The Ultimate Guide to Your Baby's Safe and Healthy Sleep

So parents can rest assured.

By Megan Griffith

Medically Reviewed by Dr. Navin Ramchandani, Medical Doctor/ Diagnostician and Owner of R&R Medical Centre in Barbados.


There are so many aspects of raising a child that makes parents ask themselves “Am I doing this right?” This is especially true when it comes to baby sleep. Those first few weeks after bringing a new baby home are a blur of crying, late-night feedings, and wondering if this is normal.

We decided to make a guide all about healthy baby sleep so parents everywhere can find all the answers to their sleep questions in one place. From sleep regressions to safe sleep positions to tips for getting better sleep as a parent, this guide has it all.

How Much Sleep Does My Child Need? 

Babies need different amounts of sleep depending on their age, but what is “normal”? How do you know if your baby is sleeping enough, or maybe too much? Check out this handy chart with all the information you need on hours of sleep needed and the number of daily naps recommended by age.

Age

Total Hours of Sleep Needed Number of Daily Naps
0-2 months 17 4-8
3-5 months 16 3
6-8 months 15 2-3
9-12 months 14 2
1-3 years 12-14 1-2
3-6 years 10-12

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Addressing Common Sleep Problems for Babies

Sometimes babies just will not sleep, and it can cause parents a lot of anxiety, not knowing the reason for their baby’s sleeplessness. In this section, we want to talk about some of the most common sleep problems for babies and what you can do about them.

The most common sleep problems for babies include:

  • Trouble sleeping through the night
  • Navigating sleep with health conditions like eczema and asthma
  • Sleep regression
  • Teething pains
  • Sleep disorders like insomnia and sleep apnea

Trouble Falling and Staying Asleep

One of the most common issues with babies and sleep is getting them to fall asleep and stay asleep. According to Columbia University’s Department of Neurology, most babies don’t start sleeping “through the night” (6-8 hours at a time) until around 3 months old, or until they weigh at least 12 pounds. But what can you do if your baby is 4, 5, or 6 months old and still struggles to stay asleep all night?

There are a few different approaches to helping your baby sleep through the night. Some experts recommend sleep training, which involves allowing your baby to cry for a bit to see if they’ll go back to sleep instead of going to soothe them right away every time they cry. 

Baby crying

The idea behind this approach is that it teaches babies how to self-soothe and shows them that even if they wake up in the middle of the night, they are okay. The other approach is to gently reassure your baby each time they wake up. 

This approach hopes to reduce nighttime wakings by demonstrating to the baby that they are safe and someone will always come to get them, so they feel more comfortable and end up staying asleep longer.

Which Method Should You Choose to Sleep Train?

Both approaches have their merits and their drawbacks, and you may have to try a combination of the two in order to find the best solution for you and your baby. It’s important to remember that every baby is different, and sleep problems are temporary. 

Any time you do go into your baby’s room at night, be sure to keep the light off and make nighttime feedings or changes as uneventful as possible to help the baby fall back to sleep quickly. It might not feel like it, but you will sleep through the night again at some point.

Other parents may find that their baby stays asleep alright— if they can actually get them to fall asleep in the first place. Some babies hit the terrible twos early and fight sleep as hard as they can, but there are a few ways to make bedtime less of a battle. 

Try noticing sleepiness cues before your baby gets cranky. Look for eye rubbing, yawns, thumb sucking, or long, heavy blinks. All of these indicate that your baby is getting sleepy. You can encourage this feeling by gently changing them into their pajamas, massaging their arms and legs with lavender-infused baby lotion, and rocking them briefly in a dark room. 

Eczema Flare-Ups

If you’ve ever had eczema, you know how hard it is to fall asleep with all of that itching going on. And a lot of babies have eczema. Around 10% of babies have eczema, and it is the single most common skin condition in the first year of a baby’s life. 

According to the American Academy of Dermatology, eczema is often related to sleep loss in infants. But there are solutions. First, buy baby-friendly eczema lotion and apply it each night before bed or any time after giving your little one a bath. 

