Many babies don’t sleep through the night, and it’s OK

November 29, 2018

Parents might expect babies to start sleeping through the night by around 6 months old to a year.

As many bleary-eyed adults can attest, that notion often doesn’t match reality. Now, a new study has found that yes, many babies up to 12 months don’t sleep uninterrupted at night, and it’s OK as far as an infant’s development.

Researchers from Montreal’s McGill University said in the study published for the December issue of Pediatrics that despite finding a large percentage of healthy babies in the study didn’t sleep solidly for six to eight hours nightly, they found no adverse health impacts on babies.

“The things that stuck out to me were they specifically talked about development not being affected, which I would agree,” said Dr. Sarah d’Hulst, a Spokane pediatrician with MultiCare Rockwood.

“We (pediatricians) intuitively felt that was true. Between my frequent wakers and my babies who sleep through the night, I don’t see a significant difference in the babies’ development. I see a significant difference in the tears of their mothers, but not in the babies’ development.”

At 6 and 12 months of age, maternal reports were used for the study to assess the longest period of uninterrupted infant sleep, along with the babies’ feeding methods. The study considered babies’ mental and motor development based on common screening guidelines.

The study found that nearly 28 percent to 57 percent of 6- and 12-month-old infants didn’t sleep through the night.

The McGill researchers also reported finding no apparent correlation between infants waking up frequently at night and their mothers’ postnatal mood. They did report that babies who didn’t sleep for six or eight consecutive hours had a significantly higher rate of breastfeeding, which offers many health benefits for babies and mothers, researchers said.

Regarding that interrupted sleep and mothers’ moods, however, d’Hulst questioned that the study seemed to look only at depression. It measured moms’ moods using a depression scale, she said, but d’Hulst thinks a better focus would be on the impacts from maternal exhaustion.

“I see many times where moms, especially breastfeeding moms, are getting up every hour and half all night long, every night, for six months to a year, and they’re exhausted,” d’Hulst said. “They are tearful, have difficulty concentrating, difficulty staying awake behind the wheel. That’s what I see.

“I had four children in five years, and I was exhausted. I remember walking into my daughter’s room in tears because she needed to be fed, but I wasn’t depressed; I was exhausted. I would have come up as normal in their study. I don’t think baby not sleeping is a cause of depression.”

Sleep patterns

The study’s nightly sleeping pattern was defined as either six or eight hours of sleep without waking up. Sleep measures were available for 388 infants at 6 months old, and 369 babies at 1 year.

For babies at six months, mothers participating in the study reported 38 percent of typically developing infants were not yet sleeping at least six consecutive hours a night. More than half, at 57 percent, weren’t sleeping eight hours.

At 12 months, 28 percent of infants weren’t yet sleeping six hours straight at night, and 43 percent weren’t staying asleep eight hours.

Researchers saw a difference between sleep patterns of boys and girls. At 6 months of age, a higher percentage of girls than boys slept for eight hours straight, at 48 percent versus 39 percent.

“Our findings suggest parents might benefit from more education about the normal development of, and wide variability in, infants’ sleep-wake cycles, instead of only focusing on methods and interventions,” said lead researcher Marie-Helene Pennestri in a press release.

Sleeping through the night somewhere between ages 6 to 12 months generally is considered “the gold standard” in Western nations, but the study should ease some parental worries, Pennestri said.

Participants were recruited from obstetric clinics in Montreal and Hamilton, Ontario.

Researchers acknowledged that sleep for children past infancy plays a fundamental role in child development, and that during childhood, a lack of sleep for a duration of time each night is associated with both physical and mental health problems.

Pediatrician input

The American Academy of Pediatrics in 2016 released a new policy that infants should sleep in the same bedroom as their parents for at least the first six months – but on a separate surface such as a crib or bassinet, and never on a soft surface – to decrease the risks of sleep-related deaths.

The group recommends breastfeeding as adding protection against sudden infant death syndrome. After feeding, the AAP encourages parents to place the baby on his or her back in a separate sleeping space with a tight-fitted sheet but without blankets, pillows or stuffed animals that might obstruct breathing.

The AAP recommends that doctors have open and nonjudgmental conversations with families about their sleep practices. In her office, d’Hulst said the question on when to expect a baby to start sleeping through the night comes up almost daily.

“When I ask about sleep, I usually ask how long does your baby typically sleep at night?” she said. “I don’t usually ask if their baby is sleeping through the night until they are a year old, and if the answer is an hour and half of sleeping, I try to assess how exhausted mom is.”

A discussion with parents regarding a full night’s rest is typically more appropriate when a baby is 12 months old, d’Hulst said. That’s because around that time an infant is eating more solid foods, usually has a set routine and is becoming better at sleeping.

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