The issue of sleep (or the lack of it!) is often on the minds of many parents and carerA carer is a person who looks after someone who is struggling with a disorder, addiction, mental health problem or a disability. This could be a parent or guardian, sibling, other family member, partner or friend. Children and young people can also be carers, sometimes without realising, for family ... mores in their children’s early years. And for good reason! Sleep is important to how we function as people and parents, and is essential for healthy child development.
As individuals, we all have our own sleep patterns and body rhythms, but when it comes to whether we can fall asleep easily and stay asleep, our relationships can play a key role. Learning to go to sleep and getting back to sleep is closely linked to what’s called emotion regulation – that is, understanding and managing your feelings.
- What's normal?
Babies need more sleep per day than adults, but they are also light sleepers and have shorter sleep cycles. All babies are different and the amount they sleep varies hugely.
- From birth to 3 months, babies tend to sleep between 14-17 hours a day, including naps. They will wake frequently through the night to be fed and cuddled. This is completely normal and is not something that should try to be prevented.
- From about 6 months, babies can sleep for longer stretches – some even through the night. But it can also take much longer for babies to sleep for 8-12 hours sleep at a time, with no crying or wakefulness whatsoever.
As babies grow into toddlers, they can explore much more and have more control over where they go and what they do. Yet they are still so dependent on their caregivers. The fear and excitement they feel as a result of being both dependent and separated can impact their sleep.
- From 12 months, toddlers will need around 12-15 hours sleep a day, mostly at night.
- Two year olds will tend to sleep for 11-12 hours a night, with 1 or 2 day time naps.
- Three-four year olds will need around 12 hours sleep, and some may still nap in the day.
Sleep regressions are times when a baby’s sleep patterns change. They tend to last between three to six weeks, but it varies. A baby may wake during the night, have a difficult time getting back to sleep, take shorter naps or skip naps. Changes in sleep are a normal part of a baby’s development and happen when babies are learning new skills. They tend to occur at around 4 months, 8 months and 18 months, but all children are different.
Refusing naps and bedtime struggles
It’s very common for toddlers to start fighting sleep-time routines, such as naps or going to bed. This is because the world has become a very exciting place for them, and they realise that family life continues once they are in bed! Children usually stop napping any time between the ages of 3 and 5.
Nightmares are common between the ages of 2 and 3, even in loved and well cared for children. The child may wake from a ‘bad dream’ or remember it in the morning. Dreams are an important way for children, like adults, to work out confusing or difficult feelings and experiences. At age two, children do not really understand the difference between fantasy and reality, or between their own feelings and those of others. So, for example, when a child feels angry with their parent or carer, they may assume that the parent is also angry with them. This can lead to an increase in fears, which sometimes get expressed through nightmares, such as monsters under the bed.
- When does a baby or toddler have a sleep problem?
Sleep problems affect about 30% of babies and toddlers at least at one point in their early years. But what is a ‘sleep problem’? It can be helpful to think of sleep problems as when a child’s sleeping habits mean they get very upset or are poorly rested, or when their sleeping habits disturb or upset parents. It might be that a baby takes a long time to go back to sleep (say, over an hour) or may wake a lot in the night for no apparent reason.
Possible factors that might be linked with sleep difficulties include:
- a child’s temperament or nature
- housing or space problems
- feeding difficulties
- the child’s physical health
- a traumatic birth.
Parents’ mental health and difficulties in their relationship with their baby are also linked to infant sleep difficulties. Parents might find it hard to put their baby down for the night - they might feel guilty for wanting time to themselves, or they may enjoy having a baby who depends on them to be rocked to sleep. They may be anxious that something will happen when they are away from them. This can all impact on how and if the baby learns to self-settle over time.
- How you can support parents with their child’s sleep at home
If parents and carers are confident about sleep time (for themselves and their baby), most infants will learn to soothe themselves back to sleep, and eventually sleep through the night.
Supporting a parent or carer to help their baby with sleeping better can be complicated. Families are likely to feel overwhelmed by exhaustion and unable to think about which steps to take next to improve the situation. Understandably, families often want to fix things as quickly as possible, coming to seek professional support when they are feeling desperate, and in need of support and compassion.
Reflect on how you feel
As professionals, our own beliefs, histories and parenting experiences about how to support babies to sleep shapes our advice to parents. Reflect on how you feel and try to put those feelings to one side. Try to be as impartial as possible and led by each family and what they are comfortable with.
Suggest a bedtime routine
As early as 2 or 3 weeks old and by the age of 3 months parents and carers can support their babies in developing good sleeping habits. A bedtime routine might include for example, washing the baby, changing them into a new baby grow, dimming the lights and singing/playing a lullaby. Babies will soon learn that time is moving from day to night.
By the time the baby is 3 months old, it can be helpful to separate feeding and bedtime routines. For example, parents and carers might want to first feed their baby, bath them, read a book and then put them to bed. Putting a baby to bed relaxed and sleepy but awake can help them learn how to get off to sleep, and to get back to sleep when they wake in the night.
