Healthy sleep habits help babies and children to grow, develop, and be healthy. Sleep influences the baby or child’s mood and behaviors. Being well rested promotes positive mood and well-being for babies, toddlers and their parents. Soothing, predictable bedtime routines that gently prepare a baby or toddler for a night of sleep can be one of the closest, most enjoyable times of the day for parents and their little ones.
Safe Sleep Practices for Infants
The American Academy of Pediatrics recommends (2008):
• Place infants on their backs to sleep. Since 1992, when the American Academy of Pediatrics began the Back to Sleep campaign, the annual SIDS (sudden infant death syndrome) rate has declined by more than 50%.
• Place the baby on a firm mattress in a safety-approved crib, with a well-fitting sheet.
• Make sure nothing covers the baby’s head
• Do not use pillows, blankets, sheepskins, or crib bumpers anywhere in your baby’s sleep area.
• Do not allow smoking around the baby.
• Avoid letting the baby get too hot. Dress baby lightly for sleep, and set the room temperature in a range comfortable for lightly clothed adult.
Work towards making bedtime the “anchor” of the day
Instead of thinking of the baby’s day as revolving around when he wakes up in the morning, try to think of the day as revolving around the set bedtime.
• Try to structure the day so that the baby’s last feed will occur about 30 minutes before bedtime.
• Space naps so the baby will be sleepy for bedtime.
• Avoid napping 2 hours before bedtime.
• Choose a bedtime that works for the family, but consider that a baby or toddler might benefit from an early bedtime.
Benefits of bedtime routines
Bedtime routines can be a close, loving way to end the day.
• Bedtime routines may include a quiet feeding, a bath, low lighting, singing a lullaby, listening to a music box or musical mobile, sharing a picture book, or rocking gently.
• By doing the same thing, at the same time, in the same place every night, the baby can develop sleep associations that will help him learn how to fall asleep and put himself back to sleep when he experiences normal night time wakings.
• When the baby has become used to the routine, place him into bed on his back, drowsy but awake. Often the more parents do to try to get the baby to fall asleep, the more dependent the child becomes on parental intervention and the less sleep everyone gets.
• Night wakings are a normal part of sleep.
• Sleeping through night is defined as not waking between midnight and 5 am. It usually occurs between 3 and 6 months.
• 25 to 50% of children over 6 months continue to have night wakings (Mindell, et al., 2006).
• Night feedings are typically not physiologically necessary after 6 months (for full-term, healthy infants).
• Make night time feedings a different experience than day time feedings by keeping them “business only.” This means to try not to rouse the baby very much, feed at the bedside, do not turn on the TV, and get the baby back to sleep quickly. Don’t even change the diaper unless you feel it is necessary.
• Infants who transition to sleep at bedtime using bottle or breast, may want the bottle or breast to transition back to sleep in the middle of the night, even if they are not hungry. They may develop feeding habits that include eating more during the night and less during the day.
• Choose a regular time for naps.
• Anticipate your baby’s nap needs. Being overly tired contributes to increased fussiness and more difficulty falling asleep.
• For children taking one nap a day, having that nap immediately after lunch helps create clear routine.
• Sleep in the same place for naps and at night.
• Introduce naps with a shortened version of bedtime routine.
If your infant or toddler continues to have challenges around sleep, call Women & Infants’ Center for Children and Families at (401) 274-1122, ext. 8935 for clinical support.