Developing good sleep habits for infants and toddlers.

Story House Early Learning has partnered with Sleep Smart to provide expert advice and support to their educators, ensuring high quality sleep practices occur in each of the Story House Services. Suzie Wood, Head of Quality at Story House Early Learning recently interviewed Cindy Davenport, Clinical Director of Ternity Group; the organisation behind the Sleep Smart, Safe Sleep Space and Nourish Baby brands. The programs are accredited under the Australian Council on Healthcare Standards, Ternity Group is one of Australia’s leading providers of antenatal and early parenting education supporting both parents and professionals with their evidence-based resources and training.

Read Cindy’s advice to parents to achieve healthy sleep habits for their child.

Why are healthy sleep habits important for children?

Healthy sleep habits assist the development of children’s life skills which supports their understanding of their own body rhythms. They also support the development of resilience skills and cultivate children’s agency and independence.

Babies and toddlers cannot regulate their own big or intense emotions. This means they may feel overwhelmed and show this by crying and being generally unhappy. Young babies and toddlers need their parents help to soothe them and make them feel safe. An overwhelmed baby is unlikely to sleep. This is intrinsically tied up with their survival needs. In order to go to sleep, they have to feel secure enough to relax and not be vigilant. The more you can offer calm, gentle and sensitive care when your baby is feeling overwhelmed, the more opportunities you can give them to learn that their emotions don’t need to feel overwhelming and that you are there for them.

How much sleep does a baby need?

There is no absolute norm when it comes to hours of sleep but one of the best ways for parents to gain more knowledge is to refer to the Australian Govt 24 hr movement guideline. This gives an indication of suggested hours of sleep for a baby and toddler and recommend the physical activity, sedentary behaviour, and screen time.

So as an example: –

For an Infant

  • Sleep: 14 to 17 hours (for those aged 0–3 months) and 12 to 16 hours (for those aged 4–11 months) of good quality sleep, including naps.
  • Sedentary behaviour: Not being restrained for more than 1 hour at a time (e.g., in a stroller, car seat or highchair). Screen time is not recommended. When sedentary, engaging in pursuits such as reading, singing, and storytelling with a caregiver is encouraged.
  • Physical activity: Being physically active several times a day in a variety of ways, particularly through supervised interactive floor-based play, including crawling. For those not yet mobile, this includes at least 30 minutes of supervised tummy time, which includes reaching and grasping, pushing, and pulling, spread throughout the day while awake.

Can you share some safety tips for good sleep environments at home?

It is essential that parents ensure their young infants and toddlers sleep safely at all times and that the research-based guidelines are followed. With clear, consistent, and evidence-based messages of safe sleep practices, we can reduce the risk of many sleeps related deaths and injuries occurring.

Download our safe sleeping recommendations and always follow Red Nose Safe Sleeping Guidelines.

Should parents give their child a dummy for sleep?

Babies are naturally driven to suck – after all, their survival depends on it. Though sucking isn’t always restricted to the breast or bottle and some babies also love to suck on their thumb, fingers and/or a dummy. The action of sucking soothes babies, it’s that simple.  Some babies are particularly fond of sucking, not just when feeding but also as they go off to sleep or need comforting.

Is a dummy better than their thumb?

The big difference is that a dummy can be thrown away.  Once the dummy becomes a problem and it starts affecting a child’s sleep, it’s time to toss the dummy away. Of course, the same can’t be said for a thumb.  Parents can ‘control’ the use of a dummy, with a thumb or finger sucking, the child is in charge.

5 tips for safe dummy use

  1. Throw away dummies which are damaged.
  2. Never put a dummy into your own mouth or allow your child to share their dummy with others.
  3. Try to limit dummy use for sleep times.
  4. Don’t use a tie to secure your baby’s dummy to themselves. This is a choking/strangulation hazard.
  5. Clean and sterilise your baby’s dummies daily.

Should I try to stop my child sucking their thumb?

