple of hours during the night.
By the third night, she was falling asleep by herself within about an hour and spent about the same amount of time awake during the night.
The improvements continued at a rapid pace. By the end of the first week, she was falling asleep within about half an hour and was spending about that much time awake at night. After the first week, we only had to enter the room to verbally comfort our daughter once or twice each night.
The speed of the improvement in our daughter's sleep was remarkable. Yes, the first night was extremely difficult — but things got better. Within a couple of nights, our daughter was back to being full of energy and highly inquisitive during the day. Our entire family felt happier and healthier.
Responding to your infant's cues in the first few weeks of life can help reduce crying. However, after that point, a more structured routine can result in fewer nighttime awakenings and improved sleep — for everyone!
Martin is the creator of Insomnia Land’s free insomnia sleep training. His online course uses CBT techniques to teach participants how to sleep better without relying on sleeping pills. More than 5,000 insomniacs have completed his course and 97 percent of graduates say they would recommend it to a friend.