Sleep

Good quality sleep is important for everyone but especially for children as it directly impacts on their mental and physical development.
During the deep states of sleep, blood supply to your child’s muscles is increased, energy is restored, tissue growth and repair occur, and important hormones are released for growth.
Good sleep helps to improve attention, behaviour, learning and memory.
 

 

In the drop down menus below you can find the age category of your child and all the related sleep advice and information.

All newborn babies will sleep in short regular periods throughout the day and night between their regular feeding requirements. Their wakeful periods will be initially short with longer alert times developing over the first few weeks and months, All babies have a different sleep requirement, which can be normal to them.

Is it normal for babies to wake at night?

Yes. It is normal for babies to wake during the night and nightly feeds are normal. Some babies sleep much more than others. Some sleep for long periods, others in short bursts. Some sleep through the night, some don't for a long time. Your baby will have their own pattern of waking and sleeping, and it's unlikely to be the same as other babies you know.

Do babies and young children automatically fall into a good sleeping pattern?

No. All babies and children need to be supported to develop a good sleep routine and good sleeping habits. It is a process that will take time and can’t be achieved in a few days. This can be a struggle, especially when you are sleep deprived and feel constantly tired yourself. All babies are different and will start sleeping through at different times. There also needs to be a degree of flexibility around sleep routines.

What routines and habits promote good sleep

Fortunately, there are many practical ways to develop and improve your child’s sleeping routine and habits. Tips for newborns are below.

Newborns (0-3 months)

  • For newborns, sleep during the early months occurs around the clock and the sleep-wake cycle is driven by the need to be fed, changed and given attention
  • All newborn babies will sleep in short regular periods throughout the day and night between their regular feeding requirements. The sleep period may last a few minutes to several hours. During sleep, they are often active, twitching their arms and legs, smiling, sucking and generally appearing restless
  • Newborns express their need to sleep in different ways. Some fuss, cry or rub their eyes

Newborns can be encouraged to sleep less during the day by exposing them to light and noise, and by playing more with them in the daytime. As evening approaches, the environment can be quieter and lighting lower with less activity.

Sleep tips for newborns:

  • Observe newborn’s sleep patterns and identify signs of sleepiness
  • Put newborn in a cot or Moses basket (even during the day) when they are drowsy, and not asleep, to encourage self-settling
  • Encourage night time sleep; as evening approaches try to make the environment quieter and lighting lower with less activity

All babies cry and it can be upsetting and frustrating. Not every baby is easy to calm but that doesn’t mean you are doing anything wrong. For tips on infant crying and how to cope see ICON and or talk to your Health Visitor

Safer sleep tips:

Simple steps can be taken to ensure that your baby sleeps in a safe environment, which will reduce the risk of sudden infant death syndrome (SIDS), commonly known as cot death:

  • The safest place for babies to sleep is close to their parents’ bed but in their own bed in the same room for at least the first six months
  • Never co-sleep on a sofa or armchair
  • Never co-sleep if you have smoked or have used alcohol, medication or drugs
  • Put babies on their back for every sleep
  • Keep babies smoke free day and night
  • Maintain a safe room temperature for babies to sleep in - between 16-20°C
  • The safest place for a baby to sleep is in their own clear, flat, separate sleep space, such as a cot or Moses basket, with a firm, flat, waterproof mattress
  • Support breastfeeding - both partial and exclusive breastfeeding have been shown to be associated with a lower SIDS risk

The Lullaby Trust has more information on safe sleep and reducing the risk of SIDS

You can see the Healthier Together page on Safe Sleeping here

Daytime naps advice:

  • Daytime naps provide much needed downtime that aids the important physical and mental development that happens in early childhood
  • They help keep babies and young children from becoming overtired, which can affect their moods and make it harder for them to fall asleep at night
  • They also give parents a break during the day and time to tackle household chores or just unwind
  • Mobile napping provides your baby a chance to rest when needed as long as you are following safe sleep guidelines wherever your baby needs to sleep

There's no single rule about how much daytime sleep children need. It depends on their age, the child and the sleep total during a 24-hour period. 

Daytime napping is important to take the edge off tiredness but should not interfere with yours and your baby’s need for social and developmental experiences.

The Oxfordshire Health Visiting website has several useful videos on baby sleep, click here to be directed!

Younger infants up to 6 months tend to sleep on and off around the clock, waking every 1–3 hours to eat. As they near 4 months of age, sleep rhythms become more set. 

Is it normal for babies to wake at night?