If you’ve tried that but your baby is still dealing with itchy flare-ups and having trouble sleeping, you may want to see a dermatologist. They can recommend the best lotions, give you a routine to help reduce itching, and help you identify potential triggers that could be causing the eczema, like rough woolen clothing, skincare products with fragrances, or getting overheated.

Nighttime Asthma

Nighttime asthma, also called nocturnal asthma, can be a problem for some babies and children. Essentially, nighttime asthma is just regular asthma, except the symptoms tend to appear only at night. 

This can happen for many reasons. Sometimes allergens in a child’s sheets can trigger nighttime asthma, gastroesophageal disease (GERD) which is associated with acid reflux can also act up at night, and sometimes just being in a reclining position can trigger asthma at night. 

Asthma is difficult to diagnose in infants and very young children because they aren’t always able to accurately report their symptoms, and the visible symptoms of asthma like wheezing, coughing, or panting could also be signs of something else, like bronchitis or acid reflux. 

baby sleep

Diagnosis becomes even more difficult when symptoms only appear at night, when your child is alone in their room and asleep. They may not even be aware that they are being plagued by asthma symptoms, but due to disrupted or uneasy sleep, they are more likely to be cranky, unfocused, and sleepy during the day.

If you notice your baby panting, coughing, or wheezing while they sleep, reach out to your doctor and see if they want to test them for nighttime asthma. If your child is diagnosed with asthma, there are a few things you can do to help reduce symptoms:

  • Regularly clean their crib or bed sheets
  • Ask your doctor if they recommend testing your child for allergies since allergies and asthma often go together
  • Use allergen-free linens
  • Reduce air conditioning at night
  • Use a humidifier in the baby’s room

Sleep Regression

Have you ever noticed that your baby is sleeping great, or at least better than they used to, when all of a sudden, they’re up and down all night again? It’s like all their progress suddenly disappears for no reason.

Well, it turns out there actually is a reason, and it’s called sleep regression. Basically, babies’ sleep needs are constantly evolving, and sleep regressions happen when babies are working on sleeping less frequently, but for longer stretches of time. 

During this transition, they may wake up more throughout the night, fight their naps, or struggle to fall asleep at night, even when before they were sleeping great. This is very normal and very temporary.

Sleep regressions are common around 4 months, 8 months, 12 months, and 18 months. Each regression is associated with major milestones that require more energy, and thus more consolidated sleep. Every baby is different, so you may notice your child’s sleep regressions falling a few months before or after the general sleep regression timeline.

Even though sleep regression is normal, there are ways to cope with it and make sleeping more bearable for everyone, both parents and babies. First, make sure your baby is getting plenty of sunshine during the day. Sunlight indicates that it’s time to be awake, so when you put your baby to sleep in the dark, they will associate it with not being awake, AKA, being asleep. 

You can also start cutting back on bedtime rocking. Instead of rocking your baby to sleep, try rocking them until they are drowsy but not fully asleep, and then lie them down in their crib. This can encourage your baby to self-soothe their way to sleep, and they can apply this skill throughout the night if they happen to wake up.

Teething Pains

Teething is a painful experience for many babies, and the pain can sometimes make it hard to fall and stay asleep throughout the night. 

According to the American Dental Association, teething typically starts anywhere from 6 to 12 months and most kids have their full set of baby teeth by age 3. That’s a long time to be teething, and a lot of sleepless nights. 

But it doesn’t have to be that way. There are several ways to reduce teething pain and help your little one sleep through the night.

Some effective teething strategies include:

  • Use teething toys throughout the day
  • Massage your little one’s gums with a clean finger before bed
  • Give them a wet, cool wash cloth to suck on before bed
  • Give them baby acetaminophen in appropriate doses

Pediatric Sleep Disorders

A lot of sleep disruptions are frustrating and exhausting, but perfectly normal. But what happens when your child’s sleep problems aren’t normal? Even though some sleep disruptions are normal, pediatric sleep disorders are also a very real thing. 

If you are exhausted from trying to take care of your sleepless baby or worried about their sleep patterns, it’s always okay to bring your concerns to your pediatrician. Below is a brief description of some of the most common pediatric sleep disorders.

