StorkNet interview with
Anne Smith, IBCLC
International Board Certified Lactation Consultant

Be sure to visit Anne Smith's website for more breastfeeding information and wonderful products. Also, read her articles on StorkNet.

Q's and A's:

ONE YEAR OLD- Still wake to nurse at night?

Lisa: My daughter turned one on Mother's Day, but she is still not sleeping through the night. She will wake to nurse and then go right back asleep. Is it normal for her to need to nurse or is it more of a comfort thing for her? I don't mind her nursing at night, whether for comfort or need, since she rarely nurses during the day anymore. I am just wondering if it is normal for her to still wake to nurse at night?

Anne: There are lots of babies (both breast and bottle-fed) who continue to wake during the night well into the second or even third year. Sleeping patterns vary widely among individual babies, just as they do among adults. Everyone knows that some people require seven or eight hours sleep in order to function effectively the next day, while others do just fine with five or six hours. Some adults are light sleepers, some are deep. Some sleep better curled up spoon-like next to their partner, while others gravitate to the far side of the bed because they need their own space. Why do we accept these differences in adults, and yet expect babies to start sleeping through the night be a certain age?

Sleep "problems " are a hot topic. There are dozens of books and hundreds of magazine articles on how to get your baby to sleep longer. In our culture, a Ďgoodí baby is defined as one who sleeps a lot and demands as little attention as possible. If you define sleep problems the way many experts do, then almost all babies have some sort of sleep problem.

Babies need more REM, or active sleep than adults. For the first three months, babies spend 45-50% of their sleep time in REM sleep, 10-15% in transitional sleep, and 35-45% in quiet or deep sleep. This high percentage of active sleep in infancy will gradually decrease to adult levels by the time the baby is two or three years old.

Babies have shorter sleep cycles than adults. A sleep cycle is the total time spent going through both active and quiet stages of sleep. Adultís sleep cycles last about ninety minutes, and periods of active sleep occur about four times a night. Babies sleep cycles are half as long as adultís, and they have twice as many periods of active, or light sleep. When a baby is moving from a quiet into an active state of sleep, he is most easily aroused. Nursing for a few minutes is what helps him transition back into deeper sleep, unless he is a self soother and is attached to a security blanket, pacifier, or thumb.

Babies who are self soothers wake up just as often as babies who use the breast for comfort, but they are more likely to put themselves back into a deep sleep state on their own.

A baby has no concept of day and night. Adults have been conditioned to stay awake during the day and sleep at night. The typical sleep pattern for infants is to sleep during the day and be awake more at night. For the first few months, most babies will sleep 14-18 hours each day without regard to the difference between day and night. His sleep patterns are similar to his nursing patterns: small frequent feedings and short frequent naps. Most newborns seldom sleep more than three or four hours at a time without waking up for a feeding. In rare cases a baby may sleep through the night (defined as a five hour stretch or longer) by ten days, but most babies donít do this until three months or later. Waking up once, twice, or three times during the night is not uncommon. Between one third and one quarter of all babies will continue to wake up during the night even after they are a year old.

Often older babies who had been sleeping long stretches at night will start waking more frequently when they begin teething, and also when they begin to deal with separation anxiety and need to be reassured that their mom is still there.

Co-sleeping is an excellent way to meet your baby's nighttime needs for milk and security while also allowing you to get more sleep than you would get if your baby was in a separate room. If she is in the room with you, you can nurse her as soon as she begins to make the transition from deep sleep to active sleep, and neither of you has to wake up completely. How you feel in the morning depends more on how you are awakened more than how many times you are awakened. I remember nights when I couldnít have told you how many times the baby nursed, because I never woke up enough to count.

Since you seem to be comfortable with the nighttime nursing arrangement you have now, then I would continue nursing her back to sleep at night until she outgrows the need. It sounds like she is already well on the way toward weaning since she has cut back so much on daytime feedings. She will continue to get the nutritional benefits of the milk she receives during those short feedings, as well as the security of knowing that you are there to meet her needs during the night as well as during the day. Before you know it, she will be an independent little person who sleeps through the night in her own bed and climbs in your bed occasionally just to snuggle. Enjoy the special closeness of these nighttime nursings while they last, because someday soon they will just be a fond memory.

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