Newborns spend around 70% of their time asleep, sleeping often, but in short periods. When they’re awake, they need feeding, changing and lots of TLC, which leaves parents exhausted. As this sleep routine is very different to parents’ sleep, many worry over whether their baby is sleeping well. There are then extra concerns when the baby goes through phases of change in their sleep pattern.
So, it’s understandable that your child’s sleep can add to your worries, but it’s also important that you’re getting enough sleep yourself. Our previous post in this series looks at the importance of sleep for parents and the first post looks at the importance of sleep during pregnancy. In this post we’ll be focusing on where it all starts: the first year of your baby’s life. We’ve taken a look at the science behind what affects babies’ sleep and the importance of good sleep for their development, along with some tips on how you can improve and encourage it.
Keep an eye out for more posts in this series, in which we’ll be looking at the importance of sleep as your little one grows.
How much should my baby sleep?
The chart above shows how much, on average, babies sleep during a 24-hour period. Of course, every baby is different and each baby’s individual pattern will change and evolve. Some babies can get by on less, and some may need more, so don’t worry if they aren’t sleeping for the average amount of time, or if their daytime and night time sleep patterns aren’t balanced in this way – they will gradually get into a rhythm as they grow. It is advised that at 0-3 months, they should sleep for more than 11 hours but less than 19, and at 4-11 months they should sleep for more than 10 hours but less than 18. If you think that your baby is sleeping too much or not enough, you should contact your healthcare professional.
A baby’s sleep cycle is different to that of an older child or adult. We looked at the sleep cycle of adults in the first post in this series: 4 stages of REM and non-REM sleep in 90 minute cycles, where only 20-25% of sleep is REM. Infants, on the other hand, have sleep cycles of around 50 minutes (for the first 9 months), and around half of it is REM sleep. REM sleep is used to consolidate memories and is critical to a baby’s development.
Shorter sleep cycles mean that they may wake more often, but they will normally just stir and fall back to sleep. They will wake up properly when they need to feed. In the first few weeks they may wake every 2-4 hours, but as their stomach gets bigger, they will take more in at each feed and only need to wake every 4-5 hours. It’s normal for your baby to have lots of night wakings when they are young, but then they learn to self soothe and fall back to sleep on their own as they adjust to the world. Remember to follow safe sleep advice when it comes to your baby’s sleep environment.
From around 6 months, your baby could stop needing night feeds so may wake up less often and eventually sleep through the night. According to Thiedke, “Children who previously slept through the night can sometimes resume night awakening, usually because of social factors rather than maturational ones.” It may take a while and they may even regress, but don’t panic if your baby is taking their time to get settled into their routine. It may be difficult, but by not responding to your baby straight away, they can learn to self soothe and fall back to sleep by themselves (although you shouldn’t leave them to cry).
Baby sleep problems
Around 20% of babies in the UK are reported to have sleeping difficulties in their first year – so if this is happening in your family, you’re not alone. Erratic, disrupted sleep can just be temporary while your baby gets used to things, but there may also be underlying issues for these problems. If your baby is having sleep problems that are concerning you, you may need to contact your healthcare professional.
Baby sleep problems include:
Excessive sleepiness or insomnia
Although your little one will sleep a lot, they generally should not sleep more than 19 hours at 0-3 months, or 18 hours at 4-11 months. If your baby is sleeping for an excessive amount of time, it may be due to a growth spurt, teething or illness, but it can also be a sign of an underlying condition (discussed below).
It is possible that things can go in the other direction, and you baby may suffer from infant insomnia, which can also be a sign of teething or illness, or other underlying problems such as colic.
Disruptive sleep apnoea
Sleep apnoea is often thought of as a problem that arises as we get older but, although it is rare, it can occur in infants. This may be because of airway abnormalities that can cause the airway to collapse, obstructing their breathing. It has been found that infants have “both anatomical and psychological predispositions toward airway obstruction and gas exchange abnormalities.”
Sleep apnoea is more prevalent in premature babies. It affects 84% of infants who weigh less than 2.2 pounds, and 25% who weigh less than 5.5 pounds. Research shows that it also correlates with gestational age – it affects nearly all infants born at 29 weeks or less, 54% born at 30 to 31 weeks and 15% born at 32-33 weeks.
