We all have our ways to interact with our child at sleep times. These differences are shaped by family dynamics, ethnic origins and cultural habits. Since each human being needs sleep, habits can vary from one child to another in the family cocoon.
The National Sleep Foundation defines “sleep hygiene” as “a variety of different practices and habits that are necessary to have good nighttime sleep quality and full daytime alertness”. Since the scope of sleep hygiene is broad, I provide information for each of the composing factors parents could influence. Ensuring good sleep hygiene from early on (sometimes as from 2 months) can help your baby to both fall asleep and stay asleep longer.
Between 3 and 6 months, infants start getting more deep sleep, which can help get longer periods of sleep at night. Negative sleep associations, also referred to as “bad habits” or “sleep crutches” are very common at this age. Your goal, as a parent, will be to help your child to replace sleep crutches with good sleep associations.
Positive sleep associations are self-soothing behaviors or rituals that a baby can create for herself, such as sucking her thumb or fingers, twirling her hair, stroking a stuffed animal or favorite blanket, rubbing things against her cheek, rocking her body, humming, or singing.
If you want to improve your child’s sleep habits, try to implement these following guidelines. It is never too early to teach good sleep habits (taking into account your child’s health and realistic learning skills) or never too late to change the bad ones. Also, preventing poor sleep habits is always easier than correcting a sleep problem. Young children are eager to learn and very malleable.
1. Create a consistent sleep schedule
What is a well-thought-out and age-appropriate bedtime? After your newborn’s first month, establishing and finding a schedule for your days (and nights) can, without a doubt, make your life easier. There is no particular bedtime that is right for every baby. Each one of us has a natural rhythm and thus an ideal bedtime. For children who are not in the day-night-confusion phase anymore (i.e. as from around 8 weeks), most sleep specialists consider the ideal bedtime to be between 6 p.m. and 8 p.m. (preferably around 7 p.m.). Starting with a consistent bedtime for small kids helps to regulate their sleep in the long run. Note that “bedtime” refers to the moment the child lays asleep in bed, not when the routine starts or when the lights are turned off.
How can you determine what is the natural bedtime of your child? This will mainly depend on her age and the naps she needs during the day.
With the help of a logbook containing information about your child’s sleeping cycles, you should be able to identify the pattern related to your child’s natural rhythm. Unfortunately, this can be very difficult because your schedule is not the same on a daily basis. Also, depending on the quality and length of naps and the feeding breaks, your baby will not always be tired at the same time. By keeping a log for a period of 1 or 2 weeks, you should get a better idea of when your baby prefers to eat, sleep and play.
Keeping a log is one big part of creating an adapted sleep schedule. The other one is watching your baby. Learn to see her natural sleep cues because they tell you more than the clock. This will help you figure out her natural sleep window and therefore understand when her body tells you she is ready to sleep.
The sleep window signs to look for are the following:
- eye rubbing
- slowed activity
- clumsy movements
- decreasing verbal expression
- sucking the thumb or pacifier
- weaker or slower suction
- general fussiness
- crying for no reason
- fussiness even after being fed
- caressing a blanket, lovey or a part of a parent’s body
- playing with a parent’s hair
- zoning or staring blankly into space
- loss of interest in people and toys
As soon as you see one or several of these signs, you know that it’s time for her to go to bed. Ideally, you should set a specific time and consider it the most suitable time to put your child to bed. Should you realize that your child goes to bed too late, make the adjustments gradually, 15 to 20 minutes at a time. This change in the schedule will not happen overnight.
Why do I insist on putting your child at a regular and not-too-late time?
First of all, children who go to bed before they are overstimulated have fewer night awakenings. Also, constant and predictable bedtimes lead to less resistance at bedtime, falling asleep with ease, better sleep quality, and help build healthy sleep habits for the future. Children who have a steady early bedtime each night have a higher chance to self-regulate, experience fewer behavior challenges, and have better performance.
Did you know that sleep experts also recommend that adults sleep at about the same time each night and wake up at the same time each morning? As in the case of children, this helps us sleep better, and feel better. Even over the weekend, our routine schedule should not vary too much from the other days of the week.