Obstructive Sleep Apnea: Obstructive sleep apnea (OSA) is a common condition among adults, but it’s also possible for children to experience OSA. According to the American Academy of Family Physicians, OSA typically starts in children around ages 2-8, and the best treatment is typically adenotonsillectomy (removal of the adenoids and the tonsils).

Sleepwalking: The first time your child sleepwalks can be very disconcerting, but it’s actually a fairly common occurrence. 17% of children sleepwalk, and the problem peaks between 8 and 12 years of age. 

Some research shows that sleepwalking in children is more common if one or both parents have had issues with sleepwalking. This issue typically resolves itself, but you will want to make sure to safety-proof the house so that the child can’t hurt themselves while sleepwalking.

Restless Leg Syndrome: This is a condition associated with the feeling that you just have to move your legs, and the feeling tends to get stronger in the evening which can make sleep difficult. It is commonly associated with attention-deficit hyperactivity disorder (ADHD), but recent studies suggest it could also be linked to iron deficiency.


Sleep Problems and Sleep Tips for Babies by Age

One of the hardest parts of being a parent is knowing what’s normal at what ages. Infants especially change so much in such a short amount of time, it can be hard to keep track of when they should be napping, how long, and how often, what kind of sleep problems they might experience from one month to the next. 

To make things a bit easier, we’ve collected all of that information right here, in one convenient place.

Birth to 2 months

Newborn sleep is tricky because your brand new baby is adjusting to life on the outside, so to speak. There are several issues you might run into with newborn sleep, but rest assured there are solutions for everything, whether that means letting your baby cry a little or inviting a friend over so you can catch a nap.

Believe it or not, most newborns sleep about 17 hours out of 24, but they typically sleep in short bursts. This is partially because they need sleep constantly throughout the day, not just at night, and partially because their tiny tummies are so small, they need to wake up frequently for feedings.

Another common problem with newborns and babies up to 2 months old is having their days and nights reversed. It’s pretty much a nightmare for parents, but there are a few ways to remedy the situation. 

Make sure your baby gets lots of sunlight during their waking hours and keep their room nice and dark while they take naps. This way, they’ll learn to associate light with being awake and dark with being asleep.

Finally, some new babies aren’t big fans of sleeping on their backs, even though that is the safest position. You may want to talk to your doctor about this issue, as it could indicate an issue with acid reflux, but they may just need a cuddly swaddle to make them feel more comfortable on their back.

Tips for Birth to 2 Months:

  • Make sure your baby is well-fed during the day; this should help stretch out their time between feedings at night.
  • Give baby lots of sunshine while they’re awake and keep their room dark during naptimes.
  • Try a swaddle if your baby is having trouble sleeping on their back.
  • If you’re too exhausted, invite a friend or family member over to watch the baby while you catch a quick nap.

3 to 5 months

The biggest sleep problem most parents run into during the 3 to 5 month stage is sleep regression. As we mentioned earlier, sleep regression is when your baby starts resisting sleep, waking up more often, or skipping naps. 

At this age, sleep regression happens for two main reasons. First, your baby is learning to sleep for longer stretches at night, whcih is wonderful for your sleep routine, but it means they may not want to take naps as much, even though they still need them.

The second reason most babies experience sleep regression at this age is because life is just too much fun. At 3 to 5 months, many babies have started rolling, their vision is improving, and they probably go more places now, instead of staying at home. The world is an exciting place, and babies may resist sleeping because they want to explore. This is a good developmental milestone, even though it can be frustrating.

One of the best ways to deal with sleep regression is to lean into this milestone. When your baby is awake, practice rolling with them. Take them on walks (or drives if it’s cold). Show them bright toys with lots of contrast. Read them stories and sing them songs. 

If you give your baby plenty of things to explore, you can tire them out a bit so that they don’t fight sleep quite so hard.

It’s also very helpful to remind yourself that sleep regression is temporary. Don’t change your routine too much to accommodate sleep regression; instead, try to stick to a similar routine. Eventually, this familiarity will take over and your baby will return to their normal sleeping patterns.

