Ten Little - Sleep

What are the popular methods for sleep training?

2022-05-09T15:50:36-04:00

There are many popular methods and strategies that have been demonstrated effective in helping babies learn to sleep uninterrupted or without signaling through the night including:

The Cry It Out Method: The Cry It Out sleep training method, also known as extinction, full extinction, or CIO, is the cold-turkey approach: parents take their baby through a bedtime routine, cuddle with them and give them a kiss goodnight, and then leave the room. If the baby cries, the parent does not respond. Eventually, the baby tires themselves out from crying and goes back to sleep.

This method is well-known, and in some cases, notorious. It feels stressful, and parents worry about causing trauma to their baby. There is no evidence of long-term trauma associated with this method, but it can be difficult for new parents to hear their baby cry and not help. However, proponents say that it works, and quickly. Many parents say their baby is sleep trained within a few days with the CIO method. It’s important to know that many parents have had to repeat this process after sickness, teething and sleep regressions.

The Ferber Method: The Ferber Method is a similar sleep training method to Cry It Out, but more gradual, hence its nicknames of “graduated extinction,” “progressive waiting”, and “the interval method”.

This is the process of creating longer and longer gaps between when a baby cries and when the parent responds to the cry. For example, a parent can wait for two minutes after the baby first cries before responding, then four, and then six minutes after the next cries. These waiting periods are gradually extended over time until the baby has learned to self-settle.

This sleep training method appeals to parents who are uncomfortable with the black-and-white nature of the CIO method, but some still feel it can be traumatizing for the baby. Ferber himself has stated that this method is not right for every baby or every sleep issue. As with CIO, studies of the Ferber sleep method have found no evidence of long-term negative effects on a child’s emotions, stress, behavior, or attachment to their parents.

The Check and Console Method: This is a variation of the Ferber method, in which parents check on their baby and console them before they even start to cry.
For example, on the first few nights, parents may leave the room and enter a minute or two later to tell them they love them or to give them a soft pat. Parents keep leaving the room and checking back in, gradually increasing the intervals to about 15 minutes, until the child falls asleep.

This sleep training method can take longer — up to a week — and requires more involvement from the parents. Be attentive to how your baby responds with the Check and Console method. Checking in may excite them and make them more upset when you leave, in which case another method may be a better option.

The Fading Method: The Fading method, also known as “camping out”, encourages parents to stay in their child’s room until they fall asleep. Parents can do this by standing, or by sitting in a chair in their child’s room, a variation known as the “Chair Method”.

Parents take their child through a bedtime routine and put them in bed while the baby is still drowsy. Then, the parents stay by their side until they fall asleep. Each night, the parent gradually moves further away from their child while still remaining in their sight. For example, they may start right next to their crib, then a few feet away, then by a dresser in the room, and then by the door.

A major tenet of the Fading or Chair method is providing minimal comfort to the child, verbal or physical. If the child starts to fuss or cry, parents should simply provide soft, reassuring sounds so the baby knows they are there, but maintain their physical distance. You might guess that fading typically takes longer than the CIO or Ferber methods — up to two weeks — and you’d be right. But it does give some parents more peace of mind since they don’t feel like they’re abandoning their child.

The “No Tears” Method: This method, also known as the Gentle Sleep Training method, focuses on helping your baby learn to sleep on their own without any crying. To accomplish this, the method leans heavily on a consistent bedtime routine followed by, in one instance, a variation of the Ferber method (leaving the room entirely, but reentering any time the baby cries).

Other parents use the Fading method as a basis, with a gradual increase of physical distance between themselves and their baby at night. But, when the baby cries, they reassure them by shushing and patting them — instead of simply using verbal cues as with the Fading method.

No Sleep Training: It’s normal and natural for babies to wake every 2-3 hours throughout the night during their first year of life. There are a variety of factors that could lead to a child waking at night, such as (but not limited to) hunger, medical reasons (such as sleep apnea or reflux), and the environment. As parents, our instinct is to respond every time our child signals for us. If sleep training is not for you, there are many other ways to optimize sleep for you and your child:

Work on creating routines that make sense for you and your family’s schedule. Make sure your child is getting enough exposure to light, noise, and activity during the day.
Schedule in naptime to allow them to get enough sleep during the day and to prevent overtiredness at night.
Follow their cues to learn how your child tells you they are tired, whether it’s droopy eyes, yawning, or irritability to get in tune with their circadian rhythm and sleep cues.
Learning to differentiate between a cry for discomfort versus hunger will help you best react and meet your child’s needs.
Choose a safe sleep setup (on their backs, firm mattress, no objects in the crib) that works best for your family, such as room sharing.
Make sure their nutritional needs are being met during the day.
If applicable and possible, enlist your partner to assist or take shifts with night feedings.

