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Bedtime habits

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YOUR NEW BABY (LESS THAN 2 MONTHS) AND SLEEP

At first, your new baby is on a 24-hour feeding and sleep-wake cycle. Newborns may sleep between 10 and 18 hours a day, staying awake only 1 to 3 hours at a time.

Signs that your baby is becoming sleepy include:

• Crying
• Eye rubbing
• Fussiness

Try putting your baby to bed sleepy, but not yet asleep.

To encourage your newborn to sleep more at night rather than during the day:

• Expose your newborn to light and noise during the daytime
• As evening or bedtime approaches, dim the lights, keep things quiet, and reduce the amount of activity around your baby
• When your baby wakes up at night to eat, keep the room dark and quiet during these feedings.

Sleeping with a baby younger than 12 months may increase the risk of sudden infant death syndrome (SIDS).

YOUR INFANT (3 - 12 MONTHS) AND SLEEP

By age 4 months, your child might sleep for up to 6 to 8 hours at a time. Between ages 6 and 9 months, most children will sleep for 10 to 12 hours. During the first year of life, it is common for babies to take one to four naps a day, each lasting 30 minutes to 2 hours.

When putting an infant to bed, make the bedtime routine consistent and pleasant.

• Give the last nighttime feeding shortly before putting the baby to bed. Never put the baby to bed with a bottle, as it can cause tooth decay. (See: Baby bottle tooth decay)
• Spend quiet time with your child by rocking, walking, or simple cuddling.
• Put the child in bed before he is deeply asleep. This will teach your child to go to sleep on his own.

Your baby may cry when you lay him in his bed, because he fears being away from you. This is called separation anxiety. Simply go in, speak in a calm voice, and rub the baby's back or head. Do not take the baby out of the bed. Once he has calmed down, leave the room. Your child will soon learn that you are simply in another room.

If your baby awakens in the night for feeding, do not turn on the lights.

• Keep the room dark and quiet. Use night lights, if needed.
• Keep the feeding as brief and low-key as possible. Do not entertain the baby.
• When the baby has been fed, burped, and calmed, return him to bed. If you maintain this routine, your baby will become used to it and go to sleep on his own.

By age 9 months, if not sooner, most infants are able to sleep for at least 8 to 10 hours without needing a nighttime feeding. Infants will still wake up during the night. However, over time, your infant will learn to self-soothe and fall back asleep on his or her own.

Sleeping with a baby younger than 12 months of age may increase the risk of sudden infant death syndrome (SIDS).

YOUR TODDLER (1 TO 3 YEARS) AND SLEEP:

A toddler will most often sleep for 12 to 14 hours a day. By around 18 months, children only need one nap each day. The nap should not be close to bedtime.

Make the bedtime routine pleasant and predictable.

• Keep activities such as taking a bath, brushing teeth, reading stories, saying prayers, and so forth in the same order every night.
• Choose activities that are calming, such as taking a bath, reading, or giving a gentle massage.
• Keep the routine to a set amount of time each night. Give your child a warning when it is almost time for lights-out and sleep.
• A stuffed animal or special blanket may give the child some security after the lights are turned out.
• Before you turn out the light, ask if the child needs anything else. Meeting a simple request is okay. Once the door has been closed, it's best to ignore further requests.

Some other tips are:

• Establish a rule that the child cannot leave the bedroom.
• If your child starts screaming, shut the door to his bedroom and say, "I'm sorry, but I have to shut your door. I will open it when you are quiet."
• If your child comes out of his room, avoid lecturing him. Using good eye contact, tell the child that you will open the door again when the child is in bed. If the child says he is in bed, open the door.
• If your child tries to climb into your bed at night, unless he is afraid, return him to his bed as soon as you discover his presence. Avoid lectures or sweet conversation. If your child simply cannot sleep, tell him he may read or look at books in his room, but he is not to disturb other people in the family.

Praise your child for learning to self-soothe and fall asleep alone.

Remember that bedtime habits can be disrupted by changes or stresses such as moving to a new home or gaining a new brother or sister. It may take time to reestablish previous bedtime practices.

References

Owens JA. Sleep medicine. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 18.

St. James-Roberts I. Infant crying and sleeping: Helping parents to prevent and manage problems. Prim Care. 2008;35:547-567.