Tips for 3 to 5 Months:

  • Give baby plenty of mental stimulation with bright toys, funny faces, and silly songs.
  • Adjust to your baby’s need for a little less sleep, but don’t change your routine too much; the familiarity can help put an end to sleep regression.
  • Remember that sleep regression is normal, even if it is frustrating.

6 to 8 months 

By 6 months, many babies sleep straight through the night, getting 10 or even 11 solid hours in a row. If this isn’t the case for your baby, don’t get too worried. Remember, every baby is different. But if your baby’s sleep schedule is driving you crazy, it might be time to teach your baby some self-soothing skills.

The biggest problem babies face between 6 and 8 months is being unable to self-soothe when they wake up in the middle of the night. Most babies, bottle or breastfed, can sleep through the night without needing a feeding somewhere around 6 to 8 months. 

So when they wake up in the middle of the night, it’s often because they simply woke up and started crying. Although this can be exhausting and frustrating, it’s also a wonderful opportunity to help your baby gain the invaluable skill of self-soothing. 

Many adults wake up throughout the night as well, but we have learned to calmly allow ourselves to go back to sleep, and babies need to learn the same thing. You can start by going in and gently cooing and stroking your baby until they calm down, instead of picking them up, and eventually you may be able to avoid going to them at all, as they learn to calm themselves down and go back to sleep.

Tips for 6 to 8 Months:

  • Develop an independent sleeping routine where your baby can fall asleep on their own rather than needing to be rocked to sleep every night.
  • Try soothing your baby without picking them up to teach them self-soothing.
  • Let your baby cry a little bit to give them the chance to soothe themselves before going to pick them up.

9 to 12 months

By 9 to 12 months in age, many babies are sleeping through the night, but there are still several problems that can arise. 

For instance, does your baby technically sleep through the night, but rise at the crack of dawn? Is your baby resisting bedtime, even though they’re clearly tired? These are common problems for this age, and there are several ways to cope with them so everyone gets a good night’s sleep.

Extra early wakings are a common problem among babies of this age, and it’s typically because of their shifting nap needs. As babies get older, they need fewer and fewer naps throughout the day because they are getting more sleep at night. 

If your baby is 9 to 12 months old and still taking three naps, they might be waking up early because they’ve had plenty of sleep and are ready to start their day. To avoid these early morning wakings, try cutting back to two naps so that by the end of the day, they’re ready for a good long sleep.

If your baby is resisting bedtime, it could be a similar problem. If your baby’s last nap of the day is too close to their bedtime, they may simply not be tired yet, and their last nap either needs to be removed from their routine or moved up earlier in the day. 

But if they’re clearly tired and still resisting, it might be another sleep regression. Sleep regression is common around 12 months because babies at this age are starting to walk and talk and their opportunities to explore are exploding all over again. 

The solution is the same: make sure you are helping them explore as much as possible throughout the day. Then, by nighttime, they should be all tuckered out and ready for bed.

Tips for 9 to 12 Months:

  • Make sure your baby gets plenty of stimulation and opportunities to explore throughout the day so they are plenty tired at night.
  • Consider cutting down on baby’s nap time or pushing bedtime back a little later if they’re waking up extra early.
  • If your baby is teething and having trouble sleeping because of the pain, try massaging their gums with a clean finger or giving them a cold, damp wash cloth to suck on before bed.

Safe Sleeping Positions for Babies

One of the scariest parts of being a parent is laying your child down to go to sleep. Will anything bad happen overnight? Will you hear them if they cry? Will they be okay without you watching over them every second?

The truth is, there are several risks involved with sleeping, including Sudden Infant Death Syndrome (SIDS). This is when a child dies in their sleep with little or no explanation. It’s every parent’s worst nightmare. But there are ways to reduce your child’s risk.

First, make sure your baby’s crib mattress is nice and firm. Extra plush mattresses or sleeping with too many soft blankets has been associated with increased risk of SIDS. Second, make sure your baby sleeps in their crib, not in bed with you. 

baby sleeping

Risk for SIDS goes down when babies sleep in the same room as their caregivers for the first several months, but risk goes up when babies sleep in the same bed. Finally, make sure your baby sleeps on their back. Sleeping on the stomach or side can cause issues with breathing that may be related to SIDS.

