Safer Sleep - Lets Get

Information for Parents and Carers of children aged 0-12 months.

How can sleep support babies?

Sleep is a natural process that not only helps to support our immune system but also regulates our body’s hormones so we can grow and repair our organs, muscles, and other cells. Sleep supports babies through a stage of intense development.

How much sleep does my child need?

It’s recommended that babies aged 0-3 months have 14-17 hours of sleep throughout a 24-hour period. This includes nap time throughout the day. Sleep patterns for new-borns can vary a lot. New-borns usually sleep in short bursts of 2-3 hours each, but others can sleep for up to 4 hours a time. New-borns sleep throughout the day and night because the -parts of their brain that control the day-night sleep cycles have not matured yet.

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.

For more information on recommended sleep times, visit The Sleep Charity

What are the different types of sleep?

New-borns have two different kinds of sleep – active sleep and quiet sleep.

During active sleep, new-borns can easily be woken up; they move around a lot and make noises during this time.

During quiet sleep, new-borns are less likely to wake. They are still and will have heavy, regular and deep breathing.

A new-born will go through various 40-minute sleep cycles including both active and quiet sleep. At the end of each cycle, new-borns wake up for a little while, and may perhaps moan or cry. You might need to help baby settle.

How do I dress my baby for bed?

Baby wrapping

Babies can be wrapped from birth, until around 4 months when they start showing signs that they can roll onto their tummies.

Wrapping babies promotes safer sleep by encouraging them to sleep on their backs. Wrapping baby also helps them to settle to sleep.

If you choose to wrap your baby, use lightweight cotton or muslin wraps.

Wraps that are too high can obstruct a babies’ breathing and can also cause a baby to overheat. It is important that the wrap does not go above your baby’s shoulders or cover baby’s head, ears or chin.

It is also important to check that the wrap is not too tight around the baby’s chest and hips and that there is enough room for your baby to stretch their legs.

Underneath the wrap, put your baby in a nappy and singlet in warmer weather. You can add a lightweight grow suit in cooler weather.

Baby sleeping bags

An infant sleeping bag can be a good option for dressing your baby for a safer sleep. A correctly sized sleeping bag is the best way to keep your baby’s head and face uncovered. It is recommended that you use a sleeping bag that has a fitted neck and armholes but no hood.

An infant sleeping bag also helps to:

reduce the risk of fatal sleeping accidents
stops your baby from rolling onto their tummy during sleep
prevents baby’s legs hanging out of a cot’s rails

Some sleeping bags have a TOG (thermal overall grade) rating. This can help you decide which sleeping bag to use in different temperatures. Please note that a TOG rating is just a guide. It isn’t a safety standard.

The rating or instructions that come with the bag can also help you work out what clothes to put on your baby underneath the bag. Always check the temperature of the room too, this will help you decide what your baby should sleep in.

Top Tips for dressing your baby at night-time:

Your baby should be comfortably warm – not hot, sweaty or cold. Getting too hot has been linked with sudden unexpected death in infancy (SUDI).
Dress your baby in layers of fitted clothing rather than just thick pyjamas. You can add or take away layers as the temperature changes.
Babies cool themselves down by releasing heat from their heads and faces. It is important babies do not wear hats in bed. Headwear in bed can also be a choking or suffocation hazard.
Although a baby’s hands and feet might feel cool, it is better to check your baby’s temperature by feeling their back or tummy.
It’s best to adjust your baby’s clothing rather than heating or cooling the room. But if you need to adjust the temperature of the room where your baby sleeps, use a heater or fan when your baby is not in the room. Make sure you turn off the appliance when they go to sleep in the room.
Never use electric blankets or hot water bottles to warm your baby during colder weather.

What is a sudden unexpected death in infancy (SUDI)?

When babies under one year die unexpectedly in their sleep, it’s often described as sudden unexpected death in infancy (SUDI).

When these deaths are investigated, they’re often found to be one of the following:

Fatal sleeping accidents: these deaths happen when babies suffocate or get trapped or strangled by things in their sleeping environments.
Sudden infant death syndrome (SIDS) – this is when investigations can’t find a cause of death.
Sometimes SUDI can be explained by a serious illness or a medical condition that the baby was born with.

The risk of SUDI including SIDS and fatal sleeping accidents is greatest at 2-4 months, although the risk is there for the first 12 months.

All babies are at general risk of sudden unexpected death in infancy, including sudden infant death syndrome and fatal sleeping accidents.

