Sleep in early years of life – Essentials
Pediatrician’s get asked a lot of questions about sleep from parents. Understanding what normal sleep is for a particular age is crucial in alleviating many of these concerns.
What is normal sleep?
When an infant or child is sleeping for the age appropriate durations, with the ability to go back to sleep without needing to call or signal you.
Age appropriate sleep:
- During first few weeks of life, babies sleep 16-20 hours in a day. They sleep for 1-4 hours followed by being awake for 1-2 hours.
- At 4 weeks of age, most babies begin sleeping for longer periods during the night.
- For the first 3 months, sleep lasts about 3-4 hours.
- At about 3-5 months, babies sleep for a longer stretches at night (5-6 hours).
- By 6 months of age, babies may sleep for 13-15 hours with 60-70% at night.
- By 9 months most babies sleep about 6-8 hours at a stretch at night and have about 2 daytime naps.
- Toddlers sleep about 10-13 hours in a day.
Even though these are the normal requirements, there can be variations of 2-3 hours from this.
How can parents help?
Many babies move about and whimper in their sleep. Swaddling them in a light weight blanket will help them sleep better. Swaddling is not recommended after the age of 2 months.
As parents, our aim should be to replicate the day/night environment for our baby. During the day, let the day light in and turn the lights on even when the baby is sleeping. Expose your child to normal levels of day time noise (no need to whisper and tiptoe around), otherwise he may become overly sensitive to noise and may wake up at every little night time sound. During day encourage the baby to stay awake for longer periods. Use this time to play with the baby. During evening and night, just do the reverse. Make the environment quieter and dimmer. Spend less time playing. Place baby in a darkened quiet room.
Establish good sleep associations:
These are conditions that the baby needs to fall asleep. They will need the same conditions to fall back to sleep after they get up at night. These can be:
- Being rocked to sleep, pacifier, sucking at breast or bottle. Some, like rocking to sleep, will pose a problem in the middle of night if your baby gets up. He will not be able to go back to sleep unless you get up and rock him back to sleep. So it is very important to have sleep associations which make it easy for them to fall back asleep by themselves.
- It is recommended to place the babies in their cribs while drowsy, but still awake. This creates a positive sleep association with the feeling of being in the crib.
- Don’t let him fall asleep while nursing.
- Don’t rush to the crib every time you hear the baby cry. Wait for few minutes and see if the baby can go back to sleep on his own. Avoid turning on the light if possible. If he needs changing, do it fast without picking him up.
- There is no relationship between starting solid foods and sleeping through the night.
- Make sure he is not overdressed, and the temperature in the room is comfortable. Use no more than one additional layer than an adult would wear to be comfortable.
- Till one years of age, babies should only sleep on their back to reduce the chance of SIDS.
- Parents may consider offering a pacifier at nap time and bed time through the first 6 months of age and wean off pacifier use by 12 months of age.
- Regular and same bed time routines will help toddlers to initiate sleep. It can be a warm refreshing bath, reading a story and soft music etc.
- Avoid TV and other screens for at least 2 hours before sleep.
- Let them take a safe object with them to bed – a teddy bear, special blanket or favourite toy. This acts as a good sleep association.
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