Realistic expectations for infant and toddler sleep
Image Credit: Vida Images
Many parents find infant and toddler sleep challenging, and it’s common to wonder whether we need to do more to support healthy sleeping patterns.
Unfortunately, some sleep advice is provided by people without qualifications in normal infant sleep and behaviour. Therefore, while well-intentioned, this advice may not reflect current scientific evidence, or consider how brain development influences sleep, leading to unrealistic expectations.
When a child does not meet these expectations, it is easy to believe they have a sleep problem, which can cause unnecessary family stress. That stress, and the reduced confidence associated with it may harm parental mental health. Understanding normal infant sleep can reduce stress and overwhelm, and support close, loving relationships.
While a wakeful baby can impact a parent’s sleep, and chronic sleep deprivation* can impact a parent’s mental health, some of the disruption can be reduced with a better understanding of infant sleep patterns and how to optimise everyone’s sleep and rest for this time.
What is normal baby sleep?
A ‘one-size-fits-all’ approach is rarely helpful with sleep in the 0–3-year age group, partly because of the wide variation in normal sleep patterns.
While infants and toddlers need more total sleep than older children and adults, this sleep is not consolidated and is spread across 24 hours. It is normal for babies and toddlers to take daytime naps, wake in the night, and need support to fall back to sleep at night.
Napping patterns also vary: some babies take regular catnaps of 20-30 minutes, while others nap for longer periods. Toddlers may nap into the preschool years or drop all naps much earlier. Night waking usually gradually reduces with age, and sleep consolidation may start sometime in the first year, though many children continue to have fragmented sleep until age 3 and beyond. This normal fragmented sleep does not cause sleep deprivation in the same way that it does for older children and adults.
Benefits of waking up
Protects against SUDI (including SIDS)
requent arousal has been suggested to have a protective effect against sudden unexpected death in infancy (infants: 0-12 months).[2]
Promotes regular feeding
While frequent waking may be tiring, it promotes regular feeding, which is important for establishing milk supply if you are breastfeeding or chestfeeding, and optimises growth and development.
Babies have small stomach capacities, and both human and formula milk are rapidly digested, which means that your baby will wake for feeds in the night, though how frequently they feed depends on their unique needs. [3]
Myths about feeding and sleep
Unfortunately, while night feeds are normal in children up to the age of 18 months and beyond, there are many myths [4] which can cause parental anxiety, including:
Babies over a certain age or weight don’t need night feeds
Babies only need 1-2 feeds a night
Babies should sleep through the night by three to six months
Babies should have scheduled feeds
Babies need long naps in the dark
Babies all need to go to sleep at 6 or 7pm
Infant brains won’t develop if they have broken sleep.
None of these are based in fact.
How to soothe your baby
One common parental issue when children wake up is getting them back to sleep. It may be helpful to remember that it is normal for children to need help falling back to sleep, though at times it may be frustrating or tiring. Children gradually require less sleep support as they mature, but this process takes a variable amount of time.
Until your child is ready to fall asleep independently, active soothing strategies can help. Babies may prefer to be close to their family at night - especially their birth mother or primary caregiver, as their smell, taste and heartbeat are familiar.
Some soothing options may include:
Feeding to sleep
Rocking and bouncing
Carrying
Touch/ Massage
Bathing
Feeding to sleep
Many babies fall asleep feeding, partly due to hormones such as the gut hormone cholecystokinin (CCK). This is released during suckling at the breast or bottle. CCK helps your baby feel full and sleepy. CCK triggers oxytocin (known as the 'love hormone')[5]. Oxytocin is also released during skin-to-skin contact during feeding. Meanwhile, brain-derived neurotrophic factor released during feeding induces deep sleep. The bottom line is that feeding and holding lead to sleep.
Rocking and bouncing
Many babies like to be rocked or gently bounced to sleep. Research shows that rocking can reduce crying, help babies get to sleep quicker and improve their overall sleep quality. [6] It’s thought that rocking or bouncing has a synchronising effect on the brain that triggers natural sleep rhythms. [7] Most babies need either holding, rocking, feeding, or bouncing to fall asleep - these are not “bad habits!”