Yes. It is normal for babies to wake during the night. Some babies sleep much more than others. Some sleep for long periods, others in short bursts. Some sleep through the night, some don't for a long time. Your baby will have their own pattern of waking and sleeping, and it's unlikely to be the same as other babies you know.

It may help to remember that all babies over 4 months of age wake 4-6 times during the night, as they come to the end of each sleep cycle. This is normal, and also occurs with older children and adults. It's the falling back to sleep that can be difficult.

Do babies and young children automatically fall into a good sleeping pattern?

No. All babies and children need to be supported to develop a good sleep routine and good sleeping habits. It is a process that will take time and can’t be achieved in a few days. This can be a struggle, especially when you are sleep deprived and feel constantly tired yourself. All babies are different and will start sleeping through at different times. There also needs to be a degree of flexibility around sleep routines.

What routines and habits promote good sleep?

Fortunately, there are many practical ways to develop and improve your child’s sleeping routine and habits. Tips for infants 4-11 months are below.

After a calming bedtime routine, children benefit from being allowed to settle to sleep on their own while awake but drowsy. If children learn to settle independently they will be more likely to self soothe back to sleep after natural night wakenings.

As your baby grows their sleep habits will change, though starting to establish a bedtime routine early on can help support these changes. During the second half of the year, infants may experience separation anxiety, which may disrupt their sleep. Illness and increased motor development may also disrupt sleep.

Sleep tips for infants

  • Develop regular daytime and bedtime schedules; maintain consistent sleep and wake times
  • Create a consistent and enjoyable bedtime routine
  • Establish a regular 'sleep friendly' environment (see advice below)
  • Try to reduce feeding your baby until they fall asleep and encourage your baby to fall asleep independently i.e. while awake but drowsy, but it is normal for babies to expect a cuddle or parents to stay close
  • See the safer sleep tips in the sleep advice for newborns section

All babies cry and it can be upsetting and frustrating. Not every baby is easy to calm but that doesn’t mean you are doing anything wrong. For tips on infant crying and how to cope see ICON and or talk to your Health Visitor.

Daytime naps advice:

  • Daytime naps provide much needed downtime that aids the important physical and mental development that happens in early childhood
  • They help keep babies and young children from becoming overtired, which can affect their moods and make it harder for them to fall asleep at night
  • They also give parents a break during the day and time to tackle household chores or just unwind
  • Mobile napping provides your baby a chance to rest when needed as long as you are following safe sleep guidelines wherever your baby needs to sleep

There's no single rule about how much daytime sleep children need. It depends on their age, the child, and the sleep total during a 24-hour period.

Daytime napping is important to take the edge off tiredness but should not interfere with yours and your baby’s need for social and developmental experiences.

Example of a good bedtime routine:

Every baby and child is different and you can adapt the following bedtime routine to meet your baby’s or child’s needs. Babies may require a shorter bedtime routine. You will wish to offer your baby a 'top-up' feed as part of the routine.

Start the 'journey to bed' an hour before bedtime using signals such as end of a favourite game. A routine before bedtime could look like this:

  • Bath time – bathing and brushing teeth
  • Change into bedtime clothes
  • Story time. If they are not interested in stories to begin with you could try gentle songs or nursery rhymes. Story time can be extended as a child gets older
  • Settle into bed, cuddle time, and goodnight. Some parents find it helpful to sing the same nursery rhyme or song every night as a signal that it’s time to go to sleep
  • Avoid return to daytime activities (e.g. not returning downstairs after their bath)

Transitional objects (soft toys) are helpful to many young children as part of positive sleep association.

Example of a 'sleep friendly' environment:

The safest place to sleep is in a cot or cot bed with all sides up.

Babies should sleep on a firm and flat mattress, and the sleeping area should be clear of toys, cot bumpers and duvets; at home and when staying with family and friends.

Place baby to sleep on their back for every sleep, with face and head clear of blankets and other soft items.

Babies need to be a comfortable temperature. A room temperature of 16-20°C – with light bedding or a lightweight, well-fitting baby sleep bag– is comfortable and safe for sleeping babies.

Ideally lights off, or at least dimmed. LEDs emit much more blue light than white bulbs and therefore have a greater impact on quality sleep, so ensure these are switched off.

There does not need to be silence, and it can be helpful for your baby to get used to some noise, though noise needs to be at a level that it does not disrupt sleep.

A smoke free environment is safest for babies and children.

My child is tired, so why won’t they sleep?

