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Nurses urged to discuss baby sleeping patterns with new parents

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Practice nurses and health visitors are ideally placed to help parents understand what “normal” sleep patterns are for their child, according to US researchers.

Most parents are not surprised by the irregularity of a newborn infant’s sleep patterns, noted the researchers.

But by six months or so many parents wonder if something is wrong with their baby or their sleeping arrangements if it is not sleeping through the night, they wrote in the Journal of the American Association of Nurse Practitioners.

“I worry about parents who feel like they can’t trust their own instincts”

Robin Yaure

Study author Robin Yaure, senior instructor of human development and family studies at Pennsylvania State University, said nurses could help parents “understand that ‘sleeping through the night’ is not entirely likely in young infants and that infants’ sleep patterns change during the first few years of life”.

According to her research, there are four common areas of concern for both parents and practitioners.

These are what constitutes “normal” infant sleep and waking patterns, whether night-wakings are a problem or not, is a parent’s presence disruptive when an infant is falling asleep, and whether sleep training is safe and healthy for infants.

Sleep training is one way to establish a sleep routine for a child, although the methods used may not be appealing to parents or in the best interests of the child, noted the researchers.

Dr Yaure and colleagues reviewed current research on infant sleep, focusing on the four areas of concern, and specifically infant safety and the wellbeing of both infant and mother during the night.

They suggest how to best integrate parents’ preferences for care and best practice information, and include conversation points for nurses.

Infants’ sleep patterns vary for at least the first three years of life, they added. There are many reasons for this, including changes in infant health and mobility and separation anxiety.

“Sharing this basic information with parents is one way of assuring parents that infants’ waking does not necessarily mean that the parents are doing something wrong,” the researchers wrote.

Parent presence at bedtime, sleep training and infant self-settling are frequently debated topics about which parents might look to healthcare professionals for advice, they said.

Dr Yaure highlighted recent research suggesting that the presence of parents at bedtime, specifically during the transition to sleep, may not trigger night-wakings, contrary to previous thinking.

The researchers also highlighted recent research on the non-responsiveness of mothers during night-time care, which suggested it could raise stress for both parent and baby.

“I worry about parents who feel like they can’t trust their own instincts,” said Dr Yaure. “Different parents have different goals and ideas for parenting, and we want parents to figure out how to incorporate best practices into their belief system.

“We have to be culturally aware and sensitive to different families and beliefs,” she said.

By encouraging nurses to talk about current knowledge on infant night-wakings and parental presence, among other things, Dr Yaure said he hoped that parents would become more comfortable and confident with their night-time care choices.

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Readers' comments (2)

  • Surely if parents have unrealistic perceptions of how long a baby should sleep overnight without waking, then perhaps realistic child development should be incorporated into health education classes at school for all teenagers.

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  • As a Practice Nurse with very little recent official paed experience, (although I am paed trained, many PN's aren't) I feel Midwives and HV's would be better groups to offer this sort of advice both antenatally and perinatally.

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