On the other hand, there is one key aspect of sleep where we differ greatly. “Setting a late bedtime will make your child wake up later in the morning” is a very popular sleep myth. Even if this advice seems logical, please ignore it. Why? If you miss your child’s sleep window, i.e. her natural time to sleep, her little body won’t be pumping out calming melatonin. On the contrary, the stress-related hormone (i.e. cortisol) will stimulate her much more than in the opposite case. She will regain energy as if she had drunk a Red Bull! She will become more agitated and be more difficult to calm down. Overtired children find it harder to fall asleep and get back to sleep if they wake up in the middle of the night. Kids who are lacking sleep are also more prone to have night terrors. By pushing back your child’s bedtime, you get the opposite of the intended effect. So, do exactly the contrary of what most people think: set an earlier bedtime to help your baby to sleep better and until later in the morning.
2. Encourage naps
The organization of your child’s sleep-and-wake phases varies greatly due to the evolution of the daytime naps. At six months, babies usually take three naps (morning, early afternoon and late afternoon naps), then, between nine and twelve months, they take two naps (morning and early afternoon), and, from fifteen to eighteen months, this should be reduced to one nap in the early afternoon. The nap then disappears at around the age of four or five.
One of the most valuable recommendations you could hear is: don’t underestimate the power of naps! Allow time for naps each day based on your child’s age and needs.
Here are some recommendations to follow that may lead you to wake your baby up during nap time (and which guarantee you a long night’s sleep!).
The morning nap should follow a certain rhythm around the twelfth week and last between 60 and 120 minutes; it should not last longer than 2 hours. If you let your child extend this resting period, your baby may have trouble falling asleep in the afternoon. When babies take two naps a day, you can try to limit the first nap to an hour and a half so that your child doesn’t become exhausted and frustrated when she is supposed to start her second nap.
Several weeks after the morning nap is set up, the afternoon nap should be regularized in terms of time and duration. This nap should not last more than 2 hours. Do not allow too much time to elapse between the end of the morning nap and the beginning of the afternoon. As mentioned above, keep an eye on the clock, observe your baby to identify possible sleep indicators, and use your log to write it down.
Finally, a third nap in the late afternoon (or “catnap”) may be shorter. It lasts between 45 and 60 minutes, depending on the quality and quantity of previous naps.
Some parents deduce that their child needs only a bit of sleep at night because they are themselves able to run on little sleep. However, I would like to stress that every child, without exception, needs a lot of rest to develop and function well. An overtired baby has more trouble sleeping. Napping helps children to sleep better at night, so keeping them awake during the day will not help them sleep longer at night. To make sure that your child is not too tired at bedtime, no more than 4 to 5 hours should have passed between the end of the last afternoon nap and the beginning of the night.
“Sleep begets sleep” is a powerful parental mantra. When talking about children’s sleeping needs, we cannot compare the needs of children with those of adults. Some people think that a child who does not take a nap will be able to make up for missed rest hours, thus they deduce that the child will sleep longer in the morning. The reality is quite different because the opposite occurs. The less a child sleeps during the day, the more disturbed her sleep will be at the end of the day. An overtired child will also wake up before 6 a.m. and have a hard time to nap. The more a baby sleeps during the day (respecting time limits and avoiding interference), the better she sleeps at night, and the longer she sleeps in the morning. This may seem illogical, but it is the simple truth.
Napping all day and not sleeping at night can be great for the baby but remains incredibly unpleasant for the parents. There is a proven correlation between the duration of daytime naps and the quantity and quality of nighttime sleep. Too much or not enough sleep during the day affects the baby’s night, and thereby yours as well.
What’s the best way to put my baby down for a nap? To ease your baby into nap time:
- Set the mood. A dark, quiet and comfortably cool environment can help encourage your baby to sleep.
- Put your baby to bed drowsy, but awake. Drooping eyelids, eye rubbing, and fussiness might be signs that your baby is tired. The longer you wait, the more overtired and wired your baby might become — and the harder it might be for her to fall asleep.