Carrying
Carrying your baby in your arms helps them to regulate their stress and take in the world while feeling calm, safe, and secure in your care [8].
Slings and carriers may help meet your child’s carrying needs
Children who are carried often stop wriggling and crying, and experience physiological calmness and stability. While not all children like them, using a sling or carrier may help soothe your baby or toddler. They are also helpful to give you two hands-free.[9] Note, that if you use a sling or carrier, be sure to follow the TICKS safety principles.
The power of touch
Baby massage can help your baby feel calm and sleep soundly. Research has shown that babies who were massaged had a better quality of sleep than those who weren’t [10]. Similarly, snuggling, shushing and patting your baby may also calm them.
Bathing
Giving your baby a bath may help them sleep better. Not only does water mimic the in-utero environment, helping your baby feel calm and relaxed, but research shows that a warm bath can help children sleep better. [11]
Tips for better baby sleep
While it’s normal for babies and toddlers to wake through the night, the following can help improve your infant’s sleep.
Keep your baby in your room until at least 6 months old, ideally 12 months. Room-sharing has been shown to be a protective factor reducing the risk of SUDI by 50%. It may also reduce your fatigue, tending to night-time needs..[12][13][14]
‘Prepare to share’: It is really common for people to fall asleep with their baby, even if they don’t intend to. By preparing a shared sleep surface ahead of time, you can make it safer if this happens. A shared sleep surface can include using a sidecar cot, a cot by your bed or a floor bed, and can also mean creating a clear space around a baby if they are sharing in an adult bed.
*Couches and nursing chairs increase the risk of sleep accidents. A firm, flat, clear surface is safer.[15][16][17]
Understand and accept that your child is likely to wake frequently and need physical contact throughout the night for a while, as this is normal.[18]
Your baby can’t read a clock. Clock-watching can increase your anxiety – do what’s easiest to get your baby back to sleep.
Use a sling or carrier appropriate to your infant’s development to help your infant sleep or nap during the day. (Remember the TICKS principles of sling safety)
Sometimes, eye rubbing and grizzly behaviour can be a sign of boredom. Try a change of scenery if baby is fighting sleep.
Ensure you and your child are exposed to sunlight during the day, as this helps regulate the circadian rhythm (sleep/wake cycle).
Develop a bedtime routine that will help you and your child relax and prepare for sleep.
Use dim lighting for night-time care to minimise interference with your and your baby’s circadian rhythm.
Ensure your child’s sleepwear, bedding and room are not too hot or too cold.
Some babies have health issues that cause them to wake more often. Check with your trusted medical professional if you think this could be the case.
10 tips for maximising YOUR sleep/rest
Do all the things you can while baby is AWAKE so you can try to rest/sleep while they nap/ sleep.
Go to bed when baby goes to bed … this is often their longest stretch of the night, so if you can get to bed then as well, you get your longest stretch (It doesn’t have to be every night, even a couple of nights a week can help!).
If you’re breastfeeding/chestfeeding/nursing, maximise the benefits of the sleepy hormones in your breastmilk and side-lie feed in a prepared shared space so you can doze off with baby.
Minimise your alcohol intake, and caffeine after lunchtime, for better quality sleep.
If you have someone who can take baby first thing in the morning so you can sleep a bit longer … do it! If bub is typically unsettled with someone else, they could try taking baby for a walk in the carrier for some bonding time - movement is soothing.
If you’re tracking/ watching the clock … give it a rest. Clock-watching can increase your anxiety about sleep.
Stay off your phone at night; it messes with your sleep regulators, making it harder to get back to sleep.
Keep baby close to minimise the physical exertion needed to tend to their nighttime needs.
Up to 40% of parents may have parental insomnia not connected to their infant’s sleep. Check in with your medical professional if you find yourself not able to sleep when baby is.