If a child is happy, comfortable, and tired, problems falling asleep are likely to be behavioural (such as bedtime resistance) or environmental (such as noise).

I’ve tried all of the above and my baby is still waking frequently!

Some babies take longer than others to respond to a routine and settle into good sleep habits. Look after yourself. Almost all adults find interrupted sleep makes them feel tired and irritable, and relationships can suffer. For further advice see the useful resources section at the bottom of the page.

The Oxfordshire Health Visiting website has several useful videos on baby sleep, click here to be directed!

Young toddlers might still be taking two naps, but over time this will reduce to one nap. Naps should not be too close to bedtime, as they may make it harder for toddlers to fall asleep at night.

Do babies and young children automatically fall into a good sleeping pattern?

No. All babies and children need to be supported to develop a good sleep routine and good sleeping habits. It is a process that will take time and can’t be achieved in a few days. This can be a struggle, especially when you are sleep deprived and feel constantly tired yourself. All babies are different and will start sleeping through at different times. There also needs to be a degree of flexibility around sleep routines.

What routines and habits promote good sleep

Fortunately, there are many practical ways to develop and improve your child’s sleeping routine and habits. Tips for toddlers are below.

When they reach about 18 months of age their naptimes usually decrease to once a day. Naps should not occur too close to bedtime as they may delay sleep at night.

Many toddlers experience sleep problems including resisting going to bed and night-time awakenings. Night-time fears and nightmares are also common.

Many factors can lead to sleep problems. Toddlers' drive for independence and an increase in their motor, cognitive and social abilities can interfere with sleep. In addition, their ability to get out of bed, separation anxiety, the need for autonomy and the development of the child's imagination can lead to sleep problems. Daytime sleepiness and behaviour problems may signal poor sleep or a sleep problem.

Sleep Tips for toddlers:

  • Maintain a daily sleep schedule and a consistent and enjoyable bedtime routine
  • Maintain a regular 'sleep friendly' environment, and teach the child to settle in the same environment that they will later wake up in during the night (i.e. their bedroom)
  • Encourage your toddler to fall asleep independently i.e. while awake but drowsy
  • Set limits that are consistent, communicated and enforced. If parents do not set limits children will invariably choose a later bedtime

See the safer sleep tips on the newborn sleep advice section above.

Daytime naps advice:

  • Daytime naps provide much needed downtime that aids the important physical and mental development that happens in early childhood
  • They help keep babies and young children from becoming overtired, which can affect their moods and make it harder for them to fall asleep at night
  • They also give parents a break during the day and time to tackle household chores or just unwind
  • Mobile napping provides your baby a chance to rest when needed as long as you are following safe sleep guidelines wherever your baby needs to sleep.

There's no single rule about how much daytime sleep children need. It depends on their age, the child, and the sleep total during a 24-hour period.

Daytime napping is important to take the edge off tiredness but should not interfere with yours and your baby’s need for social and developmental experiences.

Example of a good bedtime routine:

Every baby and child is different and you can adapt the following bedtime routine to meet your baby’s or child’s needs. Babies may require a shorter bedtime routine. You will wish to offer your baby a 'top-up' feed as part of the routine.

Start the 'journey to bed' an hour before bedtime using signals such as end of a favourite game. A routine before bedtime could look like this:

  • Bath time – bathing and brushing teeth
  • Change into bedtime clothes
  • Story time. If they are not interested in stories to begin with you could try gentle songs or nursery rhymes. Story time can be extended as a child gets older
  • Settle into bed, cuddle time, and goodnight. Some parents find it helpful to sing the same nursery rhyme or song every night as a signal that it’s time to go to sleep.

Avoid return to daytime activities (e.g. not returning downstairs after their bath). 

Transitional objects (soft toys) are helpful to many young children as part of positive sleep association.

My child is tired, so why won’t they sleep?

If a child is happy, comfortable, and tired, problems falling asleep are likely to be behavioural (such as bedtime resistance) or environmental (such as noise).

I’ve tried all of the above and my baby is still waking frequently!

Some babies take longer than others to respond to a routine and settle into good sleep habits. Look after yourself. Almost all adults find interrupted sleep makes them feel tired and irritable, and relationships can suffer. For further advice see the useful resources section.

Some pre-schoolers require an afternoon nap, though you should be working towards your child dropping a regular afternoon nap before they start school.

Do babies and young children automatically fall into a good sleeping pattern?

No. All babies and children need to be supported to develop a good sleep routine and good sleeping habits. It is a process that will take time and can’t be achieved in a few days. This can be a struggle, especially when you are sleep deprived and feel constantly tired yourself. There also needs to be a degree of flexibility around sleep routines.

