Sleeping like a baby?

Babies' and children's sleep problems are a source of concern or stress for parents, and it's one of the most common things they look for advice about.  Is the baby's sleep pattern normal? When will they 'sleep through the night'? What can they do to improve sleep?

What's 'normal'?

In the early days and months of life, babies' sleep is irregular and takes place during both day and night. Some babies start to sleep mainly at night earlier than others, but a developmental trend in sleep length and timing is apparent. The greatest change in sleeping patterns occurs during the first six months, with most babies developing the ability to sleep for longer periods of time at night, reflecting the sleeping patterns of adults. This pattern continues to develop up to the age of two.

Impact on parents

It can have a huge impact on parents with sleep disturbance linked to increased fatigue, depression, anxiety and stress.  Experience of fatigue can undermine parents' satisfaction and beliefs about their competence as parents. And, parents who worry about the amount of sleep their baby is getting are more affected by it.  However, much of the evidence is based on the experience of parents attending sleep clinics; and those parents may report a greater impact on their wellbeing than the wider population of parents.

Parents who expect their child to sleep and place greater value on their child sleeping through the night report higher levels of fatigue in comparison with parents who expect frequent night awakenings in the early parenting period.

Improving infant and child sleep

Behavioural interventions aim to train infants and children to be able to sleep and settle themselves at night. Methods can include delaying the response to infant signals such as crying; regulating feed times, sleep duration and bedtimes; and other strategies that aim to train the infant to fall asleep without being fed or with physical contact with their carer.

Babies under six months experience significant physical changes which lead to self-regulation of sleep. Evidence suggests that behavioural interventions for sleep in babies at this age are ineffective, unnecessary and may even be damaging to consolidating sleep and establishing breastfeeding.

Sleep behavioural interventions in older children (3 to 5/6 years) can result in longer self-sustained sleep periods at an earlier age. However, there is also the potential for an associated negative impact on family functioning and individual wellbeing.

Support for parents

Practitioners can play an important role in helping expectant and new parents to understand infant sleep and manage the potential effects on their functioning. They can provide support and information on practical strategies to manage fatigue and improve parents' own sleep.

It's important that parents know that night time awakening is 'normal' for babies and young children, and that sleep patterns for most children will settle over time without intervention.

For more information on infant and child sleep see: www.healthscotland.com/documents/23540.aspx