Sleep (0 to 6 years)

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The text for this topic is copyright Parenting SA, Government of South Australia.

Managing sleep for babies and children is one of the most common concerns for parents. Many worry about whether they are doing the right thing if their child doesn’t sleep soundly all through the night. There is no right way or place for parents to put babies and children to sleep—patterns vary between different cultures and different families. What matters is that bedtime is relaxed and comfortable and that babies and children have comfort when they need it. If what you are doing feels okay for you and your child it is right for you. If things aren’t working well for you, some of the following information may help.

Some facts about sleep

How we sleep

There are two main kinds of sleep. One is light sleep. This is when we dream and when we ‘go over’ the day’s events and wake feeling refreshed. It is also the kind of sleep where we wake more easily. With infants this is the major part of sleep, but by adolescence it is only about 20 per cent of sleep.

The other kind is deep sleep where growing and healing take place. It is much harder to wake people from this kind of sleep.

Each night we all go through sleep patterns where we go from light sleep to deep sleep then light again.

Babies, like adults, move through these two types of sleep but the cycle for babies is shorter.

Toddlers usually take about an hour for each sleep pattern or cycle.

It is between the stages of light and deep sleep that, as adults, we may pull up another blanket or roll over and then fade back into sleep again and not necessarily remember that we have done this.

For babies and toddlers this may be where they cry and need help to resettle back to sleep.

Where should babies sleep?

Part of our Australian society is to have separate bedrooms for children away from parents. However, sleeping alone for babies and young children is not the only way and sometimes children find it hard to sleep by themselves.

In many cultures and families young children sleep with or near parents, other children sleep wherever they are.

What is important is that your children’s sleep is safe and that wherever they sleep suits you and them.

Sudden Infant Death Syndrome (SIDS) research has shown the safest place for young babies to sleep is in a bassinet or cot next to the parent’s bed.

How long do babies and children sleep?

Sleep is very individual and can vary a lot at any age. Children in one family may have very different sleeping needs. Sometimes a child’s sleep pattern does not match parents’ expectations.

The best way to work out how much sleep your baby or child needs is to keep a sleep diary or chart. Mark when your baby or toddler is asleep and when she is awake. Do it for at least two weeks. This way you can get an average of how much sleep she needs each day.

Remember that sleep needs change quickly as babies and children grow.

Settle/sleep chart

Start the chart from a time that suits you. Mark it for the 24 hour day. (see chart in PDF version of this guide).

Routines

Most of us have some kind of winding down routine before we go to sleep. Routines can also help babies and children to relax and settle into sleep.

They generally find comfort and security in routines, for example, a bath, a quiet story, a song, a prayer and special goodnight kiss. Routines can often help parents too in organising bedtimes and so reduce tension and stress.

Controlled crying

Controlled crying, or controlled comforting, is one way that is sometimes used to teach children not to cry at night. Some babies can become very stressed by this. It is advisable not to use any method that stresses or distresses babies and young children.

Babies need to be responded to when they cry in order to feel safe and secure. Learn to know your child’s cry—when it is just a settling ‘grizzle’ that is part of going to sleep and when it is a ‘real’ cry that you need to attend to.

Night waking

For many parents just knowing that night waking is ‘normal’ in the early years helps remove some of the stress. Each family needs to deal with night waking in the way that best suits their family.

Often babies and children just need to know someone is near and they will settle back to sleep.

It is important to meet your child’s need for comfort in the way that also gives you the best rest. Some parents like to have their baby sleep in a cot next to them; others prefer their baby to sleep in a separate room and put a day bed in there so they can lie down near an unsettled baby.

Sometimes night waking can be due to pain such as ear-ache, a cold or teething, so check this out if it occurs suddenly. With pain, your child may not settle even if you are there to comfort, or may settle for a short time and then re-wake.

Parents also need sleep and broken sleep can bring added stress in family life.

It is so important to find ways, and support from others, to help ‘get you through’ when your sleep is reduced or broken.

