這是
達醫曉護
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3464
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在生命早期的前六個月，嬰兒會需要在夜間醒來喝奶，從而獲得足夠的食物來滿足生長髮育的需要。大多數嬰兒發育到適合的階段時，可以睡整晚並自己安靜入睡。但在最初的幾個月裡，我們可以做以下3件事來幫助嬰兒入睡和安靜下來：
·強調夜晚和白天的區別。
·在寶寶睡意朦朧但還沒睡著時放到床上。
·開始建立有規律的睡前儀式。
如果在孩子出生後六個月內做到這些，可以幫助你的寶寶在發育到適合的階段時能自行入睡和安靜下來。需要記住的是，寶寶出生後最初的幾個月裡，及時迴應寶寶並保持靈活性是最重要的。比如，有時寶寶有時在喝奶時睡著了也沒關係。如果寶寶有哭鬧不安，輕輕搖動或哄抱寶寶入睡也可以。
另外，安全的睡眠習慣可以最大程度降低嬰兒猝死的風險，包括讓寶寶仰臥，確保寶寶在睡覺時頭部沒有任何遮蓋，在寶寶1歲以前或至少6月齡以前和寶寶同睡一個臥室。
強調夜晚和白天的區別
剛出生不久的新生兒並不知道白天和黑夜的區別，所以我們常常發現新生兒在夜間完全清醒，然後在白天昏昏欲睡。所以在小寶貝生後的頭六個月裡，我們可以透過一些小事情來幫助他開始習慣夜晚和白天的不同，從而明白晚上是好好睡覺的最佳時間：
·晚上要保持房間黑暗或光線昏暗，並且保持安靜。
·夜間需要照顧寶寶時使用比較昏暗的燈光，儘量不要開啟明亮的頂燈。
·晚上聽到寶寶的哭聲要迅速回應，儘可能快的給寶寶餵奶或安撫。
·夜間餵奶在臥室進行，這樣可以讓餵養簡單快速地完成，還可以讓寶寶意識到晚上和白天的喝奶是不一樣的。
·在晚上和寶寶的親子互動時，儘可能讓寶寶有安靜平和的睡前時間。反之，在白天儘量讓寶寶多玩耍。
從寶寶3月齡以後，可以嘗試安排寶寶在一個安靜和昏暗的地方午睡。隨著年齡的增長，嬰兒醒著的時間會越來越多，所以他們在光線和噪音很大的地方，例如客廳等家庭公共活動空間，容易睡得不好。
在寶寶睡意朦朧但還沒睡著時放到床上
嘗試在寶寶睡意朦朧但還沒睡著時放到床上。這樣做的目的在於讓寶寶可以逐漸把睡覺和躺在床上聯絡起來。如果寶寶建立起了這樣的睡眠關聯，那麼在他晚上醒來時，可能更容易自己重新入睡。這種情況稱為自我安撫，就是指寶寶能夠自己平靜放鬆下來，然後在床上再次入睡。能做到自我安撫入睡的嬰兒會有較長的時間段的睡眠，並且夜間睡眠總時長更多。
如果寶寶將入睡與你抱著他哄睡，拍著睡或喝奶關聯在一起，那麼當他們在夜間醒來，寶寶可能需要你抱著哄，拍，或餵奶後再次入睡。當然，如果這樣做對媽媽和寶寶都合適的話，晚上抱著哄睡或餵奶寶寶哄睡也是完全可以的。
下面列出的3個小妙招可以幫助你實現把在寶寶睡意朦朧時能放到床上的：
·給寶寶一點時間讓他安靜下來。避免在寶寶一開始哼唧時就立即抱起他們。當你嘗試第一次把嬰兒放下到嬰兒床時，許多嬰兒會表現出哼唧，這時候可以給他們一兩分鐘時間讓他們安靜下來而不是馬上又抱起來。但如果寶寶開始哭，那表示他們需要你的安慰。
·隨著寶寶月齡增大，如果寶寶在夜間醒來時有哼唧，可以給他一些時間讓他自己平靜下來——寶寶可能會在沒有你幫助的情況下自己重新安靜下來。不過如果你聽到寶寶真的哭了，那你就需要幫助他重新進入安靜的狀態。
·嘗試拍睡的技巧。你可以用這個方法拍拍你的寶寶直到他們可以平靜下來，但要在寶寶睡著之前停止拍撫。拍睡的好處寶寶還是在他自己的床上入睡。
嬰兒、兒童和成人都有自己的睡眠關聯條件，是和我們在發睏想睡覺時相伴隨的常規和習慣。睡眠關聯幫助我們入睡，以及在夜間醒來時能再次入睡。嬰兒的睡眠關聯條件一般有躺在自己的小床上、被抱哄，被拍撫和使用安撫奶嘴。
開始建立睡前儀式
當合適的時候，可以開始建立寶寶的睡前儀式。這樣可以幫助你每天按照相似的順序給寶寶安排睡前的作息規律——例如，餵食、玩耍、睡覺。像這樣的嬰兒睡前儀式會幫助寶寶進入一個有規律的睡眠模式。因此，當您的寶寶在白天醒來時，規律的作息可能是：
·給小寶寶餵奶
·給小寶寶換尿布
·和小寶寶聊天、抱抱和玩耍
·當小寶寶出現疲勞困倦表現時，把寶寶放到小床上睡覺。
夜間的睡前作息，你可以選擇直接讓寶寶安靜下來重新入睡，跳過玩耍這一步。
對於出生一個月內的新生寶寶來說，還是要在餵養和睡眠時間上保持一定的靈活度，但不管如何按照類似的順序開始安排作息規律還是很有幫助的。
Helping babies sleep and settle in the early months
In the first six months of life， babies need to wake at night to get enough food for growth and development。 For most babies， sleeping ‘through the night’ and settling by themselves comes later， when they’re developmentally ready。 But there are three things you can do in the early months to help with baby sleep and settling：
·Emphasise the difference between night and day。
·Put your baby to bed drowsy but awake。
·Start a sleep routine。
And if you do these things in the first six months， it can help your baby learn to sleep and settle independently later on， when baby is developmentally ready。 Remember： responding to your baby and being flexible are the most important things in these early months。 It’s OK if your baby falls asleep while feeding sometimes。 It’s also fine to cuddle or rock your baby to sleep if they’re unsettled。
Safe sleeping practices can help you minimize the risk of sudden unexpected death in infancy （SUDI）。 These practices include sleeping your baby on their back， making sure your baby’s head is uncovered during sleep， and sharing a room with your baby for the first year of life， or at least for the first six months。
Emphasising the difference between night and day
Your newborn doesn’t understand the difference between day and night。 It’s quite common for newborns to be wide awake during the night and then sleepy during the day。 In these first six months， here are some things you can do to help your baby get used to the idea that night is different from day， and that night is a good time to sleep：
