Reprinted with permission from Jossey- Bass.

 Q: My two week old will sleep only if he’s in our arms.

A: You shouldn’t worry too much about your baby’s independent sleep skills until he or she is about four months old. So if your newborn needs to be held or he will cry hysterically from 4:00 p.m. to 9:00 p.m., hold away. Just make sure you aren’t so exhausted that you are inadvertently falling asleep while holding him. As much as you love your baby, if you’re in a deep sleep while holding your baby, it’s hard to be safe. Accidents happen all the time to loving parents, so do your best to safeguard against them.

Q: My baby is up all night and asleep all day. When do they grow out of this?

A: Babies do not produce melatonin the first six weeks or so of life. This is why day and night confusion is very normal among newborns, and there’s not a whole lot you can do to change it. After six weeks of age, however, you can start to communicate that daytime is for fun and nighttime is for sleep. First, take your baby out of the house for at least an hour each day. New experiences and fresh air are stimulating. Sunlight also helps reset babies’ sleep clocks. Second, make sure nighttime is extremely boring for your child. That means only basic interaction at times they should be sleeping. Even whispering to your baby can be an invitation to play.

Q: Is cosleeping safe?

A: The American Academy of Pediatrics recommends parents not sleep with infants in an adult bed, stating that the practice puts babies at risk of suffocation and strangulation. If you want your baby very close at night, cosleeper bassinets (bassinets that attach safely to the side of an adult bed) are an option for families interested in cosleeping during the first few months. We know that many people do decide to cosleep on a permanent basis. If you choose to share your bed with your baby, make sure to follow these safety precautions:

•            Always place your baby on her back.

•            Make sure your bed’s headboard and footboard don’t have openings or cutouts that could trap your baby’s head.

•            Don’t place a baby to sleep in an adult bed alone.

•            Don’t use pillows, comforters, quilts, and other soft or plush items on the bed.

•            Don’t drink alcohol or use medications or drugs that may keep you from waking and may cause you to roll over and accidentally harm your baby.

Q: How do I know when to stop swaddling?

A: Keeping a child swaddled for too long can start to be uncomfortable and may affect physical development. The optimal time to stop swaddling is between two and four months. At this point the Moro reflex (newborns’ instinctive startle) has started to wane. When parents stop swaddling their children, they’re often astonished to see how much they travel around their crib while they sleep. They move and flop from one end to the other several times a night. Babies may look peaceful when they sleep, but don’t be fooled: they’re actually doing important exercise while they slumber. A swaddled baby doesn’t have a chance to refine these skills at night.

 Q: When should I move my baby from a bassinet to a crib? From a crib to a bed?

A: There’s no perfect time to move your child to a crib for sleep. Some children sleep exclusively in their crib from the start, and that’s just fine. However, many parents keep their children in a bassinet or cosleeper at night because it makes nighttime feedings easier to manage. Most children start to grow out of bassinets around three to four months of age, so that is often a natural transition point for many families. When you’re ready to make the move, try acclimating your baby to the crib first. Try having him nap once or twice a day there before you make it his full-time sleeping space. The best age for moving to a bed is around three years of age. Before that, children are very impulse driven and will have a hard time staying in their room if they are prone to problematic night wakings.

 Q: Why doesn’t my two-month-old baby sleep more than twenty minutes at a time?

A: If your baby is under eight to ten weeks and still cat napping all the time, don’t worry. Short bursts of sleep at irregular intervals are normal at this age. Sleep will start to consolidate soon. After two months, you should aim for naps to be between forty-five and ninety minutes. If your little one is sleeping less than that, we have two recommendations. First, space naps an hour and a half to two hours apart to avoid letting your baby get overly tired and make the act of falling and staying asleep even more of a challenge. Second, make sure the nursery is sleep friendly: dark, between sixty-eight and seventy- two degrees, distraction free, and equipped with some white noise.

Q: Will a baby grow out of sleep issues?