- Avoid holding, rocking or feeding your baby to sleep. Eventually, this might be the only way your baby can fall asleep. If your baby tends to fall asleep in your arms after a feeding, do something gentle right afterward — such as changing her diaper or reading a short story. This will help to wake her up and put her drowsy in bed.
- Be safe. Place your baby to sleep on her back and clear the crib or bassinet of blankets and other soft items.
- Be consistent. Your baby will get the most out of daytime naps if she takes them at the same time each day and for about the same length of time. Occasional exceptions are inevitable, of course, and won’t harm your baby.
3. Feed well and enough during daytime
Sleeping and feeding are closely connected, even inseparable. Not sleeping enough can impact a child’s development because it impacts the weight gain. On the other hand, eating too little calories during the day can cause nighttime wakening due to hunger.
The first 10 weeks of an infant’s life, hunger triggers the awakenings. At that age, a baby should be fed every 2 or 3 hours all around the clock.
But how can you tell when a baby wants to eat? She can’t verbally express her need. What parents can look for are the hunger cues:
- opening mouth and/or smacking lips
- sucking (on fingers or entire hands, toes, clothing, lips, etc.)
- fidgeting body movements
- looking for the breast when Mommy holds her
- fussing or crying (making the “Neh” sound – Read: How can I get my baby to stop crying?)
If you learn how to read your baby’s cues, she might not even get to the crying stage. Crying is, in fact, the last hunger cue to appear.
If you are breastfeeding, try to avoid products containing caffeine (e.g. coffee, tea, sodas and chocolate, unfortunately!). Like alcohol, caffeine gets mixed with breast milk and can impact your baby’s sleep. She can become more irritable and have difficulty falling asleep. Breastfeeding moms say that eliminating caffeine and reducing dairy products help their kids to be less fussy and sleep better. Know that if you decide to change your diet, it could take 2 to 3 weeks to notice any change.
Around 10 weeks, babies gain weight, have a more developed gut and internal clock. They can build up some reserves to sleep for a little longer. Their sleep time at night can be extended to 5 to 6 hours, which means that some babies as young as 10 weeks old are physically capable to sleep through the night. Some babies still reverse the day/night cycle sleep longer during the daytime. In such a case, parents should wake up their baby after a 90 to 120-minute nap to offer food and help to fix the day/night confusion.
One common practice I have seen in the United States is to apply the 4-hour schedules. Based on the principles described in the book “12 hours’ sleep by 12 weeks old”, it is recommended to feed young babies every 4 hours. However, this practice can hinder maternal milk production and newborns do not get the calories needed to grow and gain weight. Therefore, many sleep experts do not recommend this early-on sleep shaping technique.
If you worry about whether your child is eating enough and growing enough, whether Mommy is producing enough milk and whether you need to supplement, talk to your pediatrician and/or a lactation consultant to address your concerns and questions.
After the fourth trimester, you can work on breaking the feeding-sleep association (i.e. a baby can’t fall asleep without nursing or the bottle). You can do this by feeding your baby when she wakes up from sleep rather than before she goes to bed. You can feed her a bit later if she is awake and still hungry. In the evening, try to feed her at the beginning of your bedtime routine. That way, she will learn to fall asleep without sucking. In the case where she falls asleep, make sure to wake her up gently to put her to bed drowsy but awake.
Finally, the American Academy of Pediatrics (AAP) strongly discourage parents to put their children to bed with a bottle of formula, milk, juice or any other sugared drinks. It is said that children who drink bottles while lying down may be more prone to ear infections and frequent exposure to sugary liquids contributes to the caries process. The AAP also recommends to stop night feedings once teeth erupt, i.e. around 6 months of age.
4. Plan outdoor activities every day
Especially for babies whose day/night cycle is still reversed, it is highly recommended to expose them to sunlight during the day or place them in a sunny room when awake. Being exposed to sunlight during the day and darkness during the night will help to fix the day/night confusion and settle the circadian rhythm.