For toddlers, a routine might include brushing their teeth, putting on their pyjamas and then reading two books.
Listen to how parents or carers feel
Be genuinely curious about what the parent or carer feels the difficulty is. Just listening to a parent or carers' feelings and worries about sleeping difficulties and their relationship with their baby can really help them to start to make sense of what might be happening.
Suggest an attachment-informed approach to ‘sleep training’
There are many approaches to helping a baby learn to sleep independently, and they are often referred to as ‘sleep training’. However, the term ‘sleep training’ is controversial, and so are some of the methods you may find suggested in books or on the internet. If you’re interested in the research about sleep training methods, you can read more: https://www.basisonline.org.uk/sleep-training-and-managing-how-babies-sleep/
You can also listen to this Zero to Three podcast on sleep difficulties.
Here, we explain how parents and carers can help babies learn to go to sleep independently in a gentle, loving and safe way.
- Parents might want to start trying to help their babies sleep more independently from around three months old.
- Reassure parents and carers that babies can learn to soothe themselves, and that learning to sleep independently is an important skill, just like crawling or walking.
- Remind parents that babies and children pick up their cues from them – so it’s important to try and stay calm, confident and reassuring. It can be helpful to go into the room and say, for example, ‘it’s ok, it’s night-time, I love you, go back to sleep now.’
- Recommend that parents don’t rush in at the first sounds of a baby being unsettled. Parents might do this to prevent the baby waking up fully or because a parent’s instinct is to want to soothe them as soon as possible. However, babies often move, murmur or cry out during lighter phases of sleep, and it can be helpful for the baby to give them a few brief moments to try and practice getting themselves back to sleep.
- Reassure parents that it’s OK for babies to cry a bit when they are learning to settle themselves to sleep at first. This doesn’t mean that in order to help babies sleep independently they have to be - or should be - left crying for longer than a few minutes. It’s important to go into the baby’s room regularly to check on them, and to give them love and reassurance. This should be as often as the parent feels comfortable, whether that be every 30 seconds or every 5 minutes.
- Parents can help to reassure babies by sitting next to them and stroking them. If this doesn’t help to calm a baby, it’s also always OK to pick up the baby for a cuddle. It takes time to learn how to go to sleep independently and will be a gradual process.
- Advise parents and carers that if baby has trouble settling themselves over time, they may be too young to self-soothe, and it may be best to wait for a few weeks before trying again.
Get more help
If a parent or carers' level of exhaustion is so great that it is affecting their mood or ability to carry out their daily activities, they should discuss this with a health professional. A lack of sleep may actually increase chances of postnatal mental health difficulties, such as depression, which in turn, can make it more challenging for a new parent to get enough sleep.
- Sleep in nursery or other childcare settings
Babies’ sleep at home will impact on their sleep in a childcare setting, and vice versa. There are some ideas below to encourage healthy sleep in your setting, but remember, all children are different, and some will simply nap better at home than in a childcare setting.
Replicate a child’s sleep routines at home
Recreating a child’s at-home sleep routine, where possible, can help babies and children relax and sleep when at your setting. You may find that offering a familiar toy or blanket to cuddle helps.
Help them explore sleep
It’s useful to help young children begin to understand the importance of sleep. Often the easiest starting point is thinking about the bedroom. Children can talk about their bedroom at home or ideal bedrooms, about curtains, lights, books and toys. A bedroom could be set up in the role play area and going to bed acted out.
- Tips to share with parents and carers
Tips to share with parents and carers
- Being a parent of a baby or young child can be very tiring. It’s OK and normal to feel exhausted and fed up with the lack of sleep. It will get easier.
- All babies and children are different and will need different amounts of sleep
- Getting enough sleep helps babies and children thrive. Learning how to go to sleep independently is an important skill, like learning to walk. You can start to help your baby learn this skill from around three months old.
- It takes time for a baby to learn how to go to sleep on their own. Here are some tips to do this in a gentle, loving way:
- Try not to rush in at the first sounds of your baby being unsettled. Give them a few minutes to see if they can settle themselves first.
- Rather than picking them up immediately, try other ways of soothing them, like gently reassuring them or stroking them.
- Try to stay calm, confident and reassuring, as they pick up on your feelings.
- Have a bedtime routine. Children love routine, and having a bath and reading a book, for example, gives your child time to wind-down ready for sleep. Try and get into a routine when your baby is still small.
- If your baby has trouble settling themselves, they may be too young to self-soothe. Wait for a few weeks before trying again. Babies and young children will also have more trouble sleeping if they are unwell, teething or in the process of learning a new skill like crawling.
- Some babies and young children develop sleep problems, and this can take its toll on a family. If you are feeling exhausted, desperate and overwhelmed, ask for help and advice from a professional you trust, like your health visitor, GP or staff at your children’s centre.