A: Much like eating well, sleeping well is a skill that people hone and practice over a lifetime. We can’t tell you how many people jokingly ask when we are going to start working with adults. The truth is, 40 percent of babies who have problematic night wakings at eight months of age still have sleep issues at four years of age. Those aren’t great odds. Even if your child may outgrow poor sleep habits later, we think giving your baby the opportunity to be the best that she can be from the beginning is a true gift.

Q: At what age is it okay to start a schedule?

A: If you like schedules and thrive on having order to your day, you can start a loose schedule after eight weeks of age. (See our suggested schedule for two to four month olds in Chapter Five.) Just remember that many babies under four months still need a feeding or two at night. If your baby needs a feeding, feed him when he rouses and then try to put him back down as soon as he is finished. Also, if you do start a schedule early, try to have realistic expectations. Your child may not be able to conform to your ideal schedule every day, especially when you introduce it. However, by four months of age, children have more mature sleep cycles and are big enough to consume enough calories during the daytime, so they can follow a regular eating and feeding schedule.

Q: I don’t think I can wait until my baby is four months old to get sleep. How can I cope?

A: There are some parents who are desperate for sleep after just a few weeks home with a newborn. There’s not much you can do to teach your baby sleeping skills this early, but you can help yourself. Perhaps you can hire a night nurse or rely on family members to pull an occasional night shift. If you feel depressed or if your baby is starting to lose weight because she’s so tired, make an appointment with your respective doctors before working on sleep teaching. Sleep teaching before sixteen weeks of age is frequently an uphill battle, so we don’t usually recommend it. In terms of dealing with sleep deprivation, try to sleep whenever your baby does. We know it’s hard to do that with everything else in your life you need to attend to, but it’s very important for you to rest. This is easier said than done if you’re relying on caffeine (we hazily recall hourly coffee breaks from 6:00 a.m. to 3:00 p.m. with our first kids), so our advice is to do everything you can to protect the first three hours of your nighttime sleep. This is when you’re in your deepest, most restorative sleep. If you can find a few nights a week for uninterrupted deep sleep, your days will be much more enjoyable. Because sleep deprivation is related to postpartum depression and feelings of despair, avoiding a buildup of serious sleep loss is important.

 Q: Our baby used to go to sleep easily, but now he wakes every hour or two, sometimes to be fed and sometimes to just be held.

A: This is very common, especially in children who are three to four months old. Your child is most likely experiencing a wakeful period. This period is associated with sleep regression because it’s when children become much more aware of their surroundings and their connection to others. Increased curiosity and attachment to parents can cause sleep challenges to start cropping up, especially at bedtime. One way you can help your child though this period is by practicing short bursts of separation during the day (making sure the child is safe when you do). This shows babies that parents leave but always come back. It’s also helpful to remember that development is not linear when it comes to babies and children. It looks more like a stock market chart than a straight line up a hill. They can have several great days or months of progress and then stumble a little. This is totally normal. It’s our job as parents to maintain awareness of all the outside factors, like consistent response, consistent environment, and consistent schedule; remain supportive; and make sure the baby is not in pain or sick. By sticking to what you can control during the times that seem out of control, you’ll help these periods be less disruptive. And when it’s over, your baby will go back to sleeping like an angel.

 Q: Should I ever wake a sleeping baby?

A: Yes! Particularly if it’s the last nap of the day and bedtime is only a few hours away. A child who takes a four-hour nap in the afternoon most likely will have a hard time falling asleep at bedtime. Our sleep schedules provide you some flexibility in allowing your child to get some extra sleep if she needs it, but not too much that it starts to disrupt her nighttime schedule.

Q: Wouldn’t it be best to use my sleep logs to find the bedtime that mirrors when my baby is the most tired? I don’t want to mess with her naturally established sleep rhythms.

A: Bedtime is something parents should choose. If your life has felt a bit helter-skelter lately, we’re guessing it feels liberating to be in control of something. Pick a bedtime between 6:00 and 8:00 p.m., and try to stick to it for the long term. Don’t worry about your baby’s current sleep patterns. If your baby goes to bed at mid- night, it’s okay to jump to this earlier bedtime (say, 7:30 p.m.) in one day. Our sleep teaching plan will help you time your day so your baby is ready for bed at the time you choose.

 Q: Won’t my milk supply decrease if my baby goes eleven to twelve hours without a feeding at night?

A: Many breast-feeding moms don’t realize that their milk supply decreases when they are exhausted and that getting more sleep can help boost supply. Once you start sleep teaching, you should not need to wake up in the middle of the night to pump. If your baby is sleeping at night, then you should too. However, it’s a good idea to help communicate to your body that it should keep milk production up even when you are off the clock, so to speak. Assuming you nurse your child before you put her to sleep, it’s helpful to pump twice before bed: once immediately after you put your baby to sleep and then one last time before you go to sleep for the night. In the morning, your breasts will feel very full—which is great, because your baby is hungry and primed for a big feed. If you are still full after this feeding, pump again to completely empty each breast. Expect a few odd days as your body adjusts. But doing these extra pumpings will keep your supply up and recalibrate your production for daytime feedings.

Q: My baby is eight months old and only fifteen pounds. If I eliminate my nighttime feed I’m afraid she’ll lose weight.

A: By four months, almost all full-term healthy babies can go eleven to twelve hours at night without a feeding. A good measure of health is your baby’s ability to maintain her own growth curve—be that at the ninety-fifth, fiftieth, or tenth percentile. Also, at this age, a child should be eating three meals of solids as a complement to her daily milk feedings. Given all of this, it’s incredibly unlikely that she truly needs to eat at night. She may be accustomed to eating, but it’s not a requirement. It will actually serve her well to stop the feedings so both your body and her digestive system can get some rest at night. If you are still concerned, give yourself some peace of mind: check with your child’s doctor and confirm that you can drop night- time feedings. Our guess is that once she stops waking to eat, she will be better rested and will be able to eat more throughout the day. When you do drop nighttime feeds, expect some protesting. And honestly, who can blame her? If someone was willing to come to our bedside and give us a little bowl of mint chip ice cream during the night, we could probably get used to it pretty quickly. And although we don’t need it, we’d probably put up a fight if it were taken away.

Q: We live in an apartment complex where the walls are like paper. How can we sleep-teach?

A: First, try to start sleep teaching on a Friday because most people won’t have work the next day. Then make the rounds on your floor. Tell your neighbors about your plan to sleep-teach. Give them the details about when you are starting, and explain that they may hear a few nights of protesting. You may want to sweeten the deal by bringing over a bottle of wine or some freshly baked cookies. Everyone will understand, especially when they see how exhausted you are.

Q: I want to teach my baby to sleep, but my partner is very against crying of any sort. What can I do?

A: We strongly recommend you and your partner talk out your differences before you attempt any sleep teaching. Sensitivity to crying is often about something else, and talking about our feelings is productive. If you attempt sleep teaching without the support of your partner, it’ll not only be much more difficult for you, but your child will be affected because at some point your partner will be left in charge of your child and may respond differently than you would. An inconsistent response is incredibly frustrating to children because they never know what others want from them.

 Q: When can I sleep-teach my preemie? She was born six weeks early.

A: If your baby was born more than two weeks premature but is otherwise healthy and thriving, you can still follow our sleep advice. However, you’ll need to adjust your child’s age so it is gestationally correct. Therefore, your child will need to be five and a half months (four months plus a six-week gestational correction) before we recommend starting any sort of sleep teaching. As always, before you start sleep teaching, check with your child’s pediatrician to confirm that there is no reason that your baby shouldn’t be able to sleep through the night.

Q: Can I sleep-teach if my baby has a gastrointestinal issue such as acid reflux or a milk intolerance?

A: Yes—if your baby is being treated by a physician. Sleep teaching will be an uphill battle if your child has a digestive condition that is not being managed. If you suspect your child has a GI or reflux issue, you should speak to her pediatrician. Signs your child may have acid reflux include crankiness when lying flat on her back,

 Q: How can I sleep-teach when my kids share a room?