For older children, several factors have been linked to nighttime sleep duration; not only bedtime and napping, but also daytime physical activity, and outdoor time. Harvard Health Publishing mentions that “we need sun exposure to make vitamin D, a vitamin that plays a crucial role in many body processes, from bone development to our immune system. Sun exposure also plays a role in our immune system in other ways, as well as in healthy sleep — and our mood. Our bodies work best when they get some sunshine every day.” Exposure to outdoor light (preferably in the morning and for at least one hour per day) helps to set children’s body clock for a better and earlier night’s sleep. (Don’t forget the sunscreen!)
This also explains why it is recommended to get some fresh air when you are jet-lagged or right after daylight saving time is adopted or let aside.
Finally, daily outdoor activities in nature and the sight of green spaces particularly help stress levels fall within minutes.
5. Create a safe and boring environment
If you wish to get useful tips about creating the ideal sleep environment for your little one, have a look at the following: How does a sleep-friendly room look like?
6. Develop routines (and stick to them)
“Routine, in an intelligent man, is a sign of ambition.” – W. H. Auden
Routines sound boring to adults, but they are utterly important for children from the earliest age. When you create a routine, you introduce a predictable pattern of events with an activity. The same routines can happen several times a day and they don’t have to be too rigid. It is just a way to tell your child what she can expect next.
There are three types of sleep routines you can put in place: the bedtime routine, the wake-up routine, and the naptime routine.
a. Bedtime routine
Sleep is a pleasure that needs some preparation. A bedtime routine sets the stage for sleep, helps a child unwind and get her ready for bed. In a global study of more than 10’000 children from newborn to three-years-old, Jodi Mindell’s team found an intercorrelation between having a bedtime routine and sleep. Her team concluded that “regular nightly bedtime routine is associated with improved sleep in young children.”
The evening must be a moment of calm, avoiding as much as possible screen time, scary stories, video games, television, tickling stress or family conflicts. Choose quiet and relaxing evening activities to enjoy moments of tenderness, comfort, and serenity. Many parents follow with the “4B” rule: Bath, Bottle/Breast, Book (with a happy ending) and Bed. You can also include songs, cuddles or a massage. Massages allow babies to relax and helps their body to secrete more melatonin, a.k.a. the sleep hormone, which improves the wake-sleep cycle.
After the routine, put your child in bed drowsy but awake, give her the pacifier, and wish her and the lovey good night. Remember to keep the bottle outside the bed.
Your going-to-bed procedure may vary from day to day, depending on how tired your child seems to be. However, the basic elements should always be the same (even during the weekends and holidays). To ensure the continuity and consistency of the bedtime routine, the chosen activities should be enjoyed by both the child and the parents.
Allow adequate time each night so that this can be a pleasant and relaxed experience. If your child is not overtired, the routine should last between 45 minutes to an hour. Start not later than 7 p.m. to avoid your child falling asleep too late. Remember to read your child’s sleep cues. If she seems ready to go to bed, go through a shorter version of the usual routine.
b. Wake-up routine
This routine will help to make her brain switch from the sleepy mode to the active mode. If your child wakes up after 6 a.m., get her out of the bedroom, turn on the lights or open the blinds, sing a “good morning” song, change her, feed her, and start the day. If it is earlier than 6 a.m. (even at 5:55 a.m.), give her space to fall asleep on her own or help her to calm down. You can turn on a dim light, change her if needed but stay in her room and make sure to put her back to bed drowsy but awake.
By implementing this drastic wake-up, you help her to distinguish daytime awakening from nighttime awakenings. If your baby is crying to get out of her crib, go check on her and leave the room for 10 to 15 seconds. This way, you tell her that her day starts because it is time to wake up, not because she was crying.
You can also do this routine after each daytime nap to emphasize the difference between sleep-wake habits.
c. Naptime routine
The naptime routine is an abbreviated version of your child’s bedtime routine. It is also a predictable sequence of activities helping children to sleep easier and faster. A story, a song and a cuddle can do the trick. Prepare her for a nap about 15 minutes before putting her in bed drowsy but awake.
