A Tour of Safe Sleep in the First 3 Years

Good sleep health is vital for your child’s development and well-being. But there is so much information out there it can be hard to know who and what to trust! As sleep scientists and paediatric sleep practitioners, we established Infant Sleep Australia to bring evidence-based advice and information directly to parents. In this blog post, we describe how to set up a safe sleep space and briefly describe what to expect sleep-wise across the first 3 years.

The sleep environment and safe sleep

We need to ensure our babies are safe while they sleep. By following Red Nose Australia’s safe sleep guidelines, you can help reduce the risk of sleep accidents and SIDS for your little one. 

Babies

Aim to keep their sleep space simple, boring, and just for sleeping. Use a cot and mattress that meet Australian safety standards, with well-fitting bedding. If using a bassinet, make sure it has a firm, flat mattress, sides that allow air-flow, and a stable base. Keep the room dark for a sleep, consider white noise to muffle environmental sounds, and aim for a comfortable room temperature (eg. 18-20 degrees). You can swaddle your baby until they show signs of rolling, and then change to sleeping bags or suits. If you have a mobile, put it over the change mat to entertain your baby during nappy changes, rather than over the cot/bassinet.

In addition, follow these six steps recommended by Red Nose for safe sleep:

1. Always place your baby on their back to sleep
2. Keep your baby’s face and head uncovered 
3. Keep your baby smoke-free before and after birth
4. Use a safe sleeping environment both night and day
5. Share a room with your baby for first 6-12 months
6. Breastfeed your baby, if you can.

For more information, go to www.RedNose.org.au or email education@rednose.org.au

Toddlers

Move them into a bed when they either outgrow their cot or when they seem close to climbing out of the cot (whichever comes first). Consider putting a safety gate on their door to stop them leaving their room and getting up to mischief at night. Remove or secure potential hazards in their bedroom, e.g., electrical cords, curtain cords, and heavy furniture that could topple. Keep noisy and exciting toys out of the bedroom or pack them away each night. Some parents continue to use sleeping suits once their toddler is in a bed, others switch to a doona. Your toddler may feel super excited or nervous about moving to a “big bed”, so if that is the case, stay with them as they fall asleep, or even sleep in their room for a few nights as they adjust.

What to expect sleep-wise

Sleep changes a lot in the first 3 years so it can be helpful to know what to expect so you aren’t taken by surprise. 

0-3 months

Newborns and very young babies have immature circadian rhythm systems, small tummies, and an immense amount of growing to do. They need to feed frequently, day and night, and they need lots of sleep. By the time they have fed, burped, and had a nappy change, they’ll be ready for sleep again.

Once you see your baby’s tired signs, you can cuddle, rock, or feed them to sleep, or you can put them in their bassinet or cot and gently pat and shush them to sleep.  They may sleep as much as 17 hours per 24 hours, or as little as 13 hours. They may have 5-6+ naps a day, reducing to about 4 naps at 3-months. 

4-12 months 

You are likely to see a more predictable daily rhythm emerging, with your baby having the lion’s share of their sleep at night. Your baby will spend more time awake during the day because they have lots to learn! At 4 months, your baby will have 3-4 naps a day, and sleep un-swaddled. By 6-7 months, your baby will manage longer stretches awake during the day to develop and practice new skills, moving to 2 naps. Sleep changes so quickly in the first 7 months that it can feel like a rollercoaster ride! When your baby is having 2 naps, those changes slow for a while. Once having solids, you’ll find they feed less overnight and may drop overnight feeds altogether. 

12-36 months

Toddlers usually move to one nap when they are 12-18 months old. It becomes easier to manage your day when you just have one nap to plan around! Nap length will depend on your toddler’s individual sleep needs. For example, if they need 12 hours per 24-hours, they may nap for 1-1.5 hours and sleep for 10.5-11 hours overnight, but if they need 14 hours, they may nap for 2-3 hours and sleep for 11-12 hours overnight. Your toddler will stay on one nap until they are anywhere between roughly 2 and 3.5 years old. 

How will you know that your baby or toddler is ready to drop a nap?

Common signs to look out for that your baby or toddler is ready to drop a nap:

• Taking longer to fall asleep for naps, sometimes skipping a nap; 
• Taking longer to fall asleep at night time; 
• Starting to wake overnight; or 
• Waking early for the day. 

When you have seen any combination of these signs for 1-2 weeks, it may be time to drop a nap!

Common sleep problems and when to seek help

Most babies and toddlers have brief periods of disrupted sleep which resolve on their own. However, some experience persistent sleep problems including:

• Waking frequently overnight (when not due a feed or a nappy change) and needing hands-on support to go back to sleep. 
• Needing intense support to go to sleep, including bouncing, rocking, feeding, pram rides or car rides.
• Protracted bedtimes including using stalling behaviours (toddlers).
• Being awake for extended periods in the middle of the night (split nights).

If your child’s sleep difficulties are persisting, are impacting their behaviour during the day, and/or are having a negative impact on you and your family, it is okay to seek help. Speak to your GP or health nurse to check for any medical causes of the poor sleep. There are then gentle, effective, evidence-based ways to support your child’s sleep health. In doing so, you are supporting their health development and well-being.