This general risk increases when babies:

have extra underlying risk factors
are young
have unsafe sleep environments (for example being exposed to tobacco smoke or drugs and overheating)

are born prematurely
are small when they’re born

You can’t usually control extra underlying risk factors like a heart condition and your baby’s age, but you can reduce the overall risk of SUDI including SIDS and fatal sleeping accidents by following these safe sleeping tips:

Safer sleep tips:

Always put your baby on their back to sleep as it is the safest position for them to sleep in. Once your baby can roll over (at around 4-6 months), keep putting your baby to sleep on their back, but let your baby find their own sleeping position.
Keep your baby’s face and head uncovered to reduce the risk of overheating and suffocation. To prevent bedding from covering your baby’s head, put your baby with their feet down at the bottom of the cot. Use only lightweight bedding and tuck it in securely at chest level. You could use a safe infant sleeping bag instead of blankets.
Keep your baby’s environment smoke free, before and after birth. The exposure to second hand smoke and smoking during pregnancy is harmful to babies.

Don’t use soft objects where your baby sleeps. Babies can suffocate from or overheat by rolling into or being covered from pillows, cot bumpers, soft toys in their cot.
Share a room. Although it is a personal choice where your baby sleeps, it is safest for your baby to share a room with you for at least the first six months of their lives, sleeping in a cot next to your bed. If your baby sleeps in a separate room from you, check your baby regularly to ensure that your baby stays on their back and their head and face stay uncovered.
Babies should sleep in a cot. Babies should not be put to sleep at night, whether in your room or elsewhere in the house, in a bouncinette, hammock, sofa, pillows or bean bags.

Should I co-sleep with my baby?

Co-sleeping is when parents sleep on the same surface as their babies – for example, when they bring their babies into bed with them to sleep.

The safest place for a baby to sleep is in their own clear, flat, separate sleep space, such as a cot or Moses basket.

Although co-sleeping is associated with an increased risk of sudden unexpected death in infancy (SUDI) some parents do choose to have their babies in bed with them. It is important if bed sharing to follow this advice:

Keep all adult bedding or any other items away from the baby so they do not obstruct your baby’s breathing or cause them to overheat.
It is advisable to use a baby sleeping bag if bed sharing.
Put babies on their back every time they sleep.
Never leave a baby alone in an adult bed.
Ensure your baby will not fall out of bed or does not get trapped between the mattress and the wall.

Sleeping with a baby on a sofa or chair is always unsafe. Move your baby to a safer sleep environment if you think you might fall asleep in a chair or sofa while holding your baby.

You should never bedshare with your baby if any of the following apply:

Your baby was born premature (before 37 weeks)
Your baby was born at a low weight (2.5kg or 5½ lbs or less)
If anyone sleeping in the bed smokes (even if you do not smoke in the bedroom)
Either you or your partner has drunk alcohol or taken drugs (including medications that may make you drowsy)

What is a new-born baby’s’ tired signs?

Your child’s tired signs let you know it is time to reduce stimulation and settle your child to sleep.

New-borns can get tired very quickly. Some are tired as soon as 1-1½ hours after waking. Others can be happy and keep playing without tired signs for two hours or more.

If your new-born is tired, you might see some of the following tired signs:

Yawning
Fluttering eyelids
Pulling at ears
Closing fists
Sucking on their fingers
Making jerky arm and leg movements, or arching backwards
Frowning or looking worried

Is it normal for my baby to wake up during the night?

Although it can be exhausting for new parents, it is normal for babies to wake up in the night. This can be for a variety of reasons such as being uncomfortable, hot or cold or wanting comfort. Another reason is that babies often wake up to feed, generally every 3-4 hours.

There are lots of advantages of night feeding. Firstly, it maintains a good milk supply for the mother. Most breastfeeding mothers need to feed or express roughly every 2-3 hours during the early new-born days. In addition to this, a mother’s prolactin levels (the hormone designed to support milk production) is at it’s highest during the night time.

Breastmilk also is high in the amino acid tryptophan; this not only helps your baby to sleep better but also helps their internal systems to recognise the difference between day and night.

Between one and three months, your baby might start waking less often and have a longer period of sleep at night because overtime babies will not need milk to fall asleep or to support them to feel safe and calm as they will learn to self-regulate.

By the time your baby is around three months old, they might regularly be having a longer sleep at night – for example, around 4-5 hours. But you can expect that your baby will still wake at least once each night.

Can I have a sleep routine for my new-born?

All children need to be supported to develop a good sleep routine; they do not automatically have good sleeping habits. All babies are different and will start sleeping through at different times.

For new-borns, 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. The key is being flexible and following your baby’s lead.

Your baby’s tiredness cues will support you to understand when your baby wants to sleep or if they are hungry or need stimulation.

If it feels right for you, and your baby, it is okay to try to do things in a similar order. For example, you could try a simple routine of feed, play, sleep.

Offer your baby a feed when they wake up.
Change your baby’s nappy.
Interact with your baby through talking, playing and cuddling.
Put your baby back down for sleep.

New-borns 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. Putting a baby in a cot or moses basket during the day when they are sleepy can encourage self-settling. As evening approaches, the environment can be quieter and lighting dimmer with less activity.

Are there any rules for daytime napping?

