Quality sleep is vital for your baby’s daily routine. Not only do healthy sleep habits help give parents a much-needed break but they also support a baby’s rapid mental and physical development.
But what if your baby isn’t sleeping regularly or soundly through the night? It’s important to remember that this is totally normal. In fact, a temporary sleep regression (a change in sleep pattern) may be caused by a developmental leap, such as learning to crawl or walk.
So how can you get your family’s sleep schedule back on track? In honor of National Baby Sleep Day, Rhonda Patt, MD, medical director of Atrium Health Levine Children's Charlotte Pediatrics, provides recommendations and best practices for families when it comes to sleep training and sleep safety.
How to promote healthy sleep hygiene
The best way for parents to help a baby develop a good circadian rhythm (sleep-wake cycle) is to promote more daytime wakefulness and keep lights and stimulation low overnight. When a baby is 3-4 months of age, parents should develop a bedtime routine that is consistent each evening and may include lullabies and rocking. At this age, parents are encouraged to put their baby to bed when drowsy but not fully asleep.
“Many parents don’t realize that sleep is developmental and that infant sleep development follows a predictable pattern,” Dr. Patt explained. “When you know what to watch for and make adjustments accordingly, babies will often develop healthy sleep patterns on their own.”
Some babies never have to "cry it out" or end up with tired parents sleeping on the floor beside the crib. “However, most parents will hit a bump in the road with sleep during the first year, so understanding some practical sleep training strategies can be beneficial,” said Dr. Patt.
Napping is also developmental. During the early months of life, babies nap around the clock after brief periods of wakefulness. By 4 months of age, most babies are taking a predictable first morning nap. Between 6-9 months, babies are generally taking 2-3 predictable naps each day.
When to start sleep training
Sleep training and fostering healthy sleep hygiene can begin right away. In the first 2 months of life, babies need 16-18 hours of sleep a day. However, many babies sleep better during daytime hours than at night.
Sleep training methods
Sleep training refers to ways that parents can promote healthy sleep habits for their infants. The way to approach sleep training varies according to the child’s age. Consider the following sleep training methods:
- Cry it out. This method involves putting a baby to bed and allowing them to cry themselves to sleep without parental intervention. For many reasons, this would be a last resort method when all else has failed and the risks of lack of consolidated sleep for baby outweigh the stress associated with listening to your baby cry.
- No tears. This training method is the opposite of crying it out. With the "no tears" method, babies are tended to quickly and comforted by the parents.
- Fading. This method is a compromise between the "no tears" and "cry it out" strategies. With the fading method, parents gradually decrease stimulation and support until the baby learns to fall asleep on their own and the parents are able to leave the room while the baby is still awake – without tears. If the baby does cry, parents can return to the room after a few minutes and provide comfort but then exit again while the baby is still awake.
“It’s important to remember that there’s no one-size-fits-all approach to sleep training,” Dr. Patt noted. “Each child is born with their own temperament and innate sleep skills.”
Some babies fall asleep easily with little need for rocking or swaying and stay asleep for longer stretches of time. Other babies may fight sleep and wake from sleep entirely at the end of each sleep cycle. For this reason, what works for one baby may backfire on another. After exploring these options, it’s best to tailor your baby’s sleep strategy to meet the needs of your family as a whole.
Sleep training concerns
“Some families may think of sleep training as allowing a baby to cry at night, but it’s better to think of sleep training as a process that begins in the newborn period by creating a healthy, nurturing sleep environment,” Dr. Patt explained.
Naturally, parents may have concerns about increased maternal and infant stress levels when babies are left to cry during sleep training. The good news for parents is that a 2018 article published by Canadian Family Physician reported that sleep training was shown to improve infant sleep issues, “with no adverse effects reported after 5 years.” In addition, maternal mood scales also showed significant improvement.
How to prevent SIDS
Sudden infant death syndrome (SIDS) is the unexpected, often unexplained death of a newborn. Since SIDS usually occurs when babies are sleeping, this may cause parents to worry about the safety of their children’s sleep habits.
To help prevent SIDS, Dr. Patt recommended the following precautions:
- Sleep position. Make sure your baby is sleeping on their back.
- Crib accessories. Avoid putting blankets, bumpers or stuffed animals in the crib, since these items can increase a newborn’s risk of SIDS.
- Bed-sharing vs. room-sharing. Bed-sharing (when parents and their children sleep in the same bed) can also lead to SIDS. Room-sharing can be a safe alternative to sharing a bed. “The newest recommendation is to have your baby in your room for at least 6 months and even up to a full year,” she said. “Room-sharing has been shown to reduce the risk of SIDS, perhaps because parents are present and more aware of the baby’s sleep habits.”
Besides preventing SIDS, beware of other potential safety risks for sleeping infants. For example, pacifier clips can be used when the baby is awake. But if the baby falls asleep, a pacifier clip with a long tether (more than 7 inches long) may go around the baby’s neck and cause strangulation.
If you’re struggling with your child’s sleep habits, you’re not alone. Sleep regressions are totally normal and can be managed with sleep training strategies. Following our tips for healthy, safe sleep can help your baby sleep longer at night and help you feel well rested in the morning.
Learn more
If your baby is having sleep problems, make an appointment with their pediatrician. Contact the sleep specialist at Levine Children’s to discuss more serious conditions.