This article has been reviewed by our team of experts.

Disclaimer: The contents of this article does not constitute medical advice. If you have concerns about any health or medical condition, diagnosis, or treatment you should consult with your pediatrician or a licensed healthcare provider.

When should my child move from a crib to a bed?

2022-05-04T18:05:30-04:00

Approximately one-third of toddlers transition to a bed between the ages of 18 months and 2 years old, and another third transition between ages 2 and 2.5. In general, most children make the move from a crib to a bed between the age of 18 months and 3 years old.

This wide age range means you should be watching for signals, not a specific date, that it’s the right time to transition:

Climbers: If your child can climb over and out of the crib on its highest rails setting, it’s time. And when the crib rail is at your toddler’s nipple line, whether they’re an escape artist or not, it’s also time.
Asking for it: If your toddler mentions it, it may be time.
Baby on the way: This is a common reason for the change — a sibling on the way. If this becomes part of your family’s plans, make sure to move your toddler at least 2 or 3 months before the new baby’s arrival, or 3+ months after, to make the transition easier on everyone.
Toilet training: A potty-trained child who can regularly use the bathroom during the day will likely still need time to develop night-time training. For this reason, a crib won’t do — get your kid in a bed!

This article has been reviewed by our team of experts.

Should my baby sleep on their back or their belly?

2022-05-02T12:42:01-04:00

Many of us were raised sleeping on our bellies, but research now shows that your baby is safest on their back! Place your baby on their back for all sleep times — naps and at night. Even if a baby spits up during sleep, their anatomy and gag reflex help prevent them from choking while sleeping on their backs. If you see that your child is noticeably uncomfortable sleeping on their back (ie: they wake up every time they are placed asleep on their back), it is best to check with your pediatrician to rule out any underlying causes.

This article has been reviewed by our team of experts.

At what age can my child sleep with pillows, blankets, and stuffed animals?

2022-05-02T12:41:42-04:00

The American Academy of Pediatrics (AAP) recommends keeping soft objects and loose bedding out of the sleeping area for at least the first 12 months. This recommendation is based on data around infant sleep deaths and guidelines for reducing the risk of SUIDS. You may want to put a sheet or comforter over your child, to cover their head or body — but don’t. Sheets, comforters, and blankets can increase the risk of suffocation and can overheat your infant. If you’re worried about your baby getting cold during sleep, you can dress them in warm sleep clothing, like a wearable blanket.

Pillows: The AAP suggests waiting until 2 years old to introduce a pillow. However, the Consumer Product Safety Commission (CPSC) states that small toddler pillows are safe to introduce at 18 months old. Be sure to consult with your pediatrician on their recommendation and the specifics of your child.
Stuffed animals: When it comes to stuffed animals or other toys in the crib, it’s important to consider the weight of the object, the material it is made of, and if there are any small parts, in addition to the AAP’s age recommendation for that toy. Larger objects can suffocate or crush, and objects with small parts (like sewn-on eyes or buttons) may be choking hazards, and should also be avoided.
Blankets: After the first 12 months, some factors to consider when determining if it’s safe for your child to have a blanket in their crib include the blanket’s size, thickness, fabric type, and edging. Even for older children, blankets with long strings and ribbons could be choking hazards, and aren’t recommended. Some other notable considerations include:

Larger blankets can present strangulation and suffocation hazards.
Thick, quilted blankets are not as breathable as muslin.
Weighted blankets that are sometimes used for older children with sensory concerns are not safe for use with infants.
Small children can be active sleepers. If you find that your child likes to rock and roll around their bed during the night, a sleep sack or footed pajamas may be safer than a blanket until they are older.

This article has been reviewed by our team of experts.

What kind of sleeping surface / mattress / crib should my child sleep on?

2022-05-02T12:41:38-04:00

Use a firm, flat sleep surface, such as a mattress, in a safety-approved crib or bassinet covered only by a fitted sheet. It’s natural to want to rest your baby on a pillow and cover them with a blanket, but soft surfaces can increase the risk of sleep-related death. Stick to a firm sleep surface to help reduce the risk of SUIDS (Sudden Unexpected Infant Death Syndrome ) and suffocation, with nothing else in their sleeping area. Your child should also not spend the night unsupervised in a swing, reclined chair, or in their car seat.