Safe sleep

Know what to look for when setting up sleeping, for example, bassinets, cots, beds and bedding to make sure your baby or child will be safe during sleep. (There are Stardards in Australia for cots).

Babies who have their heads covered, whose breathing is blocked in some way, or who become too hot, may be more likely to die suddenly. Remember babies cannot get themselves into a safe position, for example, if they get underneath the bedclothes. Place babies half way down the bassinet/cot with their feet almost touching the end. Avoid clothing that has long strings, ribbons or cords (less than 10cm long if a dummy is attached to clothing).

To prevent overheating use light bedding (not doonas, thick quilts or heavy blankets). They do not need a pillow to sleep comfortably.

Avoid sleeping with your baby if you have been drinking, taking medicines that make you sleep more deeply, or are extremely tired, very overweight or a very heavy sleeper. It is particularly dangerous to sleep on a sofa with a baby, as baby’s head can easily become caught between the seat and back of the sofa. Large toys and pets can smother a baby.

The main factor that shows up in all the research is that a baby is more at risk of sudden death if an adult smoker sleeps wiht the baby.

Babies should always sleep on their backs.

Wrapping

Some babies settle better if they are wrapped in a light sheet, while others do not. It can help small babies develop a more settled sleep pattern and older unsettled babies may sleep better. Wrapping helps to prevent arm movements that can disturb sleep. (With older babies it is usually better to leave their arms out).

Wrapping should be made from muslin or light cotton sheet and the baby should be wrapped firmly. Bunny rugs and blankets are not safe and babies should not be over-dressed—all these can cause over-heating. The wrap should not cover your baby’s face (see diagram) 

Babies 0 to three months

How much sleep?

In the first few weeks, many babies sleep much of the day and night.

They have little idea of day or night and most wake regularly around the clock every two or three hours needing a feed and attention. As a guide, many babies sleep 14–20 hours a day in the first weeks and by six weeks 25 per cent of babies are sleeping a six-hour stretch (not necessarily at night).

By three months, many babies will have settled into a pattern of longer times awake during the day, and longer sleep times (perhaps four to five hours) at night. When a baby sleeps five hours straight this is considered sleeping through the night.

Routines to get ready for sleep

• At this age babies are often relaxed and sleepy after a feed. Some develop a pattern of waking often and needing a feed to settle. Some babies are helped by a daytime routine of a feed and then settling after a small play, cuddle, talk and touch. Watch your baby’s signals for when he is alert and wanting to play and when he is sleepy.
  Note: it takes time to learn the signs that babies are tired. Apart from yawning, tired signs include random jerky movements, starey overbright eyes.
• Some young babies tend to be more wakeful in the evening or night rather than during the day. It helps your baby learn about day and night if you settle them at night in a quiet, dark place and don’t play with them or do anything that makes them more wakeful.
• Even with young babies you can start a bedtime routine. You may sing a little song, kiss goodnight, find the dummy (if he has one) and then give a gentle kiss with some special soft words of love when you put him down.

Settling

Put your baby on his back for sleep. Often a tired newborn will accept being put into his crib while awake and fall asleep on his own. Some new babies settle best in a quiet, dark place, others settle more easily in noisier places. Some babies are harder to settle than others and many need help to relax into sleep.

Very young babies do not always settle well in a large space—many parents use bassinets for the early weeks.

Some things to try to settle your baby:

• have some constant noise such as humming, singing a little song, relaxing music or household noise—many babies love the vibration noise of the washing machine or dryer
• wrap him in a thin cotton sheet
• settle him in the crib and then pat him with a cupped hand. Start patting quickly and then slow down as he calms, usually at about the pace of your heartbeat
• rock him in a pram, crib or your arms for a short period and then settle into bed (a baby should not be left to sleep unsupervised in a pram)
• push him in a pram back and forth over a bumpy surface such as the edge between your carpet and tiles or over footpath bumps
• check that he is not too hot or cold, and that clothing is not too tight
• a warm bath
• offer another feed, (often called a ‘top-up’ feed)
• allow him to suck on a dummy or thumb (do not give a dummy until breast feeding is going well as the sucking motion is different)
• use a baby sling so your baby is close and can hear your heart beat. This may help him settle and allow you to do a few household tasks.

