Sleep is almost always an issue in families with young kids. Every family is different, with different expectations and different abilities to cope with the sleep deprivation that comes with parenthood. Don’t expect miracles before 6 months- the young baby is programmed to require night feeds which can be normal until 8-9 months of age. Thereafter, demanding a milk feed is usually not a nutritional issue but a comfort “prop” to help them fall asleep again.
Teaching a child to self soothe is an important tool to impart on your young one and can be done from about 4 months of age when the baby’s brain becomes mature enough to learn patterns. They may need a comforter such as a special taglet-blanket, soft toy or dummy (or a combination of these) to help them fall asleep. Whatever it takes, teaching a child to self-settle with gentle support requires a lot of patience but is certainly worthwhile in the long run.
In older children and teenagers, sleep is of utmost importance to maintain optimal importance in the classroom and on the sportsfield.
In fact in a keynote address by the American Academy of Sleep Medicine, they commented that “We’ve rushed head long into this 24-7 world, and we simply aren’t adapted to deal with it.” In this 24-7 world, we need to make sure our basic needs are met, including sleep requirements.
What can we expect as within normal limits for sleep?
- Newborn babies are generally reasonably easy for the first 10 days or so then may become more difficult as the brain “wakes up” and colic and wind set in. Their sleep requirements are high (about 16 hours a day in total for the first few weeks), gradually settling into a pattern of approximately 3 naps per day by 3 months of age. If possible, some naps should be more than 40 minutes long to provide restoring sleep. At night time they will continue to wake 3-4 hourly for feeds for the first few weeks; by 3 months there is often a longer “stretch” of sleep during the night of 5-6 hours.
- Some babies may need night feeds for longer than “normal”:
- Babies with small tummies/refluxers may need frequent small feeds
- ex-prems and those with growth concerns may need night feeds
- Total sleep requirements vary over time, and to promote optimal health, the American Academy of Sleep Medicine has recently issued these recommendations per 24 hours:
- 16-18 hours in newborn, which includes 3-4 naps per day
- 12-16 hours in 4-12 month olds, which includes 2-3 naps a day
- 11-14 hours in 1-2 year old, which includes 1-2 naps per day
- 10-13 hours in a 3-5 year old; usually only night time sleep
- 9-12 hours in 6-12 year olds
- 8-10 hours in teenagers
- “Sleep cycles” last 40-45 minutes and restorative sleep spans more than one sleep cycle
When do we need to worry about sleep?
- If there is a sudden change in sleep pattern: this could indicate illness/anxiety/teething.
- If the child not getting enough sleep: behaviour and development may be affected.
- If the parents not getting enough sleep to cope, and the family is not coping with the interrupted nights.
Under such circumstances it is worth having the child looked at to make sure there is not a physical ailment disrupting the sleep. The routine and feeding pattern should be examined to make sure the daytime sleep and feed requirements are being met. Remember that ironically an overtired baby often sleeps poorly. Sleep training should be discussed. There are a variety of forms of sleep training available, from controlled checking to gentle gradual separation techniques- please discuss with your clinic sister or doctor before embarking on these. If a child is unwell or going through a stage of separation anxiety, it is not a good time to sleep train. Remember that “this too shall pass” and that most children- even the worst initial sleepers- sleep very well by the age of 4 or 5 years.
The safety of our precious newborn babies and infants is our top priority when it comes to sleeping time.
The American Academy of Paediatrics has published extensive recommendations for a “safe infant sleeping environment” to minimise the risk of injuries and cot deaths. These include the following:
- Babies should be put on their backs to sleep for every sleep; tummy and side sleeping are not as safe
- Car seats and sitting devices are not for routine or prolonged sleeps
- Babies should preferably share a room with their parents for the first 6 months, in their own cots, without bed sharing
- Babies should be breastfed if possible
- Parents should avoid tobacco smoke, illicit drugs and excessive alcohol
- Babies should undergo their routine childhood immunisations
- Use of a pacifier (dummy) at sleep time has been found to be protective
- Babies should sleep on a firm crib mattress with a fitted sheet
- Keep soft objects such as loose bedding, blankets, soft pillows and bumpers out of the cot
- Avoid overheating: infant should be sufficiently clothed to be warm but not overheated. Generally a young infant needs one layer more than an adult to maintain a comfortable temperature.
- Do not cover the baby’s head
Remember that the safest sleep position for your baby is on the back. The “back to sleep” campaign in the UK has seen the rate of cot deaths halve over only a few years, so this is advice well worth following.
Sleep is a precious commodity- so remember, if there is a sudden change in sleep pattern, or if you feel that you or your baby are not coping with their sleep, please discuss with your healthcare practitioner.