Sleep. To a parent of a newborn or young child, it’s a magical word. It can also be one of the things of which nightmares are made if you have a little one that does not sleep well. Newborns sleep 16 hours or more per day, but usually in stretches of only a few hours at a time. After a few months, babies usually sleep 5 hours at a time, with most babies sleeping through 10 hours during their first year. But getting through the process makes for very sleepy parents or caregivers! Below are some answers to common questions about babies and sleep:

1. How can I start my infant off with good sleep habits?
Infants – to about 4 months – cry because of physical needs. They can’t be “spoiled” at this age, so when your infant cries, pick him up and give comfort by rocking and cuddling. When your infant wakes up at night, take care of him quickly and matter-of-factly, without much social contact or play. Then put him back in the crib and leave the room, to discourage waking up for the rewards of play and attention.

2. How can I put my older baby to sleep?
The older baby (4 months and older) must learn to relax and fall asleep without help. After the rituals of bathing, quiet play and feeding, put your older baby into the crib while he is still awake. Your baby will become better at relaxing and drifting off to sleep without help, which will also help when he wakes up in the middle of the night.

3. What is SIDS and can it be prevented?
According to the Centers for Disease Control, Sudden Infant Death Syndrome (SIDS) is the sudden death of a seemingly healthy baby younger than 1 year of age. Although there is no known cause of SIDS, there are things that parents can do to help with prevention:
-always place babies on their backs to sleep for every sleep
-use a firm sleep surface, such as a mattress in a safety-approved crib, with a fitted sheet
-have the baby share your room, not your bed; your baby should not sleep in an adult bed, on a couch, or on a chair alone, with you or with anyone else
-keep soft objects, such as pillows and loosed bedding out of your baby’s sleep area
-prevent exposure to smoking during pregnancy and after birth as these are important risk factors for SIDS; the risk of SIDS is even stronger when a baby shares a bed with a smoker

4. What should I do if my baby wakes in the middle of the night?
Many older babies wake up at night for the privilege of sleeping in the parents’ bed. This desire often continues throughout childhood. Unless you believe in the family bed, avoid this attractive response to nighttime waking at all costs!

5. What tips can you offer for helping my baby sleep?
Establish daytime routines, including consistent waking times. Regular meal and activity times promote regular sleeping times. Develop bedtime rituals (a story or song, bath); routines make it easier for a child to “wind down.” Provide an environment that promotes sleep. A cool, dark, quiet room is best. Discourage excess evening fluids. Be consistent!

6. If I wait a while, will bedtime be easier?
Don’t postpone bedtime in the hope that a tired child will be easier to put to bed. When an overtired child loses self-control, it can be almost impossible to meet the child’s needs and the child can’t fall asleep comfortably.

7. What if my preschooler won’t go to sleep?
If your older preschooler resists going to sleep, try allowing the child to stay awake–but only in his bedroom–as long as the child wants, but without the stimulation of television or other screens. Your child feels somewhat in control, while you maintain a defined bedtime. There’s little reason to stay awake once the child realizes that further contact with the family is unlikely, and the child is likely to drift off the sleep—perhaps while playing on the floor. Eventually, the child will find that a soft bed is a better place to spend the night.

8. What is an example of a bedtime ritual?
Following a nightly routine makes bedtime easier because children (even young babies) learn what to expect. Routines encourage relaxation, which leads to sleep. Begin by establishing a consistent bedtime. Begin the transition to sleep a half-hour to an hour before bedtime. This transition can include things such as a giving your baby a warm bath, brushing his/her teeth (even older babies need their teeth brushed!), giving your baby a last drink of water, changing baby’s diaper, and reading a story. Then—and here’s the big one—put your baby in his/her crib while still awake and say good night. He/she must get used to falling asleep alone so that baby can do it again if he/she wakes in the night!

9. When should my child move into a bed?
Generally, a bed is introduced at about age 2-1/2 or 3, when the child can get in and out of it easily. The American Academy of Pediatrics advises switching to a bed when a child is 35 inches tall. Other signs of readiness include if your child starts climbing out of the crib, or if he sleeps through the night and adheres to a regular bedtime routine. Some popular choices with regard to selecting a bed include:
-A junior bed is made for young children. It is low to the ground and has guardrails. However, as it uses a crib-size mattress, it will be good only until your child reaches age 5 or so.
-A twin-size bed will work, but push one side against the wall and use a guardrail on the other.
Be sure to keep the bed away from windows, and as your child will be mobile, remember to keep doors and entrances to off-limit areas closed and locked, and install a safety gate at the top of stairs.

10. My child is on medication. Does that affect sleep?
Medications definitely can affect a child’s sleep. Many times, unbeknownst to parents, medications—over the counter and prescription–can cause or add to a sleep problem. Always check with your child’s pediatrician before administering medications of any kind.

The bottom line is each child is different and in most cases eventually develops an acceptable sleep routine. Adhering to consistent bedtime rituals and nighttime waking strategies are important for parents and caregivers, and babies alike. Patience goes a long way too! As with any concerns, speak with your child’s pediatrician first. MKSA is always available to answer questions and make appropriate referrals. For more information about MKSA’s services, click here.