Don’t waste your precious energy worrying about ‘bad habits’, your baby won’t always need you this much, but for now, nurture on! You’re doing beautifully.
Teamwork makes the dream work
here’s no doubt that having a baby or toddler in the house can disrupt everyone’s sleep. However, this phase won’t last forever. Instead of wishing the time away, or counting how many hours you’re not sleeping, know that you’re doing important work. Remember that day or night: this is an important opportunity to connect with your child, and night-time nurturing and feeding promote brain growth and development.
Realistic expectations of what can be achieved with a young child in the house are important. A lot of time will be taken up with the essentials of feeding, caring for them and supporting their sleep. That’s why it’s important to work as a team and ask for support when you need it. This may include:
If possible, ask key people in your life who want to help (i.e., partner, family, friends) to take on more responsibility so you can sleep/rest when you can
See if you can get some help with non-baby-related jobs, e.g., household chores, shopping, meals, or looking after older children.
Don’t forget informal connections in the community — a stranger at the toy library, new friends at playgroup, an old lady in the supermarket. Small doses of social connection can make a big difference to your mental health.
Reach out for support in ways that feel comfortable to you if you can. In your community, as well as online support groups, where 'pocket friends' are increasing in popularity and availability. Peer support can help you feel seen and held.
For your peace of mind, here are the sleep duration recommendations from The National Sleep Foundation. Some babies will have higher sleep needs while others will have lower. You can’t *make* your baby sleep more than they need.
Be guided by your child
While there are recommendations for optimal sleep for infants and children, there is a huge variation in how much sleep an infant needs, which is why you should be guided by them [19][20].
All infants have different temperaments and will have their own sleep needs. Once you rule out health issues, optimise sleep environments, and follow their cues, you’ll learn how much sleep they need.
Of course, if you are concerned their sleep may be related to a health issue, speak to your healthcare provider.
You might also like to read our article “When sleep isn’t normal”.
Trust yourself and trust your baby.
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Acknowledgements
The development of this resource was made possible by the generous support of the Mary Jane Foundation as part of their Her Health Hero program.
A special thank you to the team at Peach Tree Perinatal Wellness for their feedback and collaboration on this resource.
Little Sparklers gratefully acknowledge the contribution of our working party members who participated throughout the development of this resource, particularly:
Dr Shireen Durrani, Project Lead, MBChB (Hons) MPP MSc FAFPHM
Carly Grubb, Little Sparklers Managing Director, BEd (Primary)
Lyndsey Hookway, RNC SCPHN IBCLC
Greer Kirshenbaum PhD Neuroscience, CD
Tracy Cassels PhD Developmental Psychology
Professor Jeanine Young AM, FACN, PhD, BSc (Hons) Nursing, Adv. Dip Nursing Care, RGN, Reg. Midwife, Neonatal Nurse
Aloka Kumarage, lived experience consumer
Danielle Brown, lived experience consumer and Little Sparklers volunteer peer supporter
Keren Toynton, lived experience consumer and Little Sparklers volunteer peer supporter
We also thank all our The Beyond Sleep Training Project community members who helped provide the original feedback that this resource was built off.
A special thank you also to the generous contributions of the University of the Sunshine Coast who supported Professor Jeanine Young to attend our regional photoshoot to provide safe sleep expertise and advice.
Extra acknowledgement to the talented photographer, Renee Johnstone of Vida Images and her beautiful family models who have made it possible to bring imagery to this resource.
We also acknowledge the professional skill, patience of our wonderful health communication writer, Nerissa Bentley.
We acknowledge that the information we share about realistic expectations of infant and toddler sleep, safer sleep recommendations and nurturing care is not new. It is grounded in current and emerging evidence, yet these principles have been practised for millennia.
We honour the rich knowledge, wisdom, and practices of Aboriginal and Torres Strait Islander peoples in birthing, raising, and nurturing children—ways of being, doing, and knowing that have ensured the safety, well-being, and thriving of infants and children for countless generations.
