All About Sleep: Newborn - 24 months

Babies, like adults, have various stages and depths of sleep. Depending on the stage, the baby may actively move or lie very still. Infant sleep patterns begin forming during the last months of pregnancy—active sleep first, then quiet sleep by about the eighth month. There are two types of sleep:

  • REM (rapid eye movement sleep) or "active" sleep. During REM sleep, our brains are active and dreaming occurs. Our bodies become immobile, breathing and heart rates are irregular. This is a light sleep when dreams occur and the eyes move rapidly back and forth. Although babies spend about 16 hours each day sleeping, about half of this is in REM sleep. Older children and adults sleep fewer hours and spend much less time in REM sleep.
  • Non-REM sleep or "quiet" sleep. During the deep states of NREM sleep, blood supply to the muscles is increased, energy is restored, tissue growth and repair occur, and important hormones are released for growth and development.

Non-REM has 4 stages:

  • Stage 1: drowsiness, eyes droop, may open and close, dozing
  • Stage 2: light sleep, the baby moves and may startle or jump with sounds
  • Stage 3: deep sleep, the baby is quiet and does not move
  • St age 4: very deep sleep, the baby is quiet and does not move

(NOTE: A baby enters stage 1 at the beginning of the sleep cycle, then moves into stage 2, then 3, then 4, then back to 3, then 2, then to REM. These cycles may occur several times during sleep. Babies may awaken as they pass from deep sleep to light sleep and may have difficulty going back to sleep in the first few months.)

 

Sleep and Newborns (0-3 months)

For newborns, sleep during the early months occurs around the clock and the sleep-wake cycle interacts with the need to be fed, changed and nurtured. In the first two months of life, babies sleep on a 24-hour clock because they don't secrete melatonin. Newborns sleep a total of 10.5 to 18 hours a day on an irregular schedule with periods of one to three hours spent awake. The sleep period may last a few minutes to several hours. During sleep, they are often active, twitching their arms and legs, smiling, sucking and generally appearing restless.

Newborns express their need to sleep in different ways. Some fuss, cry, rub their eyes or indicate this need with individual gestures.

It is best to put babies to bed when they are sleepy, but not asleep. They are more likely to fall asleep quickly and eventually learn how to get themselves to sleep. Newborns can be encouraged to sleep less during the day by exposing them to light and noise, and by playing more with them in the daytime. As evening approaches, the environment can be quieter and dimmer with less activity.

Myth: "All babies will start sleeping through the night by the age of six months" is just that - a myth.

6 to 9 months old

By the time babies reach six months of age their sleep patterns are more predictable than when they were younger. They may have settled into a routine of two to four daytime naps that may range from one to two hours in duration, likely to be doing most of their sleeping at night. (11 to 12 hours.) Some babies asleep at night for a stretch of several hours at a time or even through the night. Babies will start sleeping through the night at different ages; there is no correct age for children to start.

You may even find that your baby used to sleep through the night when they were younger, start waking through the night. This could be a result of teething, over-tired or increased cognitive abilities.

10 to 12 months

70-80% of babies between the ages of nine months and when you're sleeping through the night, most... but not all! At around 10 months of age your baby may start waking up and going to sleep at a predictable time each day.

By the time your baby celebrates their first birthday, they may be sleeping approximately 8 to 9 hours each night and taking two daytime naps as well, both naps totalling about two and a half hours.

Between 12 to 18 months, The morning nap disappears and is replaced with one longer afternoon nap.

Fact: About 30% of children between one and four years of age wake during the night at least once a week. These night wakings tend to peak between 18 months and two years and then decline.

24 months

At a year and a half your child may sleep 11 to 12 hours at night with a nap in the afternoon lasting 1 to 2 hours.

At 36 months your child may sleep about 12 hours at night and may or may not have a short nap.

Night waking

Night waking is very normal for small babies and even toddlers.

However, most parents want their toddlers to sleep through the night when it's no longer necessary to have a night feeding. But it is not always that easy. Children are quick to develop habits, and waking at night may have become a habit that stays even when your toddler is no longer having a night feeding. Sleep researchers have found that even adults never really sleep through the night. It's normal to wake up from time to time and not really remembering the waking. Learning to settle themselves is a skill that your child will learn to develop overtime.