When they’re tired, hungry, bored, or anxious, children who thumb suck tend to place their thumb in their mouth without too much thought. The general recommendations from orthodontists – dentists who specialise in the alignment of teeth – is to have a ‘wait and watch’ approach. If the child is still not sucking their thumb by the time the permanent teeth emerge – from around the age of six years – thumb sucking isn’t a problem.

Why does a baby ‘cat’ nap?

It is completely natural for a baby to have variable sleep patterns in the few first months of life. This can include many sleeps of 2-3 hours and occasional longer ones. Often no real pattern is seen until about 4-5 months – and when you finally see a predictable pattern, it can change! While it can be worrying for parents, it is important to remember that this is all perfectly normal.

Catnapping – is the term referred to when babies sleep for one sleep cycle: often 20-40 minutes in duration. Quite simply you can bake a cake without putting the oven timer on; your baby is the timer! Most catnapping in the early months is biological. Small babies need to wake so they can feed often because their tummy capacity is so small. The majority of babies wake, feed, and return to sleep at least 2 to 4 times overnight.

How do parents know when their baby is tired?

Babies settle to sleep better if they are not overtired. Rather than watching the clock, it’s important to look and listen for signs that your baby is tired. Look out for these tired signs:

  • Glazed eyes or long blank stares
  • Redness around the eyes and eyebrows
  • Jerky movements, fast breathing
  • Clinched fists or tense extended arms or legs
  • Hiccups
  • Some babies may look at you briefly but then turn their heads and look away – this can often be misread as a sign they want to engage with you.

Late tired cues are:

  • Squirming vigorously
  • Crying
  • Yawning

Ideally, you want to begin to settle your baby before they show the late tired signs. So, if your baby or toddler is yawning – you are about to miss the sleep window!

Remember…overtired babies are much more difficult to settle. The key is not to watch the clock but watch your baby!

How can parents support their child to develop healthy sleep patterns?

Routines won’t work for all families but for many parents, creating a gentle pattern can assist with establishing infant sleep. Watching your baby’s cues, working out why they are crying and providing a predictable routine can help to make bedtime a positive experience for you and your child.

New parents have been told not to share their bed with their infant, why?

The advice from health professionals is that all babies should sleep in their own safe sleeping space e.g., a cot or a bassinet, whichever is safest. Co-sleeping is when parents bring their babies into bed with them to sleep.

Red Nose1 advises that the safest place for a baby is in their own safe sleep space, and do not recommend co-sleeping, however if parents do choose to co-sleep, it is important for them to know the safest way to do it.

Tips for safer co-sleeping1:

  • Place your baby on their back to sleep (never on their tummy or side). This helps to protect their airways.
  • Keep baby’s head and face uncovered by keeping pillows and adult bedding away from your baby. Use a safe sleeping bag with no hood with baby’s arms out – don’t wrap or swaddle baby when bed-sharing or co-sleeping.
  • Make sure the mattress is firm and flat. Don’t use a waterbed, or anything soft underneath – for example, a lamb’s wool underlay or pillows. This can increase the risk of overheating and suffocation.
  • Tie up parents’ long hair and remove anything else that could be a strangling risk, including all jewellery, teething necklaces, and dummy chains.
  • Move the bed away from the wall, so baby can’t get trapped between the bed and wall.
  • Make sure your baby can’t fall out of bed. Consider sleeping on your mattress on the floor if it’s possible your baby might roll off the bed.
  • Create a clear space for your baby and place your baby on their back to the side of one parent away from the edge, never in the middle of two adults or next to other children or pets as this can increase the risk of overheating and suffocation.

When not to co-sleep:

You should never co-sleep or lie down holding baby if:

  • You are overly tired or unwell
  • You or your partner have recently consumed alcohol
  • You or your partner smoke, even if you don’t smoke in the bedroom
  • You or your partner have taken any drugs that make you feel sleepy or less aware
  • Baby is premature or small for their gestational age

Falling asleep holding baby on a couch or chair is always unsafe – move yourself and baby to a safe sleep environment if you think you might fall asleep.