7. Encourage self-soothing
Self-soothing can be defined as the art of teaching your baby to calm herself to sleep when she is placed in the crib, or when she wakes up in the middle of the night, to fall back asleep.
Your baby can learn to self-soothe with a little effort, practice, and time. Popular self-soothing techniques are the following:
a. Be consistent in everything you do (see also section 8)
Implement a daily sleep schedule, follow consistent routines, always put your baby to sleep in her bed and try to have the same approach when it comes to sleep training (Read: What is the best sleep-training method).
b. Introduce a transitional object
The term transitional object (also called a “comfort object”), introduced by Donald Winnicott, is an item used by children to provide psychological comfort, in particular situations such as bedtime. A lovey or a blanket can ease separation anxiety and weaken other sleep-disrupting habits.
If your child is not already attached to a teddybear, help her forge that bond. A teddybear helps a baby cope with the separation from her parents, making her feel safe and sound when they are not present. It helps to reassure her during sleep awakenings in the middle of the night. Transitions are easier if a child is encouraged to have a special stuffed animal, blanket, or similar favorite object, which she holds on to as an important companion. It is generally as from 6 months, that a transitional object is introduced. It should be small, soft, and safe.
To get your baby familiar with the lovey, you could encourage the bond between you, your child and the object during feeding time, playtime and the routines. She might not get attached right away (especially if you are nursing because it is a longer process for nursed babies). Make several attempts or find another lovey that she might like. Don’t give up too soon.
c. Offer a pacifier
If your baby is often falling asleep while being fed, sucking is one of the most familiar ways she knows to get back to sleep. For all babies, a pacifier can be the way to satisfy the sucking instinct.
The use of the pacifier should only be limited when the baby sleeps rather than all the time when she is awake and fussy. If your baby is 8 months or older, teach your baby how to put the pacifier back herself. At that age, she should have the pincer grip. As a parent, you can teach her how to find her pacifier, grab on and put it in her mouth. Place several pacifiers in the bed to increase the chance that she finds one.
Read: Pacifiers: Pros, cons and safety tips
d. Allow thumb sucking
The advantage of thumb sucking is that your child can use her finger to self-soothe if she cannot find her pacifier, satisfying that instinct to suck. Dr. Harvey Karp warns about the fact that “removing the pacifier often leads to more thumb sucking. Pacifiers are better than thumbs because sucking on fingers can seriously distort the palate and teeth, leading to the need for uncomfortable and expensive braces later.” However, do not get upset if your baby begins sucking her thumb or fingers. It helps to calm your little one if she feels stress or fatigue. The AAP mentions that about 50% or more uses this self-soothing technique and over half of them stop this soothing behavior by age six or seven months. Do not worry about it if your child is younger than 4 years old.
Read: Pacifiers: When to start, when to stop and how to wean
e. Put your baby to bed drowsy but awake
Babies can develop self-soothing skills very early on. After your baby’s second month, you can try to put her to bed drowsy – in a state of somewhat awakeness, however, almost falling asleep – at least once a day.
The term “drowsy but awake” refers to the state in which the child is aware that a person is putting her to bed and falls asleep knowing where she is. By doing so, your newborn will not panic once awake, wondering: “How did I get here!?!?!??”
To clarify the “drowsy but awake” concept, imagine a scale from 1 to 5, 1 being wide awake and 5 being deep sleep. You want to put your baby down at about 3. She should be quite sleepy but awake enough to know who puts her down and how she is getting into the crib. If she falls asleep too quickly, i.e. in less than five minutes, she was probably already too sleepy.
The best time of day to initiate this learning is the morning nap. If your child has fallen asleep just before nap time, wake her gently before bedtime. If she disagrees with this attempt at learning, comfort her by holding her in your arms. Even if the first time was a failure, continue to try the experiment once a day, day after day.
