Sleep - or lack of it - is probably the most-discussed aspect of
baby care. New parents discover its vital importance those first
few weeks and months. The quality and quantity of an infant's
sleep affects the well-being of everyone in the household -
it's the difference between being cheerful, alert parents and
members of the walking dead.
And sleep struggles rarely end with a
child's move from crib to bed. It simply changes form. Instead
of cries, it's pleas or refusals. Instead of a feeding at 3:00
AM, it's a nightmare or request for water.
you get your child to bed through the cries, screams, avoidance
tactics, and pleas? How should you respond when you're awakened
in the middle of the night? And how much sleep is enough for your
How Much Is Enough?
It all depends on your child's age. Charts that list the
hours of sleep likely to be required by an infant or a 2-year-old
may cause concern when individual differences aren't
considered. These numbers are simply averages reported for large
groups of children of particular ages.
There's no magical number of hours required by
kids in a certain age group. Two-year-old Sarah might sleep from
8:00 PM to 8:00 AM, whereas 2-year-old Johnny is just as alert the
next day after sleeping from 10:00 PM to 5:00 AM. Still, sleep is
very important to a child's well-being. The link between a
child's lack of sleep and his or her behavior isn't
always obvious. When adults are tired, they can either be
grumpy or have low energy, but kids can become hyper, disagreeable,
and have extremes in behavior.
Most kids' sleep requirements fall within a predictable
range of hours based on their age, but each child is a unique
individual with distinct sleep needs. Here are some approximate
numbers based on age, accompanied by age-appropriate pro-sleep
Babies (up to 6 Months)
There is no sleep formula for newborns because their internal
clocks aren't fully developed yet. They generally sleep or
drowse for 16 to 20 hours a day, divided about equally between
night and day.
Newborns should be awakened every 3 to 4 hours until their
weight gain is established, which typically happens within the
first couple of weeks. After that, it's OK if a baby sleeps for
longer periods of time. But don't get your slumber hopes up
just yet - most infants won't snooze for extended periods of
time because they get hungry.
Newborns' longest sleep periods are generally 4 or 5 hours -
this is about how long their small bellies can go between feedings.
If newborns do sleep for a while, they will likely be extra hungry
during the day and may want to nurse or get the bottle more
Just when parents feel that sleeping through the night seems
like a far-off dream, their baby's sleep time usually begins to
shift toward night. At 3 months, a baby averages 5 hours of sleep
during the day and 10 hours at night, usually with an interruption
or two. About 90% of babies this age sleep through the night,
meaning 6 to 8 hours in a row.
But it's important to recognize that babies aren't
always awake when they
like they are; they can cry and make all sorts of other noises
during light sleep. Even if they do wake up in the night, they may
only be awake for a few minutes before falling asleep again on
their own. It's best if babies learn early to get themselves to
sleep, so let your baby try.
If a baby under 6 months old continues to cry for several
minutes, it's time to respond. Your baby may be genuinely
uncomfortable: hungry, wet, cold, or even sick. But routine
nighttime awakenings for changing and feeding should be as quick
and quiet as possible. Don't provide any unnecessary
stimulation, such as talking, playing, or turning on the lights.
Encourage the idea that nighttime is for sleeping. You have to
teach this because your baby doesn't care what time it is as
long as his or her needs are met.
Ideally, your baby should be placed in the crib before falling
asleep. And it's not too early to establish a simple bedtime
routine. Any soothing activities, performed consistently and in the
same order each night, can make up the routine. Your baby will
associate these with sleeping, and they'll help him or her wind
down. You want your child to fall asleep independently, and a
routine encourages babies to go back to sleep if they should wake
up in the middle of the night.
6 to 12 Months
At 6 months, an infant may nap about 3 hours during the day and
sleep about 11 hours at night. At this age, you can begin to change
your response to an infant who awakens and cries during the
You can give babies at this age 5 minutes to settle down on
their own and go back to sleep. If they don't, you can comfort
them without picking them up (talk softly, rub their backs), then
leave - unless they appear to be sick. Sick babies need to be
picked up and comforted. If your baby doesn't seem sick and
continues to cry, you can wait a little longer than 5 minutes, then
repeat the short crib-side visit.
After several days, your baby should find it easier to get back
to sleep on his or her own. But if your 6-month-old continues to
wake up five or six times each night, talk to your doctor.
Between 6 and 12 months, separation anxiety becomes a major
issue for some babies and may cause them to start waking up
again. But the rules for nighttime awakenings are the same through
a baby's first birthday:
pick up your baby, turn on the lights, sing, talk, play, or feed
your child. All of these activities encourage repeat behavior.
If your baby wakes up crying at night, you can check in to make
sure he or she isn't sick or in need of a
. You can pat your child lovingly on the back or belly. Using a
pacifier or thumb sucking can also help children of this age learn
to calm and reassure themselves. If your baby continues to cry, you
can institute the 5-minute visit pattern.