Look out for the signs of obstructive sleep apnoea:
- Pauses in breathing lasting for 20 seconds or more
- Patterns of repeated breathing pauses that last for less than 20 seconds
- Related problems like low oxygen or a slow heartbeat
Other underlying medical conditions
If your baby is suffering from sleep problems, they may not be environmental or behavioural; it is possible that they have an underlying medical condition, such as:
- A fever
- An infection (ear, yeast, urinary tract, parasitic or respiratory)
- Abnormal reflux
Sleep problems can also be caused by underlying psychiatric conditions such as mental health conditions(which are difficult to diagnose in babies but will become more apparent later in life) or ADHD. A study by Thunström found that around 25% of children with sleep problems in infancy will later qualify for the diagnosis of ADHD.
Separation anxiety
If you move your baby into their own room after 6 months, they may experience separation anxiety. It is completely normal, but it can be a difficult time. At around 4-7 months your baby will develop object permanence, which means that they can understand that objects (i.e. mum or dad) still exist even when they can’t be seen. This may lead to fussing or crying (instead of sleeping) when they’re left in their own room, but they will learn (over time) that this doesn’t mean you’re gone forever. This type of anxiety has been found to be more prominent in infants between 8 and 12 months. See the tips section below for advice on dealing with separation anxiety.
Genes
Some sleep problems may simply be down to your baby’s genes. We previously discussed how gene mutations in adults can affect sleep duration, and this is also an issue for some infants. Research by Touchette et al found that genes can have a big impact on whether children sleep through the night (specifically at night time rather than day time). It is also thought that if a parent suffers from insomnia, it can make their baby more predisposed to it.
Environmental factors
A study by Jian and Douglas looked at the relationship between mothers’ emotional availability and infant temperament and sleep. They found a correlation between parent-infant interactions and infant sleep problems, and that “high level of parental involvement, short response latency to infant awakenings, and active soothing at bedtime have been related to frequent infant night wakings in correlational and experimental studies.” Of course, it’s important to be there for your child and to make them feel safe, but too much involvement may lead to more disrupted sleep.
Being emotionally available at bedtime without overdoing it can make your baby feel secure and allow them to rest easier. Research by Jian and Teti looked at babies between 1 and 6 months and found that this emotional availability (interpreting and responding to a child’s signals, supporting them, interacting peacefully while not restricting or interfering with the child’s exploration of their environment) resulted in increased sleep time. Another study by Teti et al found that “parents’ emotional availability to children in sleep contexts promotes feelings of safety and security and, as a result, better-regulated child sleep.” So it’s important to find the right balance of emotional availability.
Moving your baby into their own room may also impact their sleep, but it’s important to stick with it rather than move them back and confuse them. It may seem like a mean thing to do, but not responding to their every noise and allowing them to self soothe can help to regulate their mood, help improve the quality of their sleep (and yours) and make them calmer and better at concentrating in the future. Other environmental factors may include noise, lighting, temperature and hunger.
What does sleep impact?
Growth
Babies double their birth weight by around 5 months, and triple it by around 12 months. This is a lot of growth in such a short space of time, and good sleep plays an important role in this.
Somatotropin is a growth hormone which is released throughout the day, but “approximately 80% of it is released soon after a child or adolescent is in the Non-REM stage of sleep.” So not getting enough sleep can stunt their physical development. A study by Lampl and Johnson showed a link between increased bursts of sleep and growth spurts in body length, which showed that growth spurts both occur during sleep and are influenced by it – it is thought that this may be because of the release of somatotropin during sleep.
Weight gain
It has also been found that short sleep duration can lead to childhood obesity. Research by Tikotzky et al found significant correlations between sleep and growth in babies’ first six months, and research by Taveras et al looked at 915 children and found that “daily sleep duration of less than 12 hours during infancy appears to be a risk factor for overweight and adiposity in preschool-aged children.” So although good sleep helps them grow, less sleep can affect their weight in a negative way.
Mental development & learning
Your baby’s brain roughly doubles in size in their first year. They develop rapidly, and a lot of their learning is done while they sleep. Research by Ednick et al looked at a number of studies focused around sleep and mental development in infants and found correlations between normal sleep development and higher developmental scores, and “higher motor activity and night waking negatively correlated with mental scores.” They also looked at studies that showed that children with ‘difficult’ temperaments slept less, and that increased sleep correlated with ‘easy’ temperaments, although this is difficult to measure.
Just like older children and adults, sleep is critical when it comes to memory consolidation. According to Tarullo et al, sleep allows infants to strengthen their memories and things they’ve learned while awake, prepares them for the processing and exploration of their environment and allows them to “process sensory stimuli and learn about contingencies in their environment.” This processing of information that happens during sleep is important, especially in the first year, as this is when a child is completely new to the world and is learning all about their bodies and their environment.
