“Sleep is an essential part of how the human body operates, and it’s just as necessary for babies as it is for adults,” says Dr Iqbal Karbanee, paediatrician and CEO of Paed-IQ BabyLine, a trusted telephonic medical advice service for the first 1000 days of a child’s life, starting from conception to birth and beyond. “However, what moms and dads ideally want is for their baby’s sleep pattern to suit the family’s routine.”
Below Dr Karbanee discusses the key building blocks, and shares tips to ensure that babies – and their parents – get the rest they need.
About babies and sleep
Until the age of three years, children spend more time asleep than awake. A child of five needs 11 to 12 hours of sleep at night. A baby that is healthy and growing will be ready to sleep through the night from about 6 months of age, although some may still need an early morning feed until the age of 9 months. Newborn sleep however is very different to that of older babies. Before 14 weeks, newborns have not yet learnt to self-soothe and fall asleep on their own.
Is a medical reason keeping your baby awake?
There may be an underlying medical reason like reflux, abdominal cramps, colic, or teething that prevent a baby from sleeping.
- Abdominal pain and colic may cause a baby to become restless later in the day, and parents should try introducing probiotic drops to assist the gut. They should also book a feeding assessment at a clinic. It may comfort parents to know that colic generally peaks at about 2-3 months, and then starts subsiding by 16 weeks.
- From the age of 4 months, teething is one of the most common reasons why babies don’t sleep. A baby that tugs at its ears is a teething giveaway. There are a variety of teething powders and gels available on the shelves, but the most effective pain relief for babies who are otherwise healthy is paediatric paracetamol syrup.
- If a baby shows signs of fever or other symptoms, it’s important to see a GP or paediatrician to rule out other medical causes.
- It is only from 12 to 16 weeks that a baby’s sleep cycle or circadian rhythm starts forming and they can start falling asleep on their own. This is the time at which sleep training can start to be introduced.
Full tummies lead to sleepy eyes
Nutrition is a critical building block for good sleep. From 6 months of age a baby’s iron reserves start depleting, which is why it’s important to slowly start introducing solids into the diet, although milk should remain the primary nutrient source until 12 months. A sufficient dietary supply of iron is essential for growth and development.
A new-born’s sleep pattern is partly regulated by hunger, so if a baby is feeding well and has no other medical issues, they should be sleeping well too.
An environment that supports sound sleep
The next building block for good sleep is their environment.
- All a baby needs in its cot is a proper fitted mattress and a fitted sheet. All other loose blankets, toys and that may cause distraction should also be removed.
- Babies have a high metabolic rate so they don’t feel the cold the way adults do. A suitable room temperature is 21°C, and if the temperature goes above 26°C you may want to use a cooling fan.
- The room should be as dark as possible at night. Keeping the room dark in the day is not recommended. A night light is not necessary – babies have not yet learned to be afraid of the dark.
A routine that builds good sleep habits
Babies and children that struggle to fall asleep are often overstimulated and over-tired.
- A three-month old baby should only have 1.5 hours of awake time, a six-month old can stay awake for 2.5 hours, and a 10-month old can manage 3.5 hours before they start getting into a state of agitation and need a nap.
- For babies over four months of age, a sleep-feed-play cycle, where a child feeds as soon as they wake up, can be introduced. Play time after feeding helps the baby relieve gas and be more comfortable for its next nap.
- Establishing a bedtime routine is also an important step in preparing children for sleep as they have no concept of time, but they will learn that sleep happens after bath and story time in the evenings.
Dr Karbanee says parents must remember that it will take two to three days before a baby starts responding to new changes. “Parents must understand that incremental change works best,” he concludes.