Once babies are able to roll over onto their stomachs, many babies prefer to sleep that way and will roll themselves over in the middle of the night. So can you leave them that way? 

Research shows that the risk for SIDS peaks around 2-3 months and most babies don’t roll over until 4-6 months, so if your baby is sleeping on their belly around 6 months old (and they can easily roll themselves from back to stomach and stomach to back) then it’s probably okay to leave them on their stomach. 

However, if they still struggle to flip from their stomach ot their back, then it is recommended that you go in and gently flip them onto their back. As frustrating as that is, it’s all about keeping your baby safe.

Just remember the ABC’s of safe baby sleep: Alone, on their Back, in their Crib.

Do I Need to Talk to My Doctor? 

It can be hard, especially for new parents, to determine when a problem is “bad enough” to warrant calling the doctor. But the truth is, your doctor is there to hear about all of your problems. 

Even if your child doesn’t have a pediatric sleep disorder, even if they’re going through something perfectly normal, like sleep regression, your doctor can still offer you some helpful insights or tips for improving the situation.

When in doubt, give your doctor a call and describe the problem. A good pediatrician is always happy to provide guidance on whether something is a problem that needs to be checked out or a normal part of infant development.

Sleep Tips for Parents

Let’s be honest: babies aren’t the only ones facing sleep troubles. Parents experience sleep deprivation, fatigue, and general sleepiness as they sacrifice their sleep to take care of their new baby. And when sleep regressions pop up, those sleep problems return. 

But it’s unrealistic to expect a person to be the perfect caregiver when they’re running on no sleep, no energy, and as a result, no patience. You need sleep too, so here are a few tips to help you get the sleep you need to be the parent you want to be.

  • Sleep when your baby sleeps. This is common advice, but that’s because it’s good advice. If your baby is asleep, that’s a great opportunity for you to get some sleep too.
  • Lower your expectations for your household chores. Things might be a little messy for a while. Better to be messy but well-rested than clean and exhausted.
  • Enlist help. Ask family members or friends to bring by meals when they can, do a grocery run for you, or just hold the baby while you take a nice, relaxing shower.
  • Put your phone on Do Not Disturb and lower the baby monitor sound so you only wake up if they’re crying, not just if they make a small sound or roll over. 

Advice from the Expert

We asked Dr. Navin Ramchandani to share some expert insights on how to help your baby have healthy and safe sleep. Keep reading for some tips from the expert:

  • It’s crucial that you ensure your newborn is getting safe and healthy sleep. A few safe sleeping tips for your newborn include starting with a healthy pregnancy, sharing a room but not a bed, and double checking the bed/crib for safety.
  • Try to limit any extra toys or pillows in your newborn’s crib as these can cause strangulation and suffocation.
  • Establishing a bedtime routine helps your newborn respond better to bedtime and makes them feel safer. Predictability= safety in this situation.

Summary

Developing healthy sleep habits for both you and your baby can be difficult, but it isn’t impossible. One of the most important things to remember when you have a new baby is that you have resources. 

If you’re worried about your baby’s sleep, call the doctor. If you’re worried about your own sleep, call a friend so you can take a nap. And if you feel overwhelmed by all of this, that’s okay. It’s overwhelming, trying to keep a tiny new human alive and healthy and happy, and still manage to get a few hours of sleep. 

But you can absolutely do it. There are tips and tricks for nearly every sleep obstacle in the world, and if you take everything one day at a time, you can get through anything parenting throws at you.

Dr Navin Ramchandani

Expert Bio

Dr. Navin Ramchandani is a Medical Doctor/ Diagnostician and Owner of R&R Medical Centre in Barbados. He is also an Advanced Paediatric Life Support (APLS) International instructor with the Advanced Life Support Group (ALSG), and a Paediatric BASIC (Basic Assessment and Support in Intensive Care) international instructor. His passion is diagnosing and treating/helping people with complicated health issues to improve their overall health and quality of life.


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