Supplementary safety information included in the downloadable pilot parent resource:
Further information available in the full Queensland Clinical Guidelines document for Safer Infant Sleep
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REFERENCES:
[1] Henderson JM, France KG, Owens JL, Blampied NM. Sleeping through the night: the consolidation of self-regulated sleep across the first year of life. Pediatrics. 2010 Nov;126(5):e1081-7. doi: 10.1542/peds.2010-0976. Epub 2010 Oct 25. PMID: 20974775., https://pubmed.ncbi.nlm.nih.gov/20974775/
[2] Ramirez JM, Ramirez SC, Anderson TM. Sudden Infant Death Syndrome, Sleep, and the Physiology and Pathophysiology of the Respiratory Network. In: Duncan JR, Byard RW, editors. SIDS Sudden Infant and Early Childhood Death: The Past, the Present and the Future. Adelaide (AU): University of Adelaide Press; 2018 May. Chapter 27. PMID: 30035952. https://pubmed.ncbi.nlm.nih.gov/30035952/
[3] Peter S. Blair, Helen L. Ball, James J. McKenna, Lori Feldman-Winter, Kathleen A. Marinelli, Melissa C. Bartick, the Academy of Breastfeeding Medicine, Michal Young, Larry Noble, Sarah Calhoun, Megan Elliott-Rudder, Laura Rachael Kair, Susan Lappin, Ilse Larson, Ruth A. Lawrence, Yvonne Lefort, Nicole Marshall, Katrina Mitchell, Catherine Murak, Eliza Myers, Sarah Reece-Stremtan, Casey Rosen-Carole, Susan Rothenberg, Tricia Schmidt, Tomoko Seo, Natasha Sriraman, Elizabeth K. Stehel, Nancy Wight, and Adora Wonodi.Bedsharing and Breastfeeding: The Academy of Breastfeeding Medicine Protocol #6, Revision 2019.Breastfeeding Medicine.Jan 2020.5-6.http://doi.org/10.1089/bfm.2019.29144.psb
[4] Amy Brown and Victoria Harries. Infant Sleep and Night Feeding Patterns During Later Infancy: Association with Breastfeeding Frequency, Daytime Complementary Food Intake, and Infant Weight.Breastfeeding Medicine.Jun 2015.246-252.http://doi.org/10.1089/bfm.2014.0153
[5] Moberg KU, Prime, DK, Oxytocin effects in mothers and infants during breastfeeding, Infant, 2013, Vol 9, Iss 6, pp201-206, https://www.infantjournal.co.uk/pdf/inf_054_ers.pdf
[6] Öztürk Dönmez R, Bayik Temel A. Effect of soothing techniques on infants' self-regulation behaviors (sleeping, crying, feeding): A randomized controlled study. Jpn J Nurs Sci. 2019 Oct;16(4):407-419. doi: 10.1111/jjns.12250. Epub 2019 Feb 6. PMID: 30729735., https://pubmed.ncbi.nlm.nih.gov/30729735/
[7] Bayer L, Constantinescu I, Perrig S, Vienne J, Vidal PP, Mühlethaler M, Schwartz S. Rocking synchronizes brain waves during a short nap. Curr Biol. 2011 Jun 21;21(12):R461-2. doi: 10.1016/j.cub.2011.05.012. PMID: 21683897. https://pubmed.ncbi.nlm.nih.gov/21683897/
[8] Berecz, B., Cyrille, M., Casselbrant, U., Oleksak, S., & Norholt, H. (2020). Carrying human infants - An evolutionary heritage.Infant behavior & development, 60, 101460. https://doi.org/10.1016/j.infbeh.2020.101460
[9] Esposito G, Yoshida S, Ohnishi R, Tsuneoka Y, Rostagno Mdel C, Yokota S, Okabe S, Kamiya K, Hoshino M, Shimizu M, Venuti P, Kikusui T, Kato T, Kuroda KO. Infant calming responses during maternal carrying in humans and mice. Curr Biol. 2013 May 6;23(9):739-45. doi: 10.1016/j.cub.2013.03.041. Epub 2013 Apr 18. PMID: 23602481., https://pubmed.ncbi.nlm.nih.gov/23602481/