Night waking

In the first few months it is common for babies to wake regularly at night for feeds at least two or three times. Most babies of this age still require one or two night feeds. By three months many are settled into a pattern of longer sleep times—perhaps four to five hours at night.

Babies three to six months

How much sleep?

At this age some babies have two or three longish sleeps during the day, while others just have short naps. A few may sleep 12 hours without interruption; some manage eight hours, while many others wake fairly regularly for feeds. Most have learnt to sleep more at night than they do during the day.

Routines to help get ready for sleep

• Routines that are flexible and change to meet the needs of your baby can help. Continue the routine you may have started from birth but watch your baby for signs, for example, is she tired or does she want to play, and try to respond to them.
• Play time may be a walk, reading a book, time on the floor, shopping, visiting friends, or a cuddle. These play times will help your baby learn that daytime is time to be awake.
• At night-time keep feed times boring, do not have play time and settle your baby straight back to sleep.

Settling

It is important to use the same settling ideas each time you put your baby to sleep, day or night, as this helps her to learn about sleep more quickly.

Many of the suggestions in the zero to three months can be tried along with:

• reading a book with a soothing voice
• darken the room to make a difference between wake time and sleep time
• make a tape of household sounds and play it in your baby’s room.

Night waking

Many babies still wake at night for feeds. Some sleep through although they may wake again for a few nights when their appetite increases. They usually settle again when their feeds increase during the day.

• To help reduce night feeds at this age, a ‘roll-over’ feed may be tried at about 10pm, or before you go to bed at night and before baby wakes for her first feed. Disturb your baby as little as possible; lift her without fully waking and breastfeed. If bottle feeding, you could give a feed without picking her up from the cot, (but you still need to hold the bottle and watch the feed to keep her safe).
• The next time your baby wakes at night, try to resettle without a feed using some of the settling ideas. Some cool water may help quench a thirst (just as some adults like a drink of water at night).
• If resettling does not work in about 15 minutes or so offer another feed so that you can get some sleep, and try again the next night. Over time your baby will gradually get the idea.

Six months to three years

How much sleep?

Some babies and toddlers can sleep through because they can last longer between feeds and hunger does not wake them. Many still wake once or twice, or several times at night. Many wake in the lighter time of sleep, just as we wake (or almost wake). They may, as most adults do, turn over and go back to sleep, or they may cry because they are uncomfortable, afraid or unsettled in some other way.

By six months about 50 per cent of babies are ‘sleeping through the night’ (that is, sleeping about five hours or more).

Between the ages of two to three years 41 per cent of young children wake once or twice a night, with a few still waking more often.

Routines to help get ready for sleep

• During the day try a regular routine, for example, three meals with some snacks and one or two sleeps.
• Try and separate feeding from sleeping by playing with your baby or toddler after feeds and before he goes down to sleep. Watch for tired signs to prevent becoming over tired.
• Put your child into the cot awake and help him to go to sleep. Patting, rocking and singing a mantra (a monotonous song with a few words) like ‘bye bye baby, sleep tight baby’ can help.

Settling

• Keep to the regular routine that you have established, such as a bath, quiet play, story, cuddles and song and/or prayer.
• Put your child into the cot awake, (this will help him go to sleep there).
• Sing a little song (you may have made one up) or put on some relaxing music.
• Patting and rocking may still work at this age—a chair by the side of the cot or bed may help look after your back. Some babies and toddlers may get used to this and cry as soon as you stop, so change the timing of the patting, slow it down and become softer, finally resting your hand on his body.
• Some will still feel more secure if they are wrapped in a thin cotton sheet, others may not like it.