From ages 1 to 3, most toddlers sleep about 10 to 13 hours.
Separation anxiety, or just the desire to be up with mom and dad
(and not miss anything), can motivate a child to stay awake. So can
simple toddler-style contrariness.
Note the time of night when your toddler begins to show signs of
sleepiness, and try establishing this as his or her regular
bedtime. And you don't have to force a 2- or 3-year-old child
to nap during the day unless yours gets cranky and overly
Parents sometimes make the mistake of thinking that keeping a
child up will make him or her sleepier for bedtime. In fact,
though, kids can have a
time sleeping if they're overtired.
Establishing a bedtime routine helps kids relax and get ready
for sleep. For a toddler, the routine may be from 15 to 30 minutes
long and include calming activities such as reading a story,
bathing, and listening to soft music.
Whatever the nightly ritual is, your toddler will probably
insist that it be the same every night. Just don't allow
rituals to become too long or too complicated. Whenever possible,
allow your toddler to make bedtime choices within the routine:
which pajamas to wear, which stuffed animal to take to bed, what
music to play. This gives your little one a sense of control over
But even the best sleepers give parents an occasional wake-up
can awaken a toddler and so can dreams. Active dreaming begins at
this age, and for very young children, dreams can be pretty
alarming. Nightmares are particularly frightening to a toddler, who
can't distinguish imagination from reality. (So carefully
select what TV programs, if any, your toddler sees before
Comfort and hold your child at these times. Let your toddler
talk about the dream if he or she wants to, and stay until your
child is calm. Then encourage your child to go back to sleep as
soon as possible.
Preschoolers sleep about 10 to 12 hours per night, but
there's no reason to be completely rigid about which 10 to 12
hours they are. A 5-year-old who gets adequate rest at night no
longer needs a daytime nap. Instead, a quiet time may be
substituted. Most nursery schools and kindergartens have brief
quiet periods when the children lie on mats or just rest.
A 5-year-old child may still have nightmares and trouble falling
asleep some nights. You can prepare a "nighttime kit"
that includes activities to pass the time and relax your child. It
might include a flashlight, a book, and a cassette or CD player and
story tape or CD. Use the kit together, then put it in a special
place in your child's room where he or she can get to it in the
middle of the night.
School-Age Children and Preteens
Kids ages 6 to 9 need about 10 hours of sleep a night. Bedtime
difficulties can arise at this age from a child's need for
private time with parents, without siblings around. Try to make a
little private time just before bedtime and use it to share
confidences and have small discussions, which will also prepare
your child for sleep.
Children ages 10 to 12 need a little over 9 hours of shuteye a
night. But it's up to parents to judge the exact amount of rest
their children need and see that they're in bed in time
for sufficient sleep.
Lack of sleep for kids can cause irritable or hyper types of
behavior and can also make a condition like
attention deficit hyperactivity disorder (ADHD)
Adolescents need about 8 to 9.5 hours of sleep per night, but
many don't get it. And as they progress through puberty, teens
actually need more sleep. Because teens often have schedules packed
with school and activities, they're typically chronically sleep
deprived (or lacking in a healthy amount of sleep).
And sleep deprivation adds up over time, so an hour less per
night is like a full night without sleep by the end of the week.
Among other things, sleep deprivation can lead to:
- decreased attentiveness
- decreased short-term memory
- inconsistent performance
- delayed response time
These can cause generally bad tempers, problems in school,
stimulant use, and driving accidents (more than half of
"asleep-at-the-wheel" car accidents are caused by
Adolescents also experience a change in their sleep patterns -
their bodies want to stay up late and wake up later, which often
leads to them trying to catch up on sleep during the weekend. This
sleep schedule irregularity can actually aggravate the problems and
make getting to sleep at a reasonable hour during the week even
Ideally, a teenager should try to go to bed at the same
time every night and wake up at the same time every morning,
allowing for at least 8 to 9 hours of sleep.
Establishing a Bedtime Routine
Here's a summary of a few ways that may help your child ease
into a good night's sleep:
- Include a winding-down period in the routine.
- Stick to a bedtime, alerting your child both half an hour and
10 minutes beforehand.
- Allow your child to choose which pajamas to wear, stuffed
animal to take to bed, etc.
- Consider playing soft, soothing music.
give your baby or toddler a bottle (of breast milk, formula, or
any sugar-containing drink) to aid sleep. This can cause a
called "baby bottle tooth decay" because the fluids
tend to pool in the child's mouth.
- Tuck your child into bed snugly for a feeling of
- Encourage your older kid or teen to set and maintain
a bedtime that allows for the full hours of sleep needed at
There isn't one sure way to raise a good sleeper, but every
parent should be encouraged to know that most kids have the ability
to sleep well. The key is to try, from early on, to establish
healthy sleep habits.
Steven Dowshen, MD
Date reviewed: November 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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