What routines and habits promote good sleep

Fortunately, there are many practical ways to develop and improve your child’s sleeping routine and habits. Tips for pre-schoolers are below.

Sleep and pre-schoolers (3-5 years)

As with toddlers, difficulty falling asleep and waking up during the night are common. With further development of imagination, pre-schoolers commonly experience night-time fears and nightmares. In addition, sleepwalking and sleep terrors peak during preschool years.

Sleep tips for pre-schoolers:

  • Maintain a consistent and enjoyable sleep schedule and bedtime routine. Maintain a regular 'sleep friendly' environment, with the child settling in the same environment that they will later wake up in during the night (i.e. their bedroom). This should be without any screens an hour before bedtime – so no TV, mobile phones, tablets or computers
  • Set limits that are consistent, communicated and enforced. If parents do not set limits children will invariably choose a later bedtime. You could try giving your child one of two bedtime 'passes' that can be exchanged for a parent response, and if they are not used they can exchange them for a small reward such as a sticker in the morning 

Positive reinforcement: If appropriate behaviour is rewarded it is likely to be repeated. Parents should provide encouragement and positive praise for small achievable steps. Some parents find it helpful to use star charts for pre-school and primary school-aged children. Rewards should never be withdrawn.

Daytime naps advice:

  • Daytime naps provide much needed downtime that aids the important physical and mental development that happens in early childhood
  • They help keep babies and young children from becoming overtired, which can affect their moods and make it harder for them to fall asleep at night
  • They also give parents a break during the day and time to tackle household chores or just unwind
  • Mobile napping provides your baby a chance to rest when needed as long as you are following safe sleep guidelines wherever your baby needs to sleep

There's no single rule about how much daytime sleep children need. It depends on their age, the child, and the sleep total during a 24-hour period.

 Daytime napping is important to take the edge off tiredness but should not interfere with yours and your baby’s need for social and developmental experiences.

Example of a good bedtime routine:

Every baby and child is different and you can adapt the following bedtime routine to meet your child’s needs. 

Start the 'journey to bed' an hour before bedtime using signals such as end of a favourite game. A routine before bedtime could look like this:

  • Bath time – bathing and brushing teeth
  • Change into bedtime clothes
  • Story time. If they are not interested in stories to begin with you could try gentle songs or nursery rhymes. Story time can be extended as a child gets older
  • Settle into bed, cuddle time, and goodnight. Some parents find it helpful to sing the same nursery rhyme or song every night as a signal that it’s time to go to sleep

Avoid return to daytime activities (e.g. not returning downstairs after their bath).

Transitional objects (soft toys) are helpful to many young children as part of positive sleep association.

My child is tired, so why won’t they sleep?

If a child is happy, comfortable, and tired, problems falling asleep are likely to be behavioural (such as bedtime resistance) or environmental (such as noise).

I’ve tried all of the above and my child is still waking frequently!

Some children take longer than others to respond to a routine and settle into good sleep habits. Look after yourself. Almost all adults find interrupted sleep makes them feel tired and irritable, and relationships can suffer. For further advice see the useful resources section below.

Sleep needs vary between children, just like height, so we can’t expect all children to have the same needs.

What routines and habits promote good sleep?

Fortunately, there are many practical ways to develop and improve your child’s sleeping routine and habits.

  • Maintain a consistent sleep schedule, waking up and going to sleep at the same times (or within an hour of normal times even at weekends, allowing for some flexibility)
  • Try to maintain sleep routines in the school holidays and when away from home. Maintain an enjoyable bedtime routine. Promote story time for as long as a child will allow
  • Maintain a regular 'sleep friendly' environment, with the child settling in the same environment that they will later wake up in during the night (i.e. their bedroom). Environment should be quiet, dark, and smoke-free. LED lights emit much more blue light than white bulbs and therefore have a greater impact on quality sleep, so ensure these are switched off
  • Avoid screen use (including TV, mobile phones, tablets and computers) an hour before bed and have a no screens in bedroom agreement
  • Avoid caffeinated or high sugar products, such as fizzy drinks, sweets and tea, particularly during the afternoon and evening
  • If your child is genuinely hungry rather than trying to delay bedtime (i.e. you are serving adequate portions at meals and your child consistently says they are hungry at bedtime), it is better for the parent to be 'in charge' and offer a snack rather than your child asking. Encourage any snack as early as possible (i.e. before bath and brushing teeth time) and limit their choice to a snack high in fibre and or protein (rather than sugar or carbohydrates). Snacks such as nuts, peanut butter, Greek yogurt, hummus, eggs, beans, tofu, berries, and whole grains are all good examples. Cereal is okay as long as it’s not heavily sweetened
  • Encourage your child to get as much natural light as possible in the day, especially in the morning
  • Set limits that are consistent, communicated and enforced. If parents do not set limits children will invariably choose a later bedtime

How do I encourage my child to stick to a sleep routine and good sleep habits?

