What a sleep doctor (and dad) wishes more parents knew about baby sleep


When it comes to baby sleep, we could all use a little expert guidance, which is why we reached out to Dr. Craig Canapari, M.D., author of It’s Never Too Late to Sleep Train and the director of the Yale Pediatric Sleep Center. Here’s what he wishes more parents knew about baby sleep. (Some answers have been edited for length and clarity.)

Q: Thank you so much for joining us. What advice do you have for parents on navigating the near-constant sleep changes that occur from infancy through 12 months of life?

Well, the beginning, as anyone who’s had an infant knows, is fairly chaotic. Babies don’t really evolve their circadian schedule till 6 to 8 weeks of age, so it’s common for babies to be asleep during the day and awake at night, and it can feel like things are totally out of control. 

But we do know there’s a natural rhythm to infant sleep, even within the first few weeks of life, where babies will wake up, cry, feed, and then go back to sleep. The length of this cycle is anywhere from one and a half to three hours. 

After two months of age, you’ll start to see the emergence of longer sleep periods at night, and longer periods of wakefulness during the day. By four to six months of age, the majority of infants are finally sleeping through the night — though not all of them. Breastfed infants, especially, may wake up for one to two feeds up to around 9 months of age.

For parents, what you can do from the very beginning is make sure your baby gets natural light exposure in the first couple of months, to help them begin to distinguish between daytime and nighttime. And make sure you have a simple bedtime routine.

Q. That was one of my favorite parts of your book because I had a very complex routine with my firstborn and have since adapted.

A good bedtime routine doesn’t have to be complicated. With my first kid, both my wife and I were involved, and it was this elaborate thing, which involved singing songs and reading stories, rubbing lotion on his body… By the second kid, bedtime was a much shorter routine. You want a simple routine that one parent can do in a pinch, because the other parent may need to rest or do something else around the house.  

It’s actually really important that any adult in the house is able to help with bedtime. It’s especially important that nursing moms get a break. If you establish from a very early age that all adults in the house know how to do bedtime, then you’re able to alternate. 

So I especially encourage the dads out there to roll up your sleeves, give the bath, do the bedtime — you’ll be okay.

Q. What are some other common misconceptions about sleep that can hurt parents?

I think there’s a lot of them. One thing that’s important for parents to understand is there really is a large, natural range of how much kids need to sleep. First-time parents may make comparisons between their child’s sleep and their friends’ children’s sleep.

But the amount of sleep that each child needs is also quite variable. A child’s natural sleep requirements for the first several months of life range from 15 to 20 hours, but it can be as low as 12 hours. And for those parents whose child’s natural sleep needs are around 12 hours — I guarantee you, those 12 hours are not happening in a row. So naps may be more difficult, the middle of the night may be more difficult, or bedtime may be a little bit later. 

It really just takes some trial and error to figure out. What is the bedtime that works for your child? How long do you expect them to sleep at night? How long realistically do you expect them to nap during the day? 

I think other misconceptions parents have fall under the umbrella of a term we call sleep training. The first misconception is that sleep training just means cry it out, or extinction. [Extinction] is an evidence-based method for sleep training, but it isn’t the only one. And some parents can tolerate crying more than others.

The other misconception is this idea that crying is dangerous to children. Because the fact is, children cry all the time. If your child is old enough, is well-fed, and you’re interested in sleep training, there may be a little bit of crying. But I think there’s a lot of misinformation out there that this actually is dangerous or can cause brain damage. 

The crying is done in two to three nights. It’s really less than an hour in the first night, 20 minutes in the second night on average, and usually minimal after that. 

I think that it’s important that everybody in the house sleeps well. Parents and children alike.

Q. What do you wish more parents knew as a world-class pediatric sleep expert who has studied the impact of sleep on mental and physical health?

I want to give parents permission to think of their own sleep as important as well. It’s totally natural to want to do everything you can to give your child the best chance of success. But if you’re struggling with getting enough sleep, you will not be able to be the parent that you want to be.

You’re going to be irritable, you’re going to be short with the people that you love — your children, your family members. It’s okay to try to find a balance between your child’s sleep and your own sleep. 

Even with pretty fragmented sleep, kids tend to be okay — they’ll make it up during the day with sleep in the stroller or the car. Whereas as a parent, you’ve got to be able to drive safely to the grocery store, do your job, give a presentation… 

Fixing these issues is a priority. And really, everybody in the household needs to be sleeping well. Not just baby.

