Growth & Development

Sleep & Infant Sleep Environment

Sleep is a critical activity of child development. Adequate sleep promotes self-regulation, growth, physical health, memory and cognitive functioning. In typically developing infants and toddlers, lack of sleep has been associated with parental stress, attachment difficulties and maternal depression. In atypically developing infants, sleep problems are often attributed to neurological or physical abnormalities, although psycho-social factors also play a role.


It takes time for infants to develop a sleep-wake cycle and some infants take longer than others. Various factors such as time, cues, biology, environment and infant temperament all play a part. The amount of sleep varies greatly from one child to the other.

 

Approximate Sleep time in a 24 hour day:

  • 0 - 6 months Up to 16 hours, but as little as 10 hours has also been reported.

  • 6 - 12 months Up to 14 hours per day,

  • 12 months - 3 years About 10 to 13 hours

  • 4 -5 years 10 to 12 hours

If a child presents any of the following behaviours, consider this a red flag:

 

Dependence on caregiver presence and soothing actions i.e. nursing or rocking

► Resistance to or fears and anxieties around sleeping

► Poor airway functioning/airway obstruction i.e. noisy breathing, snoring or breathing pauses due to enlarged adenoids or respiratory infection

► Excessive crankiness or temper tantrums

► Problems in cognitive functioning i.e. attention, learning and memory

► Coordination problems e.g. accidents, injuries, slower reaction time

Parents and Caregivers please note:

There are risks associated with unsafe sleep practices. Whether or not infants should co-sleep or bed share with a caregiver has been a controversial issue. The decision of where an infant should sleep is influenced by culture, beliefs, individual practices, preferences and information obtained by health care providers.

Here is some information to help you make a more informed decision about the Sleep Environment of Infants (0-6 months) under your care:

Problem 

Signs

The SAFEST sleep environment for an infant 0 to 6 months of age is on their back within arm's reach of their caregiver, in a crib that meets current safety regulations.

An exception to this is when an infant is required to sleep side-lying or prone (on tummy) positioned as advised by a primary health care provider for a medical condition.

Sleep Environment of Infants (0-6 months) 

Sleep Position (0-6 months)

Infants should sleep on their back in their cribs meeting safety regulations. This is recommended sleeping arrangement for the first year of life.

SAFER OPTION

  • back-lying

UNSAFE OPTION (any of the following)

  • side-lying

  • stomach-lying

  • propping with rolled blankets or wedges

Co-Sleeping (0-6 months)

Infants should sleep within arms reach, in their caregiver's room for the first six months.

SAFER OPTION (all must be present)

  • crib or cradle that meets safety regulations in the room that the infant's caregiver sleeps

  • an infant is within arm's reach of their caregiver, but not on the same sleeping surface

RISKIER OPTION

  • crib or cradle in room, NOT within arm's reach of their caregiver

UNSAFE OPTION (any of the following)

  • waterbed/air mattresses

  • recliner

  • couch

  • sleeping on pillows or soft materials

  • car seats and infant seat carriers

  • child's house swing

  • any makeshift bed or hammock

Sleep Environment (0-6 months)

An infants sleep environment should be free of miscellaneous items. It should also be free of tobacco smoke with a temperature that is neither to warm or to cold (about 65 °F).

SAFER OPTION (all must be present)

  • environment is free of quilts comforters, bumper pads, pillows and pillow like-items

  • use of a firm sleep surface

  • dressing infant for sleep so that they are warm - not hot

  • non smoking home environment

  • discontinuing smoking prior to or early in pregnancy and not allowing others to smoke around infant or shared environment.

UNSAFE OPTION (any of the following)

  • use of bumper pads in crib

  • use pillows, quilts, comforters, adult bed covers or pillow-like items in crib

  • over/under dressing or overheating/chilling infant

  • infant exposure to smoke

Bed Sharing (0-6 months)

Bed sharing refers to a sleeping environment in which an infant baby shares the same sleeping surface with another person.

SAFER OPTION (all must be present)

  • bed sharing with only the infant's primary caregiver (or no caregiver at all as adult beds have potential risks and are not designed to meet most safety regulations for infants). 

  • never leaving an infant alone on an adult bed

  • ensuring that the infants head is not covered

  • no spaces between the mattress and headboard, walls, and other surfaces which may

  • use of firm mattress directly on the floor away from walls

 

UNSAFE OPTION (any of the following)

  • bed sharing with people other than the infant's parents or usual primary caregiver

  • infant bed sharing with other children and/or pets

  • bed sharing if caregiver is a smoker, extremely tired, under the influence of alcohol or drugs (legal or illegal)

  • allowing infants head to become covered

  • allowing infant to sleep on an adult bed alone

  • bed sharing with adjacent spaces that could trap infant

Having more general concerns about a child's development?

Having difficulty coping? Need some advice?