Be sure to talk to your child’s doctor about any medical, physical or teething concerns; this blog is not intended to be medical advice.
Illness, medication and teething can make it very hard for you to know what your expectations should (or shouldn’t) be of your child. And, because sleep is so important to immune function and healing, it’s important your baby stay rested, especially during times of illness. We work with many parents who think their baby has a really terrible sleep problem, when in fact the child has an underlying medical issue that NO AMOUNT of sleep training will solve! Parents and pediatricians can help identify when to expect independent, consolidated sleep, and when to put that independence on the back-burner while managing something medical.
Before starting any sleep training, make sure your child’s sleep problems are about a sleep association and NOT about something medical. How? Assess the pattern of her wake ups AND her physical symptoms with the help of your child’s doctor. Sleep association wake ups tend to be at fairly predictable times-often at bedtime and then, after a long stretch of sleep, every 60-90 mins overnight. Wakeups due to pain or illness tend to be much more erratic and random (ex: every 10 minutes, or at times that are not usual for your baby).
Some children have one severe illness after another and others have months of GI issues to work through. Although frustrating, if your child is frequently sick, or struggles with severe reflux, chronic ear infections or eczema flare ups, you may have a harder time when it comes to sleep than some new parents. You may find it helpful to know when to just accept the stage your child is in and keep her rested in whatever (safe) way you can, and when to raise your expectations when it comes to improving and consolidating sleep. Here are some common sleep disruptors and some basic tips on how to handle them:
The Science: Reflux is common, and often quite controllable with diet and medication. Reflux can also be very painful and uncomfortable for some small babies. Most babies experiencing reflux are too young to begin any formal sleep training.
The Sleep: Babies who have reflux can be great sleepers with time but, only when their symptoms are under control. Reflux is very challenging for parents who find themselves second guessing if their child is in pain. Use your parent intuition, listen to your baby’s cry, and when in doubt – comfort your baby with extra soothing! When pain is under control and if your baby is old enough, you may resume or begin a sleep training strategy to work on any habits that may have popped up during the days and weeks your baby’s reflux was still acting up. Good sleep patterns, age appropriate schedules, and environments should still be practiced even for babies with reflux.
Baby Sleep Science Sleep Tips: Work with a GI specialist who can closely follow your baby’s growth and weight gain and titrate doses of medication as your baby grows (quickly!).
The Science: If symptoms are acute, requiring active intervention by you to keep your baby comfortable (think: sitting in a steamy bathroom, holding your baby upright to ease congestion, frequent and persistent coughing, frequent nasal aspirating and nasal saline to clear small passages, etc) your baby is probably too sick to have high sleep expectations. If your baby has mild sniffles, clear runny nose, or mild occasional coughing with no apparent distress or pain, typical sleep patterns may still be expected.
The Sleep: For acute illness, pause your sleep intervention, treat or medicate your baby as directed by her doctor, keep her rested, and resume your plan when she’s feeling better. If possible, try to hold steady in any progress you already made with your sleep plan. If your baby’s symptoms are mild, continue with your plan as usual. If at any point symptoms change (even in the middle of the night) and become more acute, stop your plan and resume when she’s better.
Baby Sleep Science Sleep Tips: keep your baby hydrated, use nasal saline to keep nasal passages moist, and a cool mist humidifier.
The Science: Pain of any type (whether due to uncontrolled reflux, acute teething, illness, surgery, or injury) and fevers associated with discomfort (usually above 100 F) should be considered sleep disruptors.
The Sleep: Although the timing might not be ideal, if your baby has pain or fever, plan to pause in any sleep intervention you had begun, and give your baby the soothing, comfort, and treatments she needs to feel comfortable. Sleep is good for immune function and healing so keep your baby rested through pain or fever even if it means doing more than your usual amount of soothing. When the pain or fever has resolved, you may resume your sleep intervention. You may be able to pick up where you left off or, if the illness went on for several days and you picked up new sleep associations, you may have to start from scratch.