A: We do not recommend having a child who isn’t sleeping through the night in the same room as another child. Instead, it’s best for your baby to share your sleeping space. When you do decide to sleep-teach your baby, it is best to give your sleep learner his own space in which to learn. Sometimes parents transform an office into a temporary nursery or move out of their room into the living room and keep the baby in their room for the first few nights. Whatever you decide, make arrangements that you can live with for an extended period of time. Every baby learns at a different pace. Once your baby is sleeping well and you decide to move the children into the same room, it’s helpful to get something to separate them when sleep is supposed to be happening. We like a curtain on a ceiling track. That way you don’t have to worry about it falling over, and during the daytime it can be easily pulled back to open up the space.

 Q: Is our two year old too old for sleep teaching?

A: It’s never too late to teach your child how to sleep in a new way. That said, toddlers and preschoolers can be a bit more resistant to change and are more skilled in the area of parental manipulation. If you find your toddler really resisting sleep teaching, ensure that your daytime parenting matches your new nighttime parenting rules. What we mean is if at night, no means no and you are firm about her sleeping independently, make sure you follow the same protocol during the day. Some parents feel bad for being strict at night, so they compensate by caving during the day and letting their kids call all the shots. Inconsistent parents confuse children. As a result, many children hold on to the hope that they can call the shots at night too if they protest loudly or long enough.

Q: When is the best day to start sleep teaching?

A: Start sleep teaching only when you can commit to having your baby sleep in her crib (or a consistent place, like her crib at day care) for all naps and nighttime sleep for two weeks straight. This means not traveling anywhere during those two weeks. Generally we suggest starting on a Thursday or Friday night since the first few days of sleep teaching may be physically and emotionally trying. Many working families take the next day off so they can spend the day with their baby. That way, most spouses are home during the weekend and the parents can provide their children with ample support during waking hours.

 Q: How long will sleep teaching take to work? My son still cries at naptime.

A: Learning to sleep independently is a skill, and all children learn at different paces. Your child will be learning new skills every day during the initial two weeks of sleep teaching. Some children make a lot of quick improvement, but after a few days of consistency, they catch on to your attempt to take over and might resist longer than others. Whether you have a sensitive sleeper or a more willful child, your baby will get through all the important lessons if you keep believing in him and sticking to a consistent schedule. After two weeks, you can start to experiment with more flexibility. However, the fewer things you change, the easier his life will be for him in the long run. It can be disheartening for parents when children resist or struggle longer than others, but no baby is a lost cause when it comes to sleep. Healthy sleep (both daytime and nighttime) is the foundation for emotional and cognitive well-being. Any short- term frustration will be paid back in the grand scheme of your child’s life. Keeping the big picture in mind is best for everyone.

Q: Won’t it make me seem like a bad parent if I just listen to my baby cry?

A: No one enjoys hearing a child cry, especially your own. We’re certainly not immune to crying when it comes to our kids. But if you have set your child up for sleep teaching success with our prework, then you can be confident that your child is only frustrated by the change—especially if you have just started sleep teaching. Sometimes parents have to set limits and make unpopular choices when it is in their children’s best interest. But once your child succeeds and discovers you were right, his trust in you and your respect for him multiply. We think you should feel good about that!

 Q: Will crying hurt my child?

A: It’s very rare for a baby to learn to sleep through the night without shedding some tears. Most mothers (including us) completely melt when their own children cry. That’s because we are biologically programmed to respond this way. When you feel the urge to rescue your crying baby, run through your checklist. If nothing obvious is going on (sick, hurt, hungry, poopy diaper), it’s helpful to remember that crying is a baby’s only way of communicating for the first year or so of life. And remember too that babies don’t always want or need your help when they cry. They could be dreaming, letting off some steam, or simply expressing frustration about something. If you run in and rescue your baby for being frustrated or letting off steam, you communicate that she always needs your help when she feels this way. However, if you give your baby a little space, she may find she can help herself sometimes. Studies have conclusively shown the positive effects of good sleep on mood, intelligence, and family well-being. As long as you give your child ample attention and love throughout the day, it will not harm your child to let her be frustrated at bedtime.

 Q: My child is a great night sleeper but doesn’t nap. What’s going on?