[10] Saputro H, Bahiya C, The Effects of Baby Massage to Sleep Quality in Infant Age 1-7 Months. Journal for Research in Public Health, Vol 2 No 2 (2021) January. https://jrph.org/index.php/JRPH/article/view/33#
[11] Haghayegh, S., Khoshnevis, S., Smolensky, M. H., Diller, K. R., & Castriotta, R. J. (2019). Before-bedtime passive body heating by warm shower or bath to improve sleep: A systematic review and meta-analysis. Sleep medicine reviews, 46, 124–135. https://doi.org/10.1016/j.smrv.2019.04.008
[12] Blair PS, Fleming PJ, Smith IJ, Platt MW, Young J, Nadin P, Berry PJ, Golding J. Babies sleeping with parents: case-control study of factors influencing the risk of the sudden infant death syndrome. CESDI SUDI research group. BMJ. 1999 Dec 4;319(7223):1457-61. doi: 10.1136/bmj.319.7223.1457. PMID: 10582925; PMCID: PMC28288., https://pubmed.ncbi.nlm.nih.gov/10582925/
[13] Blair PS, Sidebotham P, Berry PJ, Evans M, Fleming PJ. Major epidemiological changes in sudden infant death syndrome: a 20-year population-based study in the UK. Lancet. 2006 Jan 28;367(9507):314-9. doi: 10.1016/S0140-6736(06)67968-3. PMID: 16443038., https://pubmed.ncbi.nlm.nih.gov/16443038/
[14] Moon RY, Horne RS, Hauck FR. Sudden infant death syndrome. Lancet. 2007 Nov 3;370(9598):1578-87. doi: 10.1016/S0140-6736(07)61662-6. PMID: 17980736., https://pubmed.ncbi.nlm.nih.gov/17980736/
[15] Cole, R., et al. (2020). "Infant care practices and parent uptake of safe sleep messages: a cross-sectional survey in Queensland, Australia." BMC Pediatrics 20(1).
[16] Ball HL. The Atlantic Divide: Contrasting U.K. and U.S. Recommendations on Cosleeping and Bed-Sharing. J Hum Lact. 2017;33(4):765-769. doi:10.1177/0890334417713943 https://pubmed.ncbi.nlm.nih.gov/28793194/
[17] Queensland Clinical Guidelines. Safer infant sleeping. Guideline No. MN22.71V1-R27. Queensland Health. 2022. Available from: http://www.health.qld.gov.au/qcg. Retrieved 26 October 2022.
[18] Pennestri, M. H., Burdayron, R., Kenny, S., Béliveau, M. J., & Dubois-Comtois, K. (2020). Sleeping through the night or through the nights?. Sleep medicine, 76, 98–103. https://doi.org/10.1016/j.sleep.2020.10.005
[19] Hirshkowitz, M., Whiton, K., Albert, S. M., Alessi, C., Bruni, O., DonCarlos, L., Hazen, N., Herman, J., Adams Hillard, P. J., Katz, E. S., Kheirandish-Gozal, L., Neubauer, D. N., O'Donnell, A. E., Ohayon, M., Peever, J., Rawding, R., Sachdeva, R. C., Setters, B., Vitiello, M. V., & Ware, J. C. (2015). National Sleep Foundation's updated sleep duration recommendations: final report. Sleep health, 1(4), 233–243. https://doi.org/10.1016/j.sleh.2015.10.004
[20] Paavonen, E. J., Saarenpää-Heikkilä, O., Morales-Munoz, I., Virta, M., Häkälä, N., Pölkki, P., Kylliäinen, A., Karlsson, H., Paunio, T., & Karlsson, L. (2020). Normal sleep development in infants: findings from two large birth cohorts. Sleep medicine, 69, 145–154. https://doi.org/10.1016/j.sleep.2020.01.009