After demonstrating that she has mastered this new skill in the morning, continue this training with post-lunch naps or at bedtime. This technique teaches a baby that she doesn’t need your presence at any time to fall asleep, even when she wakes up in the middle of the night. She will be able to fall asleep without being in your arms or without having to be breastfed or bottle-fed.
f. Give your baby time and space to self-soothe
This may be the hardest one to put in place for parents. In her book Bringing up Bébé Pamela Druckerman, describes the French parents’ philosophy with the concept of “The Pause”. The Guardian summarizes her theory about The Pause as follows: “Waiting is the key: the French do not do instant gratification. It starts more or less at birth. When a French baby cries in the night the parents go in, pause, and observe for a few minutes. They know that babies’ sleep patterns include movements, noises and two-hour sleep cycles (note: a baby’s sleep cycle is more 50 to 60 minutes), in between which the baby might cry. Left alone it might “self-soothe” and go back to sleep. If you dash in like an Anglophone and immediately pick your baby up, you are training it to wake up properly. But if a French baby does wake up and cry properly on its own, it will be picked up. Result? French babies often sleep through the night from two months. Six months is considered very late indeed.”
Your baby can be vocal when transitioning between sleep cycles. She might fuss or cry before finding a comfortable position and falling asleep. Even if you know that your baby’s needs are met, she can feel a little frustrated while learning to sleep. In such a case, I suggest that parents try to relax and wait a minute or two before rushing into the bedroom. This will allow the baby to learn how to fall back asleep without their assistance.
If the crying doesn’t stop, they can check on her, speak softly, stroke her back or pick her up if she seems very upset. Most of the time, the parents’ reassuring presence might be all she needs to fall asleep. Sleep is a learned skill and learning a new skill can cause temporary frustration.
8. Be a patient, consistent and perseverant coach
”We are what we repeatedly do. Excellence is not an act, but a habit.” – Aristotle
Even when we know that some guidelines are good for our child, they are sometimes difficult to enforce when tears roll down. Being a loving parent doesn’t mean welcoming chaos without limits. With time, children learn how to approach the world by observing the values shared by its entourage. The more consistent the words and actions, the more stable they will feel. Children need to know what to expect. Without consistency, they feel lost, insecure and encounter difficulties controlling themselves.
Setting limits does not mean that you decide everything for them. Of course, you determine when your child needs to take a bath, brush her teeth and have dinner. However, as a parent, you can be flexible. It’s good for children to know that some things are negotiable in certain situations. Therefore, you should give your child particular choices and a sense of autonomy. Let her choose the book she wants to read during the bedtime routine or the stuffed animal she wants to fall asleep with. Limit the options to 2 or 3 items to set a time limit for the decision-making process.
Moreover, all sleep-coaching methods are successful when parents understand that it takes time to change sleep associations and they have to stick to their decisions, no matter what.
Throughout her life, your child will test the limits set, your patience and your consistency. Her sleep-learning is no exception to this rule. Therefore, talk with your partner and do not start with sleep coaching until both parents are 100% committed and comfortable with the chosen sleep-training method. Make sure everyone (grandparents, babysitters, etc.) is onboard (Read: Why doesn’t sleep-training work?).
Build a relationship with your child on mutual trust. Let people around you give you advice but remember to follow your instinct. You are in the best position to know what is beneficial or, on the contrary, harmful to your child. She sees you as a role model and follows you in the decisions you make. The more confident and positive you are, the easier she will learn how to sleep. For your part, show her and tell her that you believe in her ability to fall asleep alone. Your role is not to do things for her but to guide and encourage her in learning a new skill.
Finally, make sure you have realistic expectations regarding your baby’s sleep given her age, her temperament, and your lifestyle. Rome wasn’t built in a day… So, be patient and do not give up too easily.
All in all, there are some ways to tell if your child is having enough of the right kind of sleep. Does she wake up without problems and happily in the morning? Does she seem to have sufficient energy during the day? Overall, is she in a good mood? If all answers are “yes” you are doing the right things! If you have any doubts, questions or concerns about your baby’s sleep habits, talk to your pediatrician or give me a call. I can provide you with more information on how to improve the quality and the quantity of your child’s sleep. So, schedule your first free consultation now! It is a free and non-binding offer.