A: If your child used to be a good napper but now is not, she may just be testing limits or asking for more control in her life. Sometimes, however, children are naturally very good at sleeping during the night because this is when their circadian rhythm is set to sleep for the longest period. If your baby has trouble napping, chances are that she has some negative sleep associations. Although these associations aren’t preventing her from getting nighttime sleep, chances are they will crop up at night at some point. The best way to fix the nap is by looking at the full twenty-four-hour sleep picture. Start by removing any negative sleep associations at night sleep so that she has practice sleeping in this new way during a time when it is easier for her to sleep.

 Q: How do you know when it’s time to drop a nap?

A: You’ll know that your baby is ready to drop this nap when she begins resisting it day after day for at least a week straight, without any extenuating circumstances (illness, life transition, mile- stone). This typically occurs after the one-year mark, but be careful not to jump the gun. A few days of nap resistance isn’t a clear indication that it’s time to change things.

 Q: My child is used to going to bed at 11:00 p.m. How can I make my child’s bedtime earlier?

A: The best fix for little night owls is to use daytime naps to your advantage. If you can establish a consistent, age-appropriate nap schedule, you can prime your baby for the bedtime you want him to have. Remember that babies don’t always know best. They often need you to guide them to what’s best for them. Children between four and six months should be awake for the three hours leading up to bedtime. Those over six months should be awake for approximately four hours leading up to bedtime. Their bodies will adjust to a new schedule if you are consistent. If your baby is not accustomed to being awake for three to four hours in the evening, prepare yourself. It may be hard keeping him awake until bedtime for the first few days, but he will adjust.

 Q: How can I get my child to sleep past 5:00 a.m.?

A: Early morning wakings can be very difficult for both children and parents. The good news is that most children who seem to be early risers really do want to go back to sleep. They just need someone to give them space to learn how to do it. When you’re ready to teach your child to do this, follow all the steps in our sleep teaching chapters and start teaching at bedtime. That way, your child will have all the tools she needs at 5:00 a.m. when she rouses and needs to go back to sleep on her own. If you’ve already done sleep teaching, remember that lighter sleep takes place in the last few hours of nighttime sleep, so children awaken more easily. For that reason, it’s a good idea to prevent outside distracters from sending a signal that the day has started. We suggest installing thick room-darkening shades and using white noise to help keep it looking and sounding like sleep time.

Q: My child snores. Is this normal?

A: It depends. Snoring can be normal and is often associated with temporary illnesses like colds. In cases where snoring is persistent, severe, or associated with irregular gasps, it may be a sign of allergies or an even more serious condition like sleep apnea. Adding an air purifier may help snoring due to allergies. But if you suspect sleep apnea, consult with your pediatrician immediately.

Q: My baby used to sleep through the night but has begun waking several times. When I go into his room, all I have to do is rub his back and he falls back to sleep. What’s going on?

A: It sounds as if your baby may be experiencing the beginning of separation anxiety. Some parents are frustrated when this stage happens, but it’s normal and a healthy part of your child’s development. It means your baby has the cognitive ability to understand that you exist even when he can’t see you. Your baby will eventually become more comfortable with his newfound awareness. In the meantime, stop the back rubbing at night (which is a negative sleep association) and instead help your child by giving him opportunities to practice separating from you during the day (even for a minute) and find a way to separate from your child each week even if it’s only for an hour or so. Pick a consistent time each week, and make sure your child sees you getting ready to leave your home. He may protest at first, but resist the temptation to sneak out. In fact, involve him in the process of leaving. As you put on your coat, be upbeat and say something like, “Mommy is leaving, but she’ll be back soon!”

Q: I have twins. One sleeps through the night, while the other wakes up to eat. How do I get them in sync?

A: Just because your children shared a womb for the better part of a year does not mean they will be instantly compatible room- mates once they arrive. Twins can be as different as night and day. That said, many parents want twins to be on the same schedule and share a room. We recommend that you do put them on the same eating and sleeping schedule because it will make your life much more manageable. In terms of sharing a room, it’s easiest for you to teach them how to be independent sleepers in separate rooms. So for sleep teaching, separate them for a week or so. Once they’re both sleeping, move them back in the room together but in separate cribs.