Reasons your baby is waking up

Baby is hungry - Your baby might still wake up in the middle of the night for a feeding. Sometimes if your baby was busy during the day, she may have missed the odd meal of snack and wake up hungry during the night. If breastfeeding, these feedings can help maintain your milk production. (Prolactin levels are higher during the night feedings.)

Baby is overtired - If babies are kept up in the day to help them learn to sleep at night, they can get over-tired. Have you ever been TOTALLY exhausted, lay down for a good nights sleep, and then not been able to fall asleep? Well, that happens for babies who are over-tired. It seems counterintuitive, but it's true! Keeping your baby or toddler up late will usually not lead to a later wake up time in the morning. Instead, it can cause over-tiredness, which can intern lead to even earlier wake up times. If your baby does get over-tired, help them fall asleep to catch up - A swing or a car ride could help.  Set and stick to, an appropriate bedtime for your child but just as important, watch for signs that they are getting tired. Watch for signs like a droopy eyelids or I rubbing if you took your child into bed when they are drowsy but not overtired or completely asleep, it will be easier for them to learn to fall asleep on their own. If your baby should wake, soothe your baby to sleep and try to make sure you get his naps in tomorrow.

Baby has a wet/soiled diaper - Relax the rules and diaper changes. Resist the urge to change your baby's diaper every time she wakes up he doesn't always need it, and you'll just jostle her awake. Instead, put your baby in a high-quality, nighttime diaper at bedtime. When she wakes up sniff it to see if it's soiled and change only if there's poop. To avoid waking her up fully during nighttime changes, try using wipes that I've been warmed up in a wipe warmer. If your baby tends to soil her diaper a short time after you put her to bed, try moving your pre-bedtime feeding up a bit in hopes that she will have a bowel movement before she goes to bed.

Baby is teething - If your baby is up in the night pulling on his or her teeth and gums, suspect teething pain.

Baby has diaper rash - If your baby is prone to diaper rashes change his diapers as often as possible during the day, before bed clean your baby skin with a wet washcloth and then use some diaper rash cream to protect your baby skin until the next diaper change.

Baby is ill or in pain - Medical conditions that can interfere with sleep: Acid reflex, ear infections, asthma, food intolerances, eczema, pinworms and sleep disorders. If your baby only sleeps for a short time or if your baby is only able to sleep lying in your arms it's possible that your child may be experiencing pain related to an illness.

Separation anxiety - Not wanting to be separated from the people they love most is a common cause of sleep disruptions during baby’s first year.

Baby needs some affection. Sometimes babies just need a reassuring cuddle.

Your baby’s environment - If your baby is too hot or too cold or wearing a sleeper with a irritating tag, he will have a difficult time sleeping.

Your baby hasn't learned how to get back to sleep on their own - Babies with less developed self soothing skills are more likely to wake up when they pass through the periods of light sleep.

Baby’s routine has changed - Your baby was sleeping through the night until he got a bad cold, or your night routines are inconsistent.

Baby is in the process of mastering a new skill and wants to practice it day and night- literally. - If your baby just learned how to stand up on their own, obviously they want to do it at 3 AM, and sometimes they just need your help when they can't get back down.

 

Developing good sleep habits.

Here are some tips on how you can help your baby/toddler develop good sleep habits:

  • Try to keep regular day routines.
  • Try to set up daytime routines and habits; your toddler thrives on routine.
  • Keep a regular nap schedule even on weekends if you can. If your day is very busy and naps are missed, your baby may not sleep well at night.
  • Offer plenty of regular nutritious meals and snacks during the day. (See toddler snack ideas)
  • Keep regular bedtime routines
  • Wind down the action at bedtime.
  • Some bedtime routines ideas can include: giving a baby a bath, reading to your baby, quiet cuddling, and asking other members of the family to share in quiet time.
  • Make a bedtime a special time. Set aside time for talking to your child about their day, this will help in later years as your child will come to know that this is the time of day when your child has your full attention.
  • Give some choices at bedtime, which story? Which pajamas would you like to wear?
  • Avoid watching TV or ipads before bedtime. TV is stimulating, not relaxing.

 

Keep a sleep diary!

If your baby is not sleeping well, keeping a sleep diary will help. it's easy to feel like your child has beat up every hour when realistically your baby was only up twice. Also, keeping a sleep diary will help if you change something in your routine so you can watch and see if it gets better or gets worse. Write down when your baby sleeps, for how long, when your child wakes up at night and for how long.

(See sleep diary)