Settling for older toddlers

• Try leaving a soft light on, giving a cuddly toy, giving him something of yours to cuddle, for example, an old T-shirt that has ‘your smell’ on it. Many still like their dummy at bedtime.
• Some children need you to stay near while they go to sleep. If you decide to do this, don’t sneak out without telling your child. This may keep him tense and on edge in case you do it again. You can whisper that you are going to another room and will be back soon. Make sure you do return soon. If your child copes with this you can start taking a bit longer before coming back, but make sure you always return before he gets upset as this builds trust. Even if he has fallen asleep give him a goodnight kiss and whisper something like ‘goodnight, sleep tight’.
• When your child settles to bed, but needs you nearby, this could become your relaxation time. Take a book to read or a CD and sit in a comfortable chair near your child (you are present but not doing anything that might disturb your child). Over a few nights you could gradually move your chair nearer to the door. Eventually you will be able to put it outside the door so your child can hear you but not see you. This way your child gradually learns to settle when you are not there.

Night waking

• Many children of this age wake at night and will grow out of it in time.
• If you and your baby are happy with the way things are, do not feel pressured to change.
• If you find your child is waking for a night feed, especially in the first twelve months, try a feed without waking him at about 10pm, or before you go to bed at night. This may help with a long sleep through the night.

Your child may wake at night and cry due to:

• being in a light phase of sleep so that something like a noise causes him to wake fully
• separation anxiety. This is a very common reason for children under three years to cry at night. You can tell if your child is waking due to separation anxiety because if you are nearby to reassure him, he will settle back to sleep. (By eight or nine months of age, babies have learned that their parents exist even if they can’t see them and they often get frightened when they wake and their parents aren’t there.)
• not knowing how to settle back to sleep. Sometimes babies and young children who have always been fed, rocked or nursed to sleep find it hard to settle back to sleep when they are in their own beds because they haven’t learned how to go to sleep on their own
• pain, such as ear-ache, a cold, or teething.

What parents can do

• Put a day bed in your child’s room and lie down near him so you both get to sleep.
• Put his bed in your room near you, or take him into your bed.
• Make sure he gets plenty to eat during the day if he is breastfed, and let your partner get up in the night for a few nights. If your baby smells the milk it is hard to get him to settle without a feed and babies can get into the habit of continuing feeds over 24 hours.

Children three to six years

How much sleep?

Many children of this age need about 10–12 hours sleep at night. Bedtime may vary a lot. Some may go to bed at 6.30pm, while many go to bed later, for example, up to 9.30pm or later. Wake-up time may be early or late and those who go to bed later tend to wake later.

Young children may still need a daytime sleep as well. By kindergarten age only a few still have a daytime nap.

Routines to help get ready for sleep

• To help three to six-year-olds prepare for the idea of going to bed familiar routines will help.
• Work out a routine around what is special for you and your child. A typical routine may include a bath, drink, teeth cleaning, cuddle, story, prayer or song and kiss ‘goodnight’. It might be a quiet time to sit on the bed and talk about the events of the day.
• It is helpful to let children know in advance that bedtime is coming, for example, ‘just one more game and then it’s time to get ready for bed’—and mean what you say. This can prevent the pestering for more time to stay up.
• The half-hour before bed is not a good time for tickles, wrestles, quarrels, TV or other excitement.

Settling

• If you have a routine it will help to settle your child but events of the day can sometimes mean that extra time and quiet attention is needed, for example, starting school, being unwell, family disruptions.
• Reassuring words, a longer cuddle or relaxing music can help.
• It is at these moments that older children may talk about things that are bothering them.

Night waking

Night waking is common in these years and there is no ‘right way’ to solve night waking. Sometimes doing whatever works for you as a family is good enough. Some children can resettle themselves—others may need comforting.

The inner confidence to feel secure when parents are not present is still developing by three to four years of age. If night waking is being caused by separation anxiety, it usually improves after four years of age.

At times when children are sick, lonely, sad or frightened they need help to go back to sleep.

The changes in your child’s life, for example, moving house, factor.

