Safe Sleep

Please look at this useful video for advice on reducing the risk of sudden infant death syndrome (SIDS)

It's recommended that babies up to 3 months get 14-17 hours of sleep per day (24 hour period). This includes daytime naps.

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. Most babies sleep 9–12 hours at night, usually with an interruption for feeding, and have 2–3 daytime naps lasting about 30 minutes to 2 hours each.

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 soon 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 5 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 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.
• Newborns sleep a total of 14 to 17 hours across a 24 hour period, on an irregular schedule with periods of one to three hours spent awake. 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.
• It is best to put babies down to sleep when they are drowsy, but not asleep. They are more likely to fall asleep quickly and eventually learn how to get themselves to sleep.

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 dimmer 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 dimmer 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. Following these Every Sleep Counts tips can give you the peace of mind to enjoy this special time.
• This advice is based on strong scientific evidence and should be followed for all sleep periods, not just at night.
• 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/armchair
• Never co-sleep if you have smoked or have used alcohol, medication or drugs
• Put babies on their back for every sleep
• Maintain a clear and flat sleep space
• Keep babies smoke free day and night
• Support breastfeeding

The above are the Every Sleep Counts safer sleep messages that the Hampshire, Isle of White, Southampton and Portsmouth Safeguarding Children’s Partnership promote (as at March 2020).

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.

There's no single rule about how much daytime sleep kids need. It depends on their age, the child, and the sleep kids need. It depends on their age, the child and the sleep total during a 24-hour period. For example, one toddley may sleep 13 hours at night with only some daytime catnapping, while another gets 9 hours at night but takes a solid 2-hour nap each afternoon. If your child is napping 'on the go' (for example in the car) try to ensure that this is balanced by daytime sleep in their own bed at home so that they get good quality daytime sleep over the course of a week.

It's recommended that infants from 4 months - 1 year get 12-15 hours of sleep per day (24 hour period). This includes daytime naps.

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. Most babies sleep 9–12 hours at night, usually with an interruption for feeding, and have 2–3 daytime naps lasting about 30 minutes to 2 hours each.

Babies from 6-12 months usually have two naps a day, which may last 20 minutes for some babies and for others a few hours.

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 soon 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 5 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.
• Infants typically sleep 12-15 hours during the night and take 30 minute to two-hour naps, one to four times a day – fewer as they reach age one.
• 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).
• Encourage your baby to fall asleep independently i.e. while awake but drowsy.
• See the safer sleep tips on the sleep advice for newborns page (above).

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.

There's no single rule about how much daytime sleep kids need. It depends on their age, the child, and the sleep total during a 24-hour period. For example, one toddler may sleep 13 hours at night with only some daytime catnapping, while another gets 9 hours at night but takes a solid 2-hour nap each afternoon. If your child is napping 'on the go' (for example in the car) try to ensure that this is balanced by daytime sleep in their own bed at home so that they get good quality daytime sleep over the course of a week.

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/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.

6.00pm: Bath time – bathing and brushing teeth

6.15pm: Change into bedtime clothes

6.30pm: Story time. If they are not interested in stories to begin with you could try gentle songs/nursery rhymes. Story time can be extended as a child gets older.

6.45pm: Settle into bed, cuddle time, and goodnight. Some parents find it helpful to sing the same nursery rhyme/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 below.

It's recommended that toddlers aged 1-2 years get 11-14 hours of sleep per day (24 hour period). This includes daytime naps.

Young toddlers might still be taking two naps, but over time this will reduce to one nap of 1-3 hours. 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.

Toddlers need about 11-14 hours of sleep in a 24-hour period. When they reach about 18 months of age their naptimes will decrease to once a day lasting about one to three hours. 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.

There's no single rule about how much daytime sleep kids need. It depends on their age, the child, and the sleep total during a 24-hour period. For example, one toddler may sleep 13 hours at night with only some daytime catnapping, while another gets 9 hours at night but takes a solid 2-hour nap each afternoon. If your child is napping 'on the go' (for example in the car) try to ensure that this is balanced by daytime sleep in their own bed at home so that they get good quality daytime sleep over the course of a week.

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/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.

6.00pm: Bath time – bathing and brushing teeth

6.15pm: Change into bedtime clothes

6.30pm: Story time. If they are not interested in stories to begin with you could try gentle songs/nursery rhymes. Story time can be extended as a child gets older.

6.45pm: Settle into bed, cuddle time, and goodnight. Some parents find it helpful to sing the same nursery rhyme/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.

It's recommended that pre-schoolers aged 3-5 years get 10-13 hours of sleep per day (24 hour period). This includes any daytime naps.

Some pre-schools 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. 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 pre-schoolers are below.

Sleep and Pre-schoolers (3-5 years)

Pre-schoolers typically sleep 10-13 hours each night and most do not nap after five years of age. 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.

There's no single rule about how much daytime sleep kids need. It depends on their age, the child, and the sleep total during a 24-hour period. For example, one toddler may sleep 13 hours at night with only some daytime catnapping, while another gets 9 hours at night but takes a solid 2-hour nap each afternoon. If your child is napping 'on the go' (for example in the car) try to ensure that this is balanced by daytime sleep in their own bed at home so that they get good quality daytime sleep over the course of a week.

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/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.

6.00pm: Bath time – bathing and brushing teeth

6.15pm: Change into bedtime clothes

6.30pm: Story time. If they are not interested in stories to begin with you could try gentle songs/nursery rhymes. Story time can be extended as a child gets older.

6.45pm: Settle into bed, cuddle time, and goodnight. Some parents find it helpful to sing the same nursery rhyme/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 below.

It's recommended that children aged 3-5 years old get 10-13 hours sleep a night and children aged 6-13 years old get 9-11 hours.

However, some children might have less need for sleep and be able to get away with less, whilst others may need more — 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/orange light.

here 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.

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.