After graduating from the University of Sydney, Dr Stephanie Teoh worked in general practice for ten years. With a post-graduate degree in pediatrics, Teoh worked closely with maternity hospitals, community child health and sleep centers in Sydney, Australia to help educate parents and provide them with practical assistance. She realized very early on that most parents with young children struggle to maintain a good sleeping routine. When she came to Beijing in 2008, Teoh was surprised by the lack of community support and services available to parents and babies suffering from months, or even years of restless nights. Teoh has since established free Mothercraft seminars at International SOS clinic and has become an invaluable resource for Beijing parents.
We sat down with Teoh to find out more about infant sleep issues and how parents can best manage them. At the end of the day, one good night’s sleep makes an enormous difference to the whole family, and when everyone is well rested, suddenly life’s little ups and downs don’t seem so bad.
How common is disrupted sleep among infants and are certain age groups more prone than others? [Sleeping problems] are very common. However, babies experience a wide range of sleep issues and they are only a "problem" when they cause disturbances in the parents’ lives. Babies of all different age groups may suffer from sleep issues for different reasons.
How much sleep should a baby have?
Babies have a very different sleep cycle to adults. A newborn baby needs up to 18 hours of sleep [per day], a 6-month-old baby needs three daytime naps and up to 12 hours of sleep, while a 12-month-old baby needs two daytime naps. A baby who is not getting enough sleep is more unsettled, irritable [and]cries more.
What are the most common causes of sleeplessness in babies?
There are three common causes: First is technique. There’s what I call "accidental parenting," where parents discover a technique by accident because it works on a particular occasion. The same technique,however, will not work in the long-term. Second is personality and expectations. Some parents, and babies, are simply more relaxed while others are more anxious; while some parents have unrealistic expectations of their children’s sleeping patterns. Finally, there is a small element of chance. For instance, having a low birth weight may affect how a baby sleeps. However, parents should not overemphasize this element because it’s a common myth that you are either "lucky" and your baby is born a good sleeper, or you are not.
What are the effects of sleep deprivation on parents and babies?
They are both physical and psychological: lack of concentration, moodiness, irritability, bad memory and learning difficulties. In addition,baby sleep issues place a strain on marriages, prevent parents from enjoying parenthood, as well as affecting siblings and other family members. Parents are struggling just to cope and in that sense [it can be a]serious illness.
How can you treat or manage a baby who is having trouble sleeping?
First, I try to identify the main problem together with the parents. I also try to bring their attention to some of the myths of sleep disorders and show them techniques to manage sleep issues. For example, a common misconception is that a good sleeper doesn’t wake up. However, it’s okay for babies to wake up as long as they are able to put themselves back to sleep. A bad sleeper on the other hand can’t put themselves back to sleep and needs help.
What are some common mistakes parents make when managing babies with sleeping problems?
First, some parents think that sleep issues will go away by themselves. There is the myth that being a good sleeper is a milestone in a baby’s life, so they wait for that magical moment when their baby will suddenly become a good sleeper. Second, many parents believe that having a baby who’s a good sleeper is just a matter of luck. Third, [they receive]too much advice from too many sources. And finally, some parents go for short-term, rather than long-term solutions.
What is a good sleep routine for babies and how do you establish it?
A good sleep routine isn’t rigid, but it’s necessary for babies to have a routine rather than none. Two things help babies sleep: sleep cues and sleep props. Sleep cues tell the baby that it’s time to go to sleep. [These] include where and when the baby sleeps, and setting a night-and-day sleep pattern rather than a 24-hour pattern for the baby. Sleep props are settling techniques. For example, some babies need to be fed or held to fall asleep. A good sleep prop needs to follow three rules: Can someone else do it? Is it portable? Is it easily reproduced?
How long does it take for a baby to settle into a new sleep routine?
It normally takes ten to 14 days, because it involves changing the baby’s behavior and body clock. It seems like a short time, but it’s easier for babies to unlearn a bad habit [than we think]. However, if a technique is not working, most of the time [it’s because of the way it is applied] rather than the technique itself. A technique needs to be applied consistently and persistently. Often parents try too many things in too short a time, or there might be other factors. For example, often the baby doesn’t have any sleep issues when the ayi is around, because she would hold the baby until the baby falls asleep or have the baby sleep with her.
How do you prevent your baby from developing bad sleeping habits?
Parents should be familiar with good swaddling, settling and soothing techniques. Also, don’t start doing something unless you are prepared to keep it up for the long-term.
Would you ever recommend medicinal treatments?
No. Baby sleep issues are behavioral so they should be managed with behavioral therapy, rather than medicines or sedatives.
Dr. Stephanie Teoh
Available for appointment at the International SOS Clinic, Tue-Sat 9am-6pm (6462 9112, stephanie.teoh@internationalsos.com).
For details or to reserve a seat at the International SOS Clinic’s free Mothercraft workshops (held until the end of October), e-mail seminar@internationalsos.com.