Daytime naps can provide much needed downtime that aids the important physical and mental development that happens in early childhood.
They prevent babies from becoming too tired. They also give parents time in the day to have a break, relax or have some time to complete daily tasks.
It is important to note that if your child is napping ‘on the go’ (for example in the car), this needs to be balanced with naps in their own beds so they can get the best quality sleep over the week.
There’s no single rule about how much daytime sleep babies need; it will depend on their age and how much sleep they are getting in a 24hour period.

Why can a baby struggle to sleep?

Many factors can lead to sleep problems. Sometimes babies can take a while to settle and get to sleep.

A baby’s feeling of separation anxiety
Environment
Lack of routine
They are hungry
They have a wet or dirty nappy
They are overtired

How should I respond if my baby will not stop crying?

It is important that if your baby is constantly crying at bedtime, parents should ensure their children are safe, but then walk away so they do not get frustrated and overwhelmed.

Infant crying is normal. Although babies can cry more frequently at 2 weeks old, after approximately 8 weeks babies will start to cry less as time goes on.

The ICON programme provides a simple message that supports parents/carers givers to cope with infant crying. ICON stands for the following:

I – Infant crying is normal

C – Comforting methods can help

O – It’s OK to walk away

N – Never shake a baby

The ICON programme has more information including comforting techniques and safety advise.

How can I reduce stimulation to settle my new-born?

If your child is showing signs of tiredness, reducing stimulation in their environment can help them settle to sleep.

You can do this through:

Putting toys away
Taking your child to where they usually sleep
Using dimmer lighting
Playing some soft music
Closing the curtains or blinds
Talking quietly or in a soothing way
Offering a gentle cuddle
Reading a story or singing a quiet song

What might support my baby to have better sleep?

Fortunately, there are many practical ways to develop and improve your baby’s sleeping routine and habits. Here are a few suggestions that may help your family:

Set a bedtime that is consistent, communicated and enforced.
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 and holidays).
Create an enjoyable bedtime routine. Start a “winding down” bedtime routine 20 minutes before the time that your child usually falls asleep. Set a limit on how much time you spend with your child when you put them to bed. For example, read only 1 story, then tuck your child in and say goodnight. Listening to calming music or doing some relaxation can be helpful in this time too. If they would like, allow your child to take their favourite toy, or comforter before settling into bed.
Create a regular ‘sleep friendly’ environment- check the noise and the light in your child’s room. A child’s night time space should be quiet, dark, and smoke-free. (Blue light from televisions, computer screens, phones and tablets suppress melatonin levels and delays sleepiness).
Avoid screen use (including TV, mobile phones, tablets and computers) an hour before bed.
Avoid boisterous play, this can make it harder for a young child settle.
Have an evening meal at a reasonable time – feeling too full or too hungry before bed can make it harder for a child to fall to sleep.
If your child is genuinely hungry rather than trying to delay bedtime, offer a high in fibre and/or protein snack (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. Snacking should be encouraged as early as possible (i.e. before bath/ shower and brushing teeth time).
Make sure your child feels safe at night – if your child feels scared about going to bed, praise them for being brave and offer reassurance if they are anxious. Some children with bedtime fears feel better when they have a night light.

How do I know if my baby needs further support?

Although it is common for people to experience sleep problems, if your child experiences sleep problems regularly, you may need some support or advice.

Persistent sleep problems can affect your child and your whole family, so it’s important to seek help.

The first step is talking with your GP. You may then be referred to a paediatrician or other health professional who is trained in identifying and treating sleep problems in children.

How can the Cost-of-Living Crisis affect a child’s sleep?

You may be worried about how to keep your children warm this winter with the cost-of-living crisis. You may be concerned about paying your bills, trying to keep your home warm, keeping draughts out and keeping your baby warm.

The recommended room temperature is 16-20 degrees. Keeping your children at the right temperature during the night can be challenging. As our body temperature drops overnight, children may wake up if they are too cold. It can be tempting to wrap your baby up to keep them warm, however it is important that they do not get too hot either.

These helpful tips from the sleep charity advise you how to help keep your children warm at night this winter, but in a safe and cost-effective way:

Finding support

If you are worried about or struggling to pay your bills do seek help, the
following may be able to help:

National debt helpline

Step Change

Are there any useful resources to support child sleep?

The Sleep Charity- Relaxation at Bedtime Advice Sheets

The Sleep Charity Sleep Advice For Infants

The Gentle Sleep Book: Gentle, No-Tears, Sleep Solutions for Parents of Newborns to Five-Year-Olds (2015) by Sarah Ockwell- Smith

Babies cry, you can cope resource- ICON

What are the sources used for information on this page?

The Sleep Charity- https://thesleepcharity.org.uk

The Royal College of Paediatrics and Child Health- https://www.rcpch.ac.uk/resources/health-impacts-screen-time-guide-clinicians-parents