Immune system
Sleep is important for our immune system at any age, but it is especially important for babies, as their immune systems are still immature and not as strong as adults. It takes time for immunity to develop, and sleep plays a role in this. If a baby is sleep deprived, they are more prone to disease and infection, and it can affect their recovery time. Being ill can also negatively impact their sleep, disrupting their sleep cycle and giving them less quality sleep overall.
Tips on improving their sleep
It’s completely understandable that it may be difficult to get your baby to sleep for the recommended amount of time, or to keep things consistent. Some little ones may wake at regular times, fall back to sleep easily and start sleeping through the night at 5 months; others may have sporadic sleep patterns, cry and fuss when they should be sleeping and not sleep through the night until they are past their first year. This does not mean you are any better or worse at being a parent – you’re doing a great job.
The current recommendation from the UK Department of Health, the NICE Guidelines, the NHS and the American Association of Paediatrics is that, “the safest place for your baby to sleep for the first six months is in a cot in the same room as you.” After that, you may move them to their own room (if possible). See our blog post on co-sleeping for more.
We’ve put together a few tips that might help you if you’re having problems with your baby’s sleep.
Create a comfortable sleep environment
To create a comfortable sleep environment, it’s important that your baby isn’t too hot or too cold. The Lullaby Trust recommends that the room temperature should be between 16 – 20°C, and you should use lightweight bedding – “Babies who are unwell need fewer, not more bedclothes.” And “Babies do not need to wear hats indoors, nor sleep under a duvet or quilt.” Put your hand on their back or neck to feel if they are too warm – they may be clammy or sweaty if they are.
Other things that can create a comfortable environment are keeping it very quiet, or using white noise or lullabies to soothe your baby to sleep. Use these sounds only before bed to help condition your baby to learn the difference between night and day / sleep and awake time. You also do not want to have any fluorescent light around your baby before bedtime or during night feeds and changes, so a dim nightlight that’s free from blue light will reduce disturbances and help them to sleep better.
Establish a consistent bedtime routine
For example: bath, feed, cuddle, story time, bed. It doesn’t have to be extravagant, but it should be the same every night, and you should try to get them down at the same time each night. This can help to get your child into a rhythm that will eventually allow them to sleep through the night. It might also be an idea to adjust your own bedtime to around 10 pm or earlier, to allow for more sleep for yourself.
Put them into their cot when they’re drowsy but still awake
Look out for signs of sleepiness, such as yawning, looking away, fussing or eye rubbing. If you put your baby in their cot before they fall asleep, they will begin to get used to falling asleep without you. In turn, this can mean that they will fall back to sleep after night wakings without too much of a disturbance.
Keep activity to a minimum during night wakings
Don’t talk, play, turn on the light (use a dim nightlight to see), or use your phone while you wait for them to fall back to sleep. If you’re trying to soothe them, try stroking them in their crib instead of holding them, or sing soft lullabies instead of upbeat sing-songs. If they’re hungry, make sure they are having full feeds to reduce the risk of them waking up due to hunger soon after.
Be emotionally available but not overbearing
It’s important to keep your baby feeling safe and secure, but too much involvement may hinder their sleep. A reasonable level of emotional availability includes responding sensitively to your baby’s cues, using soothing bedtime routines, not initiating play or too much talking and not becoming impatient or irritable.
As discussed previously, they will wake a lot in the night but won’t always need attention – if you hear them stir, don’t respond straight away as it’s likely they will fall back to sleep. If they continue making noises or crying then they may need feeding, changing or attention. Self soothing will help their sleep cycles to link, improving their sleep quality and, in turn, improving their health and development.
Conquer separation anxiety
Although it will take time for your baby to get used to being away from you (either to sleep or being left with another caregiver), there are a few things that you can try to make this time a little bit easier:
- Don’t leave them when they’re hungry
- Create a goodbye ritual – try singing or talking as you leave the room and for some time while they can’t see you
- Play peek-a-boo, or hide and seek in the same room while continuing to talk to get them used to you coming back
- Keep smiling to show your baby that everything is OK
- Don’t try to sneak away – be firm and let them see you leave
Don’t compare your baby to other babies
It may be difficult, but regardless of how your baby sleeps, as long as they are healthy and happy you shouldn’t worry if they’re sleeping differently to others. It may help to join a baby and toddler group to share experiences with like-minded people, or to try online forums. And don’t feel ashamed to ask for help – parenthood can be a huge challenge, and close friends and family are sure to be happy to be able to spend some time with your little angel.
We hope this has helped you to understand how important sleep is right from the very start of life. Look out for more posts, in which we’ll be looking at the importance of sleep as your baby grows.
Let us know in the comments below if you have any questions or tips on improving your baby’s sleep!