It is not safe for your child to fall asleep with you on a couch or armchair. While bed sharing is not recommended, the American Academy of Pediatrics has acknowledged that parents often become exhausted while feeding their babies at night. If you are drowsy while feeding, the safest place to be with your baby is on a firm adult bed free of blankets and pillows versus on a recliner or armchair. If you and your baby fall asleep during a feeding session, move your baby back into their crib or bassinet as soon as you wake up (AAP Safe Infant Sleep Policy Statement 2016, section 4e).

This article has been reviewed by our team of experts.

When should I stop swaddling my baby?

2022-05-02T12:41:24-04:00

Once your child begins to look like they are getting ready to roll over, it’s time to stop swaddling. The AAP recommends curtailing the swaddle around 2 months of age before your child is actually rolling. This is because your little one may need access to their hands in order to flip back over. If you choose to use a swaddle, ensure you use it appropriately. It should be snug across the chest (but not too tight that fingers can’t be inserted between chest wall and the swaddle), and loose below the hips to minimize risk of hip dysplasia (AAP Safe Infant Sleep Policy Statement 2016, section 15).

This article has been reviewed by our team of experts.

What is sleep regression?

2022-05-02T12:41:07-04:00

It is common to encounter a bumpy period of time with your kid where sleep suddenly becomes difficult, and all the hard work you’ve put into routines and nap spacing seems for naught.

Your child’s brain is developing and changing quickly. This may affect and lead to changes in sleep. And this means that, for periods of 2-6 weeks, you might encounter sleep regressions. Sometimes they happen after milestones — rolling, crawling, teething — and sometimes just out of the blue.

Common ages for sleep regressions include:

4 months
6 months
8-10 months
12 months
18 months
2 years old

The thing to remember is to stick to your routine, because while regressions can’t be avoided, your schedule is the key to quickly returning back to “normal”. A healthy bedtime routine can look different for every family, but the key to a good bedtime routine is that it’s a routine. Here's a great place to start.

This article has been reviewed by our team of experts.

Why does my baby wake up so early?

2022-05-02T12:41:04-04:00

“Early morning wakings” fall between 4:00 and 6:00 AM, earlier than that is considered a “night waking”.

Falling asleep at night, the conditions are ideal: it’s dark outside, the temperature has dipped, your child’s body and brain are tired from the day, and biologically, this is the time of day a person’s body expects to go to sleep. But from 4:00 – 6:00 AM, the opposite is happening; babies have rested, the sun’s coming through the blinds, melatonin levels start to rise, and their sleep stages get lighter. While children might need more sleep, their environment is often encouraging wakefulness.

Possibilities for why your baby might be waking early:

Sunlight is sneaking in: Make sure the room is dark enough. Blackout blinds or curtains are a good idea for keeping that nursery or bedroom as dark as possible.
Bedtime is too late: Babies don’t really “sleep in,” and in fact, a later bedtime can have the opposite effect that it does in adults! Even shifting bedtime 20-30 minutes earlier can make a huge difference. Think about a 6-6:30pm bedtime, and see if that resolves early mornings.
Overtired baby at bedtime: Sometimes the bedtime is right on time, but your kid is up too long during the day due to missing a nap or staying awake too long before sleeping. If you constantly feel like your child is going to bed exhausted, you may want to consider moving the last nap later in the day to get a happier bedtime.
Early nap timing: Sometimes an early first nap can guarantee early wakings! Based on your baby’s age, they may see that early nap as an extension of sleep, especially under 3-4 months.
Too many naps: Sometimes babies wake up because they aren’t tired! If the total nap hours and nighttime sleep hours add up to the recommended amount for your child’s age, you might consider dropping a nap to extend those nighttime hours.
Hunger: The stretch of sleep leading up to 6am will likely be their longest stretch without eating, so it is natural for them to wake up hungry. If your baby is waking up hungry prior to 6am (and that is too early for your family to start their day), consider treating it as a ‘middle of the night feed’ with low stimulation, and putting them back to bed after.

It’s important to remember that figuring out wakeups and bedtimes is a process, not a set of hard and fast rules. Sometimes your baby might be getting too much sleep, sometimes not enough sleep, or maybe their room is too bright, or none of the above! Whatever the circumstances, remember to be patient and kind to both yourself and your baby as you figure it out together.

This article has been reviewed by our team of experts.

What is sleep training? When should I start sleep training?

2022-05-02T12:41:01-04:00

Sleep training is a common phrase used to describe the process of helping get a baby comfortable sleeping for several hours and/or through the night on their own, while learning to self-settle and fall back asleep if they do wake up. This includes building routines and helping guide behaviors, for both the parent and child.