What advice would you give parents who are going to travel overseas and are worried about the impact on their babies’ sleep?

Tiny babies have virtually no circulating hormones that influence their bodies 24 hour day and night sleep behaviours. Once your baby is around 2 months of age, they begin to have measurable levels of the hormones associated with day and night sleep, but minute amounts, one you may know is melatonin. By about 7 to 9 months these levels are well and truly evident so you may well find you and your baby have some adjusting to do before sleep patterns are back to normal. Sunlight governs our 24-hour day/night body clock, or circadian rhythm, which is why when we pass a day or night in a plane, we end up with a confused body clock. To support your baby, be kind when they have that 4pm slump and the 4am waking which is classical of the sleep disruptions seen in jet lag.

Tips to help minimise the impact of jet lag:

  1. First and foremost, ‘up at dawn and to bed at dusk’ is helpful for our hormonal re-adjustment but can be a little tricky when the sun sets at 5pm – so just not too late to bed at night.
  2. Exposure to early morning sunshine to help reset that day/night clock pattern.
  3. Around 4pm your baby’s body will say ‘sleep NOW’, therefore anticipate the sudden tiredness and let your baby sleep, maybe just one sleep cycle (about 45 mins).
  4. That 3 to 4am waking will pass, just be kind and keep the stimulation low, lighting low, voices low and fingers crossed … low!
  5. Should your baby be one who is needing their night sleep to start at 5pm, just work in small time increments of adjustment and try keeping them awake for an extra 15 minutes each 2 to 3 days.

Jet lag will pass, so be kind and gentle and try to support your baby and provide sleep opportunities as needed. You may need to wake them from their late afternoon sleep so you can do the evening rituals prior to dinner and bath – before everyone collapses into bed for the night.

What strategies would you recommend for a toddler who has transitioned to a bed however keeps coming out to the adults?

It is recommended that an infant/child be slept in the safe confines of a cot until they are observed to be attempting to climb out and look like they may succeed.If the young child has been wearing a safe sleeping bag while in the cot, it is time to remove it when they transfer to a bed or mattress. Young children walking in a sleeping bag may trip and fall and injure themselves. In addition, keep the area free of objects which may cause suffocation such as soft toys or bean bags. Bean bags, sofas, large cushions, and air mattresses are not recommended as a safe surface for young children to sleep.

Key Points:

  • Most children move from a cot to bed sometime between 2 and 3 ½ years of age or earlier if you have observed the toddler attempting to climb out. It is however safe for them to stay in the cot if they are happy and show no signs of climbing out.
  • Although moving from a cot to bed is exciting, it can be unsettling for some children and it’s essential to be patient and supportive.
  • Other children may revel in their newfound independence and will just get out of bed because they can! Help your child back into bed straight away and remind them it’s time to sleep! You may have to do this several times before they settle!

Cindy Davenport is a child and family health nurse and midwife and has worked in the early parenting field since 1998. As the Clinical Director of Ternity Group she oversees a team of dedicated Sleep and Settling consultants. The organisation promotes a gentle and nurturing approach sleep and settling, with an emphasis on caregiver interaction, the child’s social-emotional and an understanding that every infant toddler and parent is unique.

Ternity Group’s Safe Sleep Space brand offers several services and resources to assist with sleep and settling of newborns, infants, and toddlers. Check out our Sleep Consultations here or our App Rockabub here or stay informed on our Facebook page.

References

1. https://rednose.org.au/article/Co-sleeping_with_your_baby 2. https://www.safesleepspace.com.au/blogs/news/thumb-sucking-or-dummy-which-is-better-for-my-baby-s-teeth? 3. https://www.safesleepspace.com.au/blogs/news/is-my-baby-tired?