What parents can do

• Try settling your child where he will be sleeping the night, so you don’t have to move him.
• During the night when he wakes, go to him and quietly reassure him that everything is all right, say something like ‘Sleep time now—Mummy and Daddy love you’, then walk out of the room. If your child remains unsettled you may need to try some of the ideas below.
• If your child comes into your room when he wakes, lead him back to his bed, and resettle him there.
• Sometimes putting a spare bed in your child’s room so that you can be comfortable and can rest while your child needs you close is an option.
• Some parents find that everyone gets a better night’s sleep if they allow the child to come into their own bed during the early hours of the morning—or they have a small mattress and sleeping bag next to their bed that their child can get into if he wakes.
• Night-time waking is for comforting and resettling, not for getting out of bed for play or anything else exciting. Be comforting but boring. Don’t respond to any games.
• Ask your child what would help her go to sleep. Some children can tell you, others may not be able to.
• Think about the changes happening in your child’s life that can cause stress. They may seem minor ones to an adult, but major in the eyes of a child.

As children grow older and become more secure they will not need to be so close to you. Most children no longer need to share their parents’ bed or bedroom by the time they are four or five years old, unless something stressful is happening in
their lives.

If you are experiencing ongoing concerns it is important you discuss this with a health professional.

Going to bed problems

Sometimes parents find it is hard to get young children to go to bed or their waking early causes problems—and there are many different reasons for this. In some cultures children sleep in or near the action, and can nap whenever they feel tired—this is not a problem. However, parents are often tired at the end of the day and need time to themselves, or need extra sleep in the morning—more than their child does.

Some of the reasons a child may not want to go to bed may be:

• having to go off on his own and leaving people or interesting things that are happening in the house behind
• being frightened of being left alone (no matter what time you put your child to bed with fear or worry he will still be unhappy)
• not being tired yet (probably will go to bed happily but later)
• a very busy or exciting day, or too much excitement just before bed
• being affected by daylight saving (just as with some adults)
• lack of a night-time routine to help him wind down

Note: children usually wake when they have had enough sleep so early waking may be because of early bedtime.

Some things to try with older children

There are some things you can’t control, for example, sunrise, however there are other things you can influence.

• Make sure your child has a regular bedtime that gets later as she needs less sleep.
• Use a relaxing bedtime routine—without excitement and stimulation. (Avoid TV, computer games and exercise directly before going to bed).
• If your child is more attached to one parent it sometimes helps if that parent spends calm and quiet time with the child before bedtime. Then the other parent puts her to bed.
• Play soft music or leave a quiet radio playing.
• Leave the door open or shut—whichever your child wants.
• Sometimes children will settle where the action is, and can be carried to their own beds later. It may mean that your child may wake later and will want you because she doesn’t know where she is and will need you to help her resettle. Children grow out of this.
• If you decide that you want your child to go to bed a bit earlier and you don’t mind if she wakes earlier too, try putting her to bed a quarter of an hour earlier. Sleep rhythms take some time to change so you can expect to wait about two weeks before you can see any real change in sleep behaviour. Then, if that works, you might try another quarter of an hour. You can help to change early waking by putting your child to bed later to see if that will help her sleep longer in the morning.

Looking after yourself

Caring for babies and young children is tiring and demands a great deal of tolerance, understanding and patience. When parents are feeling on top of things it can still be taxing—it becomes much more difficult when parents have adult worries or poor health. Little or broken sleep makes people exhausted. When you are tired you are at your lowest ebb and most parents will say that their need for sleep in the early years is one of their greatest needs.

• Don’t be ashamed to ask for help from family and friends.
• Get some rest during the day while your child is asleep or with someone else.
• Take a short break for yourself now and then.
• Try to get some regular exercise.
• If you feel desperate get help—from your partner, family, neighbours, ring a friend, or phone Parentline.
• If you feel that you might hurt your child make sure she is in a safe place and then leave until you feel you have calmed down. Contact someone immediately if you feel unable to manage.
• Talking it over with a child health professional may benefit both you an your baby. It can take courage to ask for help but it is important for yourself, your baby and your family.

Reminders

Want more information?

SIDS and Kids ACT www.sidsandkids.org 6287 4255

See other ParentLink guides:

• About babies
• Being a parent
• Dealing with a crisis
• Living with babies
• Living with toddlers
• Nightmares

ACT Govt Publication No 08/0690 June 2008