There are a number of popular methods and strategies that have been demonstrated effective in helping babies learn to sleep uninterrupted or without signaling through the night. Some sleep training methods, like “cry it out,” sometimes have a bad reputation, but there are also gentler methods, especially those that minimize crying. We will outline these methods, but please know that you do not have to sleep train your baby. It is an important distinction that while it is called ‘sleep training’, sleep is a biological function which means that it can’t be taught, and babies who are ‘sleep trained’ may still wake up as often as babies that are not, but will put themselves back to sleep without signaling. Sleep training may offer significant benefits to both children and parents, but even without it, babies will eventually learn to sleep on their own. Ultimately, every family should determine what method is right for them.

On average, babies aren’t usually ready for sleep training until they’re 4 months to 6 months old, although many aren’t ready until as late as nine months. Before four months, babies haven’t developed the circadian rhythms that will help them sleep through the night, so sleep training at 3 months and earlier is not recommended. Once they are at this point, though, they’ll naturally want to sleep more at night and be awake more during the day. For this reason, six months is generally agreed to be a good time to start sleep training if you choose to do so. Like potty training and other milestones, it’s probably best to get started well before or well after big changes or disruptions to your routine.

It’s important to remember that not all strategies work for all babies and parents, and some may even work later, after not working originally. The “right” way to sleep train is the way that works for both you and your baby. As your child grows, their routines will change and you may encounter sleep regressions, and you can revisit these sleep training methods to retrain them.

This article has been reviewed by our team of experts.

When will my baby “sleep through the night"?

2022-05-02T12:40:58-04:00

For infants, “sleeping through the night” means they sleep at least six uninterrupted hours. This can include a brief wake-up, but one where they typically self-settle and return to sleep.

There’s no “normal” for babies under four months. The American Academy of Pediatrics (AAP) and the American Association of Sleep Medicine (AASM) have not made a recommendation for babies under four months because of the high variability in sleep needs and patterns, so a lot of your experience with your newborn will depend on the baby themselves! At this age, the circadian rhythm has not been regulated, meaning that a baby may struggle to understand the difference between day and night. Hormones like melatonin only begin to be produced around week 11, which will help regulate their sleep-wake patterns.

Above the six-month threshold, your child might be ready. One study revealed that about 62% of 6-month-olds were sleeping through the night, and that number increased to more than 72% by 12 months. If your baby does not “sleep through the night” by 12 months, this is still completely normal behavior and you should always discuss any concerns with your pediatrician.

But there are things you can do to support infants in sleeping through the night.

Habits: What happens during the daytime and in the hours before bedtime affects nighttime sleep for babies. Consider a bedtime routine that includes putting your baby to bed while sleepy but not deeply asleep.
Feeding: Hungry babies have a harder time sleeping, so make sure your baby isn’t going to bed hungry.
Environment: Babies need to sleep in a quiet, dark room at night.
Soothing: Comforting our children at night can help them learn that sleep and nighttime are safe and secure places. You can start by touching your baby’s head or rubbing their back or belly to try to calm them and let them know you are nearby. If they are still upset, picking up and rocking your child to return them to feeling calm and safe will put them back into a parasympathetic state, which is ideal for sleeping.
Sleep training: There are a variety of methods to get your baby comfortable sleeping several hours through the night on their own or put themselves back to sleep if waking.

This article has been reviewed by our team of experts.

What does a good bedtime routine look like?

2022-05-02T12:40:54-04:00

Everyone’s routine is different, but the key to a good bedtime routine is that it’s a routine. Set a consistent bedtime that leaves enough time for your child to sleep the recommended amount of hours for their age, and then do the same three to five activities every night and in the same order. Eventually your child will associate the routine with bedtime, but to make the lead-up to bed even more effective, you can wind down the household by dimming lights and turning off screens.

Here are some activities you might incorporate into your bedtime routine:

If your child needs to get out their last bursts of energy, plan their schedule accordingly and give them the time and space to do so
Nutritious snack or bottle/breastfeeding
Bath and diaper change
Brushing teeth and going to the bathroom
Reading books
Lullaby or singing a song together
Massage, cuddling, and rocking
Talking about their day
Tucking your child in or putting them in their crib

Your bedtime routine can culminate in tucking your child in (or putting them in their crib) and leaving the room while your child is sleepy but not asleep yet, allowing them to learn to fall asleep on their own.