Q. In your book, you talk about the commandments of sleep success in the first year of baby’s life. What are some of them?

  1. Start your bedtime routine when you bring your kid home from the hospital.
    If your kid’s four months old, and you don’t have a bedtime routine, it’s a great time to start now.

  2. If you breastfeed, teach your child to take a bottle once nursing is established.
    Like all pediatricians, I’m a huge fan of breastfeeding. There are a lot of great biological benefits to nursing your child. But once your milk supply is established, and you feel like you’re skilled at nursing, it’s helpful if your child is also able to take a bottle.

    In the middle of the night, it is perfectly reasonable to ask another family member to give your child a bottle of formula or expressed breast milk — again, not making recommendations about what you feed your child; that’s between you and your pediatrician.

    But I think it’s very helpful for tired nursing moms to be able to say to someone else in the home, “The baby’s crying, I’m exhausted, can you take this feeding?”

  3. Make sure your bedtime routine is simple enough that any adult in the house can do it.
  1. Encourage all adults in the household to participate in bedtime.
    A couple of generations ago, people lived in multi-generational households, and new parenthood was easier if the grandparents or aunts or uncles were in the house.

    Nowadays, we don’t necessarily live close to our family members. But if there are family members in the home and they’re willing and able, it’s a great experience for the child and for them to be able to be a part of bedtime.
  1. Start to put your baby to bed drowsy but awake between ages 3 to 4 months.
    Sometimes if you do this, your child will actually surprise you and fall asleep independently. At three months of age if you put them down and they fuss a lot, it’s okay to leave the room and let them fuss a little bit.

    But if they don’t fall asleep within 10 or 15 minutes, I think it’s okay to say, You know what, let’s revisit this in a week or two, because your child is maturing rapidly at this point.

    You might find if you’re testing the waters once in a while by putting them to bed drowsy but awake, all of a sudden, they’re ready to do it. And if you capture that interval when all of a sudden they’re able to do this, often, you don’t need to worry about sleep training.

  2. You don’t need to sprint Into your baby’s room at the first sign of waking.
    Our instinct when we’re tired is to rush into our kids’ rooms and soothe them right back to sleep. But once they get to 3 or 4 months of age, if you wait a little bit, they might just fall back asleep.

    It’s natural for them to awaken, but don’t just rush right in there. If you do, you might actually train them to expect mom or dad when they have these natural biological awakenings. So just wait a little bit.
  1. Sleep at home, as much as you can.
    For the first six months, napping on the go is fine, but after that, try to have your baby nap at home. You really want to have your kid learn to be able to sleep in their own sleeping environment.
  1. Respect the nap.
    Naps are difficult, especially in the first year of life. Your naptime ritual should look like your bedtime ritual, but short — think five to 10 minutes. Pretty rapidly in the first year of life, your kid is going to go from taking four naps to three naps, and then to two naps around 15 months of age, and then one nap at some point after that.

    So it’s always going to feel like a challenge to parents. So respect the nap. Find a nap time that works, stick with it, and most days try to be home for that daytime sleep. 

Q. Do you have a reassuring message for expectant parents who are worried that they’ll never sleep again?

Every parent worries about sleep. And the fact is, you’re going to do fine. There are people around you that care that will help you. Your child’s pediatrician will help you — you’re not doing this by yourself, although sometimes it feels like that in the middle of the night.

So don’t be afraid to ask for help. Ask your pediatrician. Ask your family members. Ask a friend who can watch your baby so you can have 30 minutes to yourself during the day. You will do just fine, your child will learn to sleep, and you will look back fondly on this time, as crazy as that seems, when your children are older. So it’s really going to be okay.

Whether your kid is 6 months old or 6 years, if you’re struggling with your child’s sleep, there are things you can do about it — don’t give up.

Q. If you could give a TED Talk to shed light on a topic related to new parents’ sleep that doesn’t get enough attention, what would it be?

There’s so many different ways to be successful with your child’s sleep. The fact is, babies learn so quickly. When you think about the ways that families live all over the world, in different countries and in different settings — very different from yours or mine — and they raise successful, healthy children. You can do that too.

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Meet the Author

Dr. Craig Canapari, M.D., is a multifaceted sleep physician, Director of the Yale Pediatric Center, author, and dad, with 16 years of experience; whose passion lies in helping families get better sleep. 


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