Ideally, you want to reach a point where, as your child gets older, they take responsibility for their sleep routine and habits. If they can be encouraged to do this before they reach secondary school, it will help to inform a good sleep routine and habits as teenagers. Key to encouraging children to take some responsibility for their sleep – rather than something that they need to do battle with parents over - is explaining to them why sleep is important for their health and wellbeing. A book has been created by the Southampton Children's Hospital to help young children understand why sleep is important, you can find it here. An animation is also coming soon to help encourage children to get a good night's sleep.

Is there a link between screen use and poor sleep?

The scientific evidence base agrees that use of screens before going to bed is detrimental to sleep for people of any age. Using screens sends a signal to your brain that you should still be awake, and use of social media for example, can cause anxiety or an increased state of awareness at a time when you want your child’s brain to be in calm mode.

The Royal College of Paediatrics and Child Health recommend that children avoid looking at screens such as phones, tablets or computers in the hour before bed to reduce disruption to their sleep. They've developed guidelines for clinicians and parents on the health impacts of screen time. View it by clicking here.

Good example of a bedtime routine for a primary-school aged child:

Start the 'journey to bed' an hour before bedtime using signals such as end of a favourite game or TV programme. Have a 'screen curfew' in the hour before bed.

  • A typical good routine involves a bath or shower then quiet time in bedroom with parent before settling into bed and lights out
  • Encourage story time for as long as the child will allow as this is great bonding time for children and parents
  • Avoid return to daytime activities (e.g. not returning downstairs after bath or shower)
  • Use of a bedtime pass can limit delay tactics: one or two passes can be exchanged for reasonable requests after lights out (such as a trip to the toilet or kiss goodnight)
  • Transitional objects (soft toys) are helpful to many young children as part of a positive sleep association
  • Anxious children can write down worries in a diary or post them in a 'worry box' before the bedtime routine starts

Good example of a 'sleep friendly' environment:

A room temperature of 16-20°C.

A 'screen free' (including mobile phones, tablets and computers) bedroom as both the light they emit and the content of screen based activities stimulate the brain to keep awake.

Lights off. LEDs emit much more blue light than white bulbs and therefore have a greater impact on quality sleep, so ensure these are switched off. If some light is needed for comfort use a night-light with a red or orange light.

There does not need to be silence, and it can be helpful for your children to get used to some noise, though noise needs to be at a level that it does not disrupt sleep.

A smoke free environment is safest for children.

 
Useful links and resources

Having a baby or child who doesn’t sleep well can be difficult. Below are some tips on coping and some resources that have further information and advice that might help you.

Helping parents to cope

Encouraging and maintaining good sleep routines and habits for children can be tough for parents who are themselves tired at the end of the day. Things may get worse before they get better, if the child resists the new approach.

  • Planning is important. If parents are working or if school age siblings may be disturbed, they may have better chance of success during annual leave or school holidays
  • Mutual support is important. Agree a strategy that all parents and caregivers can work with
  • Contact your Health Visitor who can give you advice on sleep that is specific to the needs of your baby

Resources for parents with babies and young children

NHS: Sleep tips for parents of babies

NHS: Sleep tips for parents of young children

Lullaby Trust: Advice on safe sleep for babies and infants

BASIS Sleep Information: research based evidence about biologically normal infant sleep 

Pediatric Sleep Council, Baby Sleep: Developed for parents by sleep academics, with advice on a wide range of sleep problems for 0-3 year olds

The Sleep Charity: Offers advice to anyone whose child is not sleeping well

Cerebra Sleep Advice Service: Advice on sleep for children with brain conditions

Raising Children Network: Useful information on sleep in general and the sleep cycle

Resources for parents with children (including teenagers)

Royal College of Paediatrics and Child Health: The health impacts of screen time: a guide for clinicians and parents

Cerebra Sleep Advice Service: Advice on sleep for children with brain conditions

Raising Children Network: Useful information on sleep in general and the sleep cycle