Because every child is different, it might take some trial-and-error to find out what works best for your family. But when crafting your child’s bedtime routine, the National Sleep Foundation recommends the following advice:

Keep it short and sweet: Your bedtime routine should be around a half an hour not including their bath. Prolonging the routine makes it harder to shorten it when you need to.
Keep up your routine during the day: Following a daytime rhythm leads to increased sleep duration for young children. Lots of exercise, sunlight, and time outdoors also can help them sleep better.
Follow sleep hygiene rules: Keep the bedroom dark, cool, and quiet to promote sleep. If your child is scared of the dark, you can use a dim nightlight. Noise levels in the rest of the house can keep young children awake, so try to transition to quieter activities once you’ve tucked the kids in.
Make gradual changes: Try not to introduce more than one change at a time to the routine. If other changes are happening in your lives, like a new sibling or starting school, consider delaying bedtime changes — the routine will be good for your child.
Start before they are overtired: Overtired children can become hyperactive or grumpy, and will become increasingly difficult to get to sleep, so try to start the routine before that point, following physical cues such as eye rubbing, yawning, or irritability.
Limit or avoid screen time close to bedtime: The blue light from television and other electronic devices has consequences for sleep if used too close to bedtime.
Avoid sugary treats or caffeine: Try to keep evening snacks light and healthy. Caffeine will keep kids awake, and sugary treats before bed can lead to cavities. Breakfast cereals, chocolate, and pudding can be sources of caffeine you may not expect.

This article has been reviewed by our team of experts.

How much sleep does my baby need?

2022-05-02T12:40:51-04:00

The amount of sleep your baby needs changes as they age. Download our handy sleep guide that outlines recommended hours of sleep (naps and nighttime) by age range.

Babies (0 to 3 months)

Newborns may sleep for as many as 18 hours a day, for 3 to 4 hours at a time. It’s normal and healthy for babies to wake up during the night to feed. As your baby gets older, they will stay awake longer during the day and sleep for longer stretches at night.

Infants (4 to 12 months)

During this age range, babies sleep an average of 14 hours a day, between nighttime sleep and naps, but anything less or more can be normal for your baby. By 4 months, most babies will start consolidating their sleeping to three naps a day; one in the morning, one in the afternoon and one in the early evening.

When should my child transition from three naps to two? Between 6 and 12 months, your baby will probably go from having three naps a day to two longer naps, one in the morning and one in the afternoon. But every baby’s napping needs are different and there are no hard milestones. Some naps will be 20 minutes long, and some 3 hours. Some babies will hold to a regular schedule, and others won’t.

Toddlers (1 to 2 years)

Most toddlers sleep between 11 and 14 hours in a 24-hour period. Sometime during this period, they may further consolidate naps, from two to one a day.

Children (3 to 5 years)

Preschoolers typically sleep about 10 to 13 hours a day. As your child approaches 3 years old, they will probably be taking one nap a day, though some will still have two, and others will give up daytime naps altogether. If they’re rejecting their naps or having trouble falling asleep at night, consider using the time after lunch as quiet time, for everyone to relax and recharge.

At this age, it’s common for children to have some nighttime sleep problems and to resist going to bed. Your child may also wake up during the night from nighttime fears or nightmares.

Remember, all children are different. There are a range of acceptable sleep totals in a 24 hour period. Pay attention to whether your child seems rested after waking up to gauge appropriate sleep needs for your child.

This article has been reviewed by our team of experts.

When should I lower my child's crib?

2022-05-02T12:40:47-04:00

As your child begins to pull themselves up to sitting or standing, it is time to lower the crib mattress to reduce the risk or temptation for your toddler to climb or jump out.

This is also a good time to confirm that your child’s room is fully baby-proofed, just in case they do escape from their crib. Once a toddler is climbing out of their crib, it may be time to consider transitioning to a toddler bed or floor bed to reduce risks associated with falling out of the crib.

This article has been reviewed by our team of experts.

When should my child stop napping?

2022-05-02T12:40:31-04:00

Many children can benefit from regular naps until age 3, however some toddlers are ready to drop naps earlier. Offer a nap period every day even as they begin to skip naps. As your child gets older they may not fall asleep every day, but you can have your child stay in their rest space — bedroom or bed — for a specified period even if they are not actually sleeping. Their body and mind will benefit from the regular down time, and you may find they fall back into a normal napping pattern.

That said, between ages 2 and 5 years old, most children become biologically ready to give up regular napping. Here are signs they might be ready to go:

Never (or rarely) sleep during rest time. Several consecutive days of no naps.
Able to stay awake for a regular bedtime without a nap. If your child can make it through those last few hours of the day without seeming delirious, they might not need their naps anymore.
If you notice midday naps begin to sabotage bedtime efforts, you can also begin to decide the nap isn’t worth a resistant bedtime experience.

This article has been reviewed by our team of experts.