How to avoid the Four Great Disruptors of baby's night-time sleep

The Four Great Disruptors of babies' night-time sleep make it much harder for you and your baby to return back to sleep quickly. They are

1. Burping your baby

2. Holding your baby upright after a feed

3. Wrapping or swaddling your baby

4. Nappy changes.

Burping your baby

You might have been told that you need to burp your baby after a feed, before you put baby back down, so that she sleeps for another good long block. This is actually not the case. You can find out about burping here, which includes a story about one family's baby burping experiences.

Sometimes your baby might stir and grizzle after you put him down in the night. It's true that babies are sensitive, even when half-asleep, to being out of our arms. Some parents say that when they pick baby up again in response, he always burps! Then when they put him down a second time, he goes into a decent block of sleep. This is why they burp baby before putting him down, hoping it will make sleep go better.

You are the expert on your baby. You are the one observing your own unique baby's behaviours, day and night. I know you'll experiment, and decide what's best in your own situation. I figure my job is to share the way I make sense of things, both from my experience in the clinic and from the research. Hopefully that will help as you work out what's best in your own family.

Babies start to dial up when they are put out of arms, because their little body registers - even when half-asleep - that they are no longer close to the warmth and comfort of your body. Sometimes putting them down takes a couple of goes, and many breastfeeding women or parents wait for baby to fall into deep sleep first, before trying. That can take ten or 15 minutes.

When we lift a baby up from a mattress, any air that has gathered in the stomach will be released with the change of posture. That doesn't mean your baby is stirring because of the need to burp. Babies release burps, if they need to, whatever position they are in, without any effort on our part (or on their part, either). We don't have to worry about it.

In the West, for generations, much baby behaviour has been unnecessarily attributed to the gut, whether as wind or gut pain or more latterly as reflux or lactose or allergy or gut dysbiosis. Of course, we don't want to miss the occasional true medical condition! However, I invite you to experiment with not burping your baby, and see what happens.

Holding baby upright after feeds

Families are often told that they need to hold their baby upright after a feed. But this is not the case.

The reflux that rises up from your baby's tummy in the two hours after feed, whether by breast milk or formula, is close to pH neutral. It's not acidic, and doesn't cause pain. Holding upright for 20 or 30 minutes after a feed, which is commonly advised, might mean that there are less episodes of reflux. But babies reflux all the time. Your baby will manage reflux well on his back (even if you hear him swallowing it back down or if there is a puke). Holding your baby upright doesn't help with sleep. You can read more about this here.

Unfortunately, holding upright can even worsen night-time sleep, because it

• Wakes babies up (a vertical position triggers an arousal reflex in the brainstem)

• Might make you feel wide awake and delay your own return to sleep

• Might make you feel less inclined to feed your baby, because of the work and time involved when you are already exhausted. But a feed, as quick as possible without fuss, is the easiest way to dial your baby down and return to sleep in the night.

Wrapping or swaddling your baby

If you are breastfeeding, it is important to unwrap your baby, or unzip the swaddle suit, before offering the breast in the night. This is because wrapping or swaddling interferes with the way your baby fits into your body, and can create breastfeeding problems.

But wrapping your baby or zipping up the swaddle suit again after a feed can rouse your baby, and make everyone's return to sleep more difficult. It can be very helpful to know that you don't need to wrap or swaddle your baby. The research doesn't show that wrapping or swaddling improves your sleep, despite what you might have heard.

You can find out about wrapping, swaddling, and restricting baby's arm movements, including how to do it safely and whether it helps with sleep, here. You can find out about possible downsides to wrapping, swaddling or restricting baby's arm movements here.

The night-time nappy change

I've never been convinced that babies cry and become unsettled or wakeful in the night because of a wet nappy. Two studies have found that babies mostly aren't awakened in the night by the sensation of a wet nappy or by urinating.

However, your newborn will need nappy changes in the night. Newborns are still developing a circadian rhythm, and night-time nappies often contain poo or stool. Parents usually try to protect their newborn's delicate skin and avoid nappy rashes (although nappy rashes can occur despite parents' best efforts).

But as the weeks pass and your baby isn't passing stool at nights anymore, the less you need to disrupt the nights with a nappy change, the better. By using highly absorbent nappies and liberal application of barrier creams, most parents find they can stop changing wet nappies in the night, so that no-one has to get up to do it (unless there really is a poo). This helps everyone return to sleep just as quickly as possible after night feeds.

Selected references

Zotter H, Suseng W, Urlesberger B. Does bladder voiding during sleep and wakefulness change the behavioural state of infants? Acta Paediatrica. 2007;95(12):1644-1647.

Zotter H, Urlesberger B, Pichler G, Mueller W, Kerbl R. Do wet diapers induce arousals in sleeping infants? Acta Paediatrica. 2007;96(3):452-453.