Healthy Sleep
Good quality sleep is important for everyone but especially for children as it directly impacts on their mental and physical development.
During the deep states of sleep, blood supply to your child’s muscles is increased, energy is restored, tissue growth and repair occur, and important hormones are released for growth.
Good sleep helps to improve attention, behaviour, learning and memory.
For help and more information on crying babies and how to cope please go to the ICON website.
In the drop down menus below you can find the age category of your child and all the related sleep advice and information.
When should you worry?
Newborn
NEWBORN
Contact your health visitor or GP if your baby is newborn and they…
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm into their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You may also find it difficult to move your baby’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy, or have floppy arms or legs when awake
- Move their arms and legs in repetitive jerky movements, or writhing movements
- Don’t have a Grasp Reflex (doesn’t grab your finger or small object when you put it in their hand)
- Are often startling and you cannot understand why
- Move one side of their body more than the other, for example:
- Rarely moves one of their arms compared to the other arm
- Rarely moves one leg compared to the other leg
- When your baby startles, one side moves or looks different from the other
6-8 weeks
6-8 WEEKS
Contact your health visitor or GP if your baby is 6-8 weeks and they…
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm into their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You may also find it difficult to move your baby’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy, or have floppy arms or legs when awake
- Move their arms and legs in repetitive jerky movements, or writhing movements
- Have not started to bring both their hands to their face, or do not move their arms much
- Keep their hands fisted, and you find it difficult to open their hands
- Can’t lift their head when lying on their tummy
- Move one side of their body more than the other, for example:
- Mostly moves one arm or mostly brings one hand to their face
- Rarely kicks or moves one leg compared to the other leg
2-3 months
2-3 MONTHS
Contact your health visitor or GP if your baby is 2-3 months and they…
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm into their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You may also find it difficult to move your baby’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy, or have floppy arms or legs when awake
- Move their arms and legs in repetitive jerky movements, or writhing movements
- Have not started to bring both their hands to their face, or do not move their arms much
- Keep their hands fisted, and you find it difficult to open their hands
- Can’t lift their head when lying on their tummy
- Move one side of their body more than the other, for example:
- Mostly moves one arm or mostly brings one hand to their face
- Rarely kicks or moves one leg compared to the other leg
3-4 months
3-4 MONTHS
Contact your health visitor or GP if your baby is 3-4 months and they…
- Have lost skills which they could do before
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm to their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You find it difficult to move your baby’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy when awake
- Prefer to keep their arms by their sides. For example, they do not reach for things, or do not bring their hands together over their face or tummy
- Move their arms or legs in repetitive, jerky, or strange ways
- Still need you to support their head, or can’t lift their head when lying on their tummy
- Have very tight fists and it’s hard to open their hand
- Move one side of their body more than the other, for example:
- Rarely use one of their arms to pick up toys
- Rarely kick one leg compared to the other
4-6 months
4-6 MONTHS
Contact your health visitor or GP if your baby is 4-6 months and they…
- Have lost skills which they could do before
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm to their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You find it difficult to move your baby’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy when they are awake
- Move their arms or legs in repetitive, jerky, or strange ways
- Move one side of their body more than the other, for example:
- Rarely use one of their arms to pick up toys
- Rarely kick one leg compared to the other
- Are unable to roll, or can roll in one direction but not the other
- Find it difficult to reach their arms out. For example, they do not reach for toys
- Still have their early reflexes, like the startle reflex and grasp reflex
- Keep their legs flat when lying on their back. For example, they do not bring their feet to their chest
- Still need you to support their head
6-9 months
6-9 MONTHS
Contact your health visitor or GP if your baby is 6-9 months and they…
- Have lost skills which they could do before
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm to their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You find it difficult to move your baby’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy when they are awake
- Move their arms or legs in repetitive, jerky or strange ways
- Move one side of their body more than the other, for example:
- Rarely use one of their arms to pick up toys, or eat and drink
- Rarely kick one leg compared to the other
- Can’t sit without support. For example, they lean on their hand, or, when they sit, their back is very curved
- Still have their early reflexes, like the startle reflex and grasp reflex
- Keep their legs flat when lