From the Guidelines
To help babies sleep well, parents should place their infants on their backs to sleep, use a firm sleep surface, and keep the sleep environment safe by removing soft objects and loose bedding, as recommended by the American Academy of Pediatrics 1.
Key Recommendations for a Safe Sleep Environment
- Place the infant on their back to sleep for every sleep, as this reduces the risk of SIDS and other sleep-related deaths 1.
- Use a firm sleep surface, such as a crib or bassinet, and ensure it is free from soft objects and loose bedding 1.
- Room-sharing with the infant on a separate sleep surface is recommended, ideally for the first year of life, but at least for the first 6 months, to reduce the risk of SIDS and other sleep-related deaths 1.
- Keep the sleep environment safe by removing any soft objects, such as pillows, blankets, and toys, and ensuring the room is at a comfortable temperature and free from smoke and other hazards 1.
Additional Tips for Promoting Healthy Sleep Habits
- Establish a consistent bedtime routine that includes activities like a warm bath, gentle massage, reading, or singing to help the infant learn to fall asleep independently.
- Consider using white noise to mask household sounds and create a sleep-conducive environment.
- Follow age-appropriate sleep schedules, with newborns needing 14-17 hours of sleep across day and night, while 4-12 month olds typically need 12-16 hours including naps.
- Respond to nighttime wakings promptly but minimally, avoiding stimulating interactions, and consider gradual sleep training methods like "check and console" for babies over 4-6 months to help them learn self-soothing skills. Some of the key evidence-based recommendations for a safe sleep environment are based on studies published in the journal Pediatrics, including the 2016 updated recommendations for a safe infant sleeping environment 1.
From the Research
Bedtime Routines for Babies
To promote healthy sleep in babies, establishing a consistent bedtime routine is crucial. The following points highlight the importance and benefits of bedtime routines:
- A bedtime routine can provide multiple benefits to child and family functioning, including improved sleep, language development, literacy, child emotional and behavioral regulation, parent-child attachment, and family functioning 2.
- Institution of a consistent bedtime routine has been demonstrated to improve sleep in young children within two weeks, with the most rapid change occurring in the first three nights 3.
- Establishing bedtime routines in the first year of life predicts better sleep outcomes, such as longer sleep duration, less nighttime waking, and fewer sleep problems, across the first 2 years of life 4.
- Adherence to a bedtime routine is concurrently associated with a greater amount of nightly sleep and predicts an increase in nightly sleep minutes over a 6-month period 5.
- A consistent bedtime routine implemented in accordance with age-appropriate bedtimes is associated with longer and less variable night-time sleep in infancy 6.
Key Components of Bedtime Routines
The following components are essential for a bedtime routine:
- Nutrition (e.g., feeding, healthy snack) 2
- Hygiene (e.g., bathing, oral care) 2
- Communication (e.g., reading, singing/lullabies) 2, 4
- Physical contact (e.g., massage, cuddling/rocking) 2, 3
- Quiet activities 3
Timing and Consistency of Bedtime Routines
- Starting a bedtime routine after 9 PM is associated with shorter infant night-time sleep duration 6.
- A bedtime routine of at least 5 nights a week is associated with longer and less variable night-time sleep in infancy 6.
- Consistency in bedtime routines is crucial, with more bedtime routine consistency predicting less nighttime waking and sleep problems 4.