Healthy sleep for your baby and child

Sleep is very important to your child’s health and well-being. In fact, good sleep habits start from birth.

Children who do not get enough sleep may have trouble functioning during the day. At night, they may find it hard to settle.

How much sleep does my child need?

Every child is different. Some sleep a lot and others much less. This chart is a general guide to the amount of sleep children need over a 24-hour period, including nighttime sleep and daytime naps.

Source: Recommended Amount of Sleep for Pediatric Populations: A Consensus Statement (American Academy of Sleep Medicine)

Babies (birth to 4 months)

Newborns may sleep as much as 18 hours a day, for 3 to 4 hours at a time. It’s normal and healthy for babies to wake up during the night to feed. As your baby gets older, they will stay awake longer during the day and sleep for longer stretches at night.

Babies, just like adults, need the right cues to learn when it is time to sleep. For example, if you always put your baby in their crib to sleep, they will learn that this is the place where they sleep. This may not work right away, but over time, your baby will come to understand.

Sometime after 3 months, your baby’s sleep habits will become more predictable and you can expect a more regular nap schedule. Trust your baby’s cues – they will let you know when they are tired. A sleep diary might help you to recognize their regular sleeping pattern.

A naptime routine is a good idea. It could include a quiet cuddle and short story in a darkened room before it’s time to nap. 

Healthy sleep habits for your baby:

• An overtired baby has more trouble sleeping. Napping actually helps a baby to sleep better at night, so keeping your baby awake during the day will not help your baby sleep longer at night.
• Put your baby in bed when they are drowsy, but awake. Remember to put them to sleep on their back in their crib, or on a firm, flat surface. Keep soft items like pillows and stuffed animals out of the crib.
• It’s okay to cuddle and rock your baby until they are drowsy. You cannot spoil a young baby by holding them.
• A pacifier may comfort and help your baby to settle. However, it’s best not to start using a pacifier until breastfeeding is going well.
• Your baby will stir during the night. Give them a few minutes to try and settle on their own before going to them.
• Avoid stimulation during nighttime feedings and diaper changes. Keep the lights dim.

Infants (4 to 12 months)

At this age, babies sleep an average of 14 hours a day, but anything less or more can be normal for your baby. By 4 months, most babies need three naps a day; one in the morning, afternoon and early evening.

Between 6 and 12 months, your baby will probably go from having 3 naps a day to 2 longer naps, in the morning and afternoon. Every baby’s napping needs are different. Some nap for as little as 20 minutes at a time, while others sleep for 3 or more hours.

Healthy sleep habits for your infant:

• Maintain a regular daytime and bedtime sleep schedule as much as possible.
• A consistent bedtime routine is important. Many parents like to use the “3 Bs”: bath, book, bed.
• Don’t put your baby to bed with a bottle. This can lead to choking or tooth decay.
• At around 6 months, if your baby wakes at night and cries, go check to see if there is anything wrong; perhaps they are too cold or too warm, but try not to take them out of the crib. You can comfort them by stroking the forehead or talking softly to let them know you’re there. This helps your baby learn how to self-soothe, an important step toward falling back to sleep on their own.

Toddlers (1 to 2 years)

Most toddlers sleep between 11 and 14 hours in a 24-hour period. 

Healthy sleep habits for your toddler:

• It’s still important to keep a sleep schedule your child is familiar with. The routine you established during the first year is even more important for your toddler.
• Avoid naps that are too late in the day, because at this age, they can affect nighttime sleeping.
• Help your child wind down about half an hour before bedtime with stories or quiet activities.
• Be gentle but firm if your child protests.
• Make the bedroom quiet, cozy, and ready for sleeping. Keep the lights dim.
• Soft, soothing music or white noise can be comforting, but is not essential.
• Security items (such as a blanket or stuffed animal) are often important at this age.

Children (3 to 5 years)

Preschoolers typically sleep about 10 to 13 hours a day. As your child approaches 3 years old, they will probably be on one nap a day, but many will still have a second nap at some point in the day. Some days they may need a nap, while other days they may not. Some children give up daytime naps altogether during this period. You can use that time—often after lunch—as quiet time for your child to read and relax.

At this age, it’s common for children to have some sleep problems and to resist going to bed. They may also wake up during the night from nighttime fears or nightmares.

Healthy sleep habits for your preschooler:

• Don’t give your child drinks with caffeine.
• Avoid screens before bedtime. Don’t allow tablets, televisions, computer or video games in the bedroom.
• Some children will try to delay bedtime. Set limits, such as how many books you will read together, be sure your child knows what they are, and stick to them.
• Don’t ignore bedtime fears. If your child has nightmares, reassure and comfort them.

What are some common sleep problems?

• Sleep deprivation: Some children don’t get enough sleep. If your child is fussy, cranky or has difficulty staying asleep at night it might be because they aren’t getting enough naptime or aren't getting to bed early enough.
• Separation issues: Your child may have difficulty relaxing and going to sleep if they feel upset that you are not there. Try a long cuddle before bedtime, a security object such as a blanket or stuffed animal, a small night light, or leaving their door open when you put them to bed.
• Nightmares: Most children will experience nightmares at one time or another. Nightmares can happen after a stressful physical or emotional event or can be caused by fever. Your child may call out to you for comfort. Talk calmly, cuddle and reassure your child. Don’t “search for monsters”.  Tell your child that it is their imagination and monsters aren’t real.

When should I talk to my doctor?

• Loud snoring and/or gasping breaths: If your child regularly snores loudly or seems to stop breathing for a short time, then gasps, this can be a sign of a problem.
• Sleepwalking: Sleepwalking is a disorder where a child is partly awake, but not completely, during the night. Your child may sit up in bed and repeat certain movements, such as rubbing their eyes. They may get out of bed and walk around the room. When you talk to your child, they usually won’t answer you. If your child sleepwalks it is important that you ensure the area is safe. Gently guide your child back to bed without waking them. If the problem continues, contact your doctor.
• Night terrors: These are different from nightmares. Children with night terrors scream uncontrollably, may breathe quickly, and seem to be awake. If you wake your child, they will likely to be confused, and may take longer to settle down and go back to sleep. Night terrors usually happen between the ages of 4 and 12, but can happen to children as young as 18 months old. Most children will outgrow them, but talk to your doctor if they persist.

What if my child regularly has trouble falling asleep?

Some children have trouble falling asleep on their own and can lie awake for long periods of time. This can be caused by too much screen time before bed, caffeine from soda and energy drinks, or upsetting events.

• Try limiting screen time and cut it out of the bedtime routine. No screens for 1 hour before sleep. 
• Don’t feed your child anything with caffeine (chocolate, pop).
• Try doing relaxing activities before bed such as reading, listening to calming music, or laying in bed with your child talking quietly about their day.

If these reasons aren’t the cause, talk to your doctor about other ways to help your child learn to fall asleep on their own.