·During the night， keep the room dark or dimly lit， and quiet。
·Use a dim light when you need to attend to your baby during the night。 Try not to turn on a bright overhead light。
·At night， respond to your baby’s cries quickly， and settle or feed baby as soon as you can。
·Give night feeds in the bedroom。 This will help to keep these feeds brief and make them different from daytime feeds。
·At night try to be soothing and quiet when you’re with your baby。 Try to keep play for daytime。
From three months on， try to make a quiet， dark place for your baby to nap during the day。 Babies become more awake and alert as they get older， so they don’t sleep as well in places that have a lot of light and noise， like the family room。
Putting babies to bed drowsy but awake
Try to put your baby to bed drowsy but awake。 This gives your baby the chance to associate falling asleep with being in bed。 If your baby has this sleep association， baby might be more likely to self-soothe when they wake in their bed in the night。 Self-soothing is when your baby can calm down， relax and go to sleep again in their bed。 Babies who can self-soothe sleep for longer periods and have longer total sleep times at night。
If your baby associates falling asleep with rocking or feeding， baby might want rocking or feeding if they wake in the night。 Of course， it’s completely fine to rock or feed your baby to sleep in the night if this suits your baby and you。
Here are some ways you can help your baby settle in bed， drowsy but awake：
·Give your baby some time to settle。 Avoid picking up your baby as soon as they grizzle。 Many babies grizzle when you first put them into the cot， and giving them a minute or two to settle can help。 But if your baby starts crying， they need comforting。
·As your baby gets older， give baby some time to settle if they grizzle when they wake during the night – baby might re-settle without your help。 If you hear real crying， you need to help your baby re-settle。
·Try the patting settling technique。 With this technique， you pat your baby until they calm down， but you stop patting just before sleep comes。 A benefit of patting is that your baby is still going to sleep in the cot。
Babies， children and adults all have sleep associations。 These are the routines and habits that we connect with feeling sleepy。 Sleep associations help us go to sleep and go back to sleep when we wake in the night。 Sleep associations for babies might include being in the cot， being rocked， being patted and using a dummy。
Starting a sleep routine
When it feels right for your baby and you， it can help to start doing things in a similar order each day – for example， feed， play， sleep。 A baby sleep routine like this will help your baby settle into a regular sleep pattern。 So when your baby wakes up during the day， a routine might be to：
·offer baby a feed
·change baby’s nappy
·take time for talk， cuddles and play
·put baby back down for sleep when baby shows tired signs。
At night， you might choose not to play and instead focus on settling your baby straight back to sleep。
With a newborn， it’s good to be flexible about feeding and sleep times – but it can still help to start doing things in a similar order。
作者：澳大利亞墨爾本大學醫學院兒科博士
百匯醫療（中國）兒科醫師
蔣本然