Kids Health Info

Sleep problems – babies and toddlers

  • Waking up many times through the night (recurrent night waking) is very common in babies and toddlers. It can be very distressing and exhausting for their parents and caregivers.

    In children aged six months to 18 months, sleep is made up of cycles that last about an hour.  A sleep cycle consists of both light and deep sleep. It is normal for children to wake at night when a sleep cycle comes to an end, when they are in light sleep. Many children can easily resettle themselves, while others will call out or cry because they need help settling back to sleep.

    For sleep problems in older children, see our fact sheet Bedtime problems – children.

    Strategies to promote good sleep habits

    It is common for parents and caregivers to feed their child to sleep or use techniques such as patting, rocking or holding the child until they fall asleep in their arms. When these techniques become habits that are needed to soothe a child to sleep, they are known as sleep associations. Specific attachment to one parent or caregiver can also be a sleep association.

    Sleep associations are not a problem for all children, but those who don't settle easily and wake frequently at night are more likely to become dependent on sleep associations.

    To reduce your child's dependence on sleep associations, try the following suggestions for promoting better sleep routines:

    • Try to keep a consistent and predictable routine each evening so your child learns what to expect and when.
    • Screen time or high-energy play in the hour or two before bedtime can make it harder for your child to fall asleep. Instead, try to have some quiet time before your child is put to bed (e.g. having a bath and bedtime story).
    • Feeding your child immediately before bedtime can become a sleep association. Instead, try to time the last feed for at least half an hour before bed.
    • If dummies have become a sleep association, attempt to help your child to give them up. 
    • Letting your child hold a comforter (e.g. a soft toy or small blanket) can be helpful, but this should not be done for babies under six months of age as it can be a choking or suffocation hazard.  
    • Techniques such as patting or rocking your child to sleep are OK for newborns, but older children can form a sleep association with these actions. Try to cut down on these techniques if this is the case.
    • Begin to put your child into the cot awake at bedtime as this can help them to learn to settle themselves to sleep.
    • Try to leave the room and go back for brief but regular checks until your child is asleep. If this is too distressing, sit quietly on a chair in the bedroom until they fall asleep. You can gradually move out of the room in time.
    • Be consistent in your behaviour, and set your own limits. Each family is different.
    • Try to share your child's bedtime routine with your partner.
    • If you are having trouble, contact your doctor or Maternal and Child Health Nurse for extra help.

    Follow-up

    Once your child has learnt to fall asleep and stay asleep throughout the night, be wary of times of change. Coughs and colds or holidays away can be enough to upset your child's routine and may lead to a recurrence of night waking. Be aware of this, and try to be consistent during those times of change. If holidays away cause disruption, try to return to the sleep routine once you are home again.

    Key points to remember

    • Night waking happens when children cannot settle themselves back to sleep when they wake up during the night.
    • Night waking can be distressing and exhausting for parents.
    • Sleep associations can encourage night waking. These sleep associations should be reduced or stopped if they seem to be causing the problem.
    • Good routines and consistency can help resolve the night waking.

    For more information

    Common questions our doctors are asked

    I've tried the suggestions for good sleep routines but nothing seems to help. Should we go to sleep school?

    Speak to your Maternal and Child Health Nurse. They may be able to provide you with some other useful advice for getting your baby to sleep better. If nothing seems to help, they will be able to recommend a sleep school (otherwise known as an early parenting centre). Sleep schools have expert staff who can teach you how to help your baby self-settle. They may have day-stay programs or residential programs where you stay overnight. A sleep consultant may also be able to perform a home-visit and provide a tailored plan for settling your child.

    I've been told to try controlled crying to teach my baby to self-settle, but I am not comfortable with this technique. What are some other effective options?
    There are a number of different techniques for settling children. These include controlled crying, pat-and-shush and camping-out. You should discuss these with your Maternal and Child Health Nurse, sleep specialist or doctor to determine which is suited best to your family.


    Developed by The Royal Children's Hospital General Medicine department. We acknowledge the input of RCH consumers and carers. We acknowledge the input of RCH consumers and carers.

    Reviewed July 2018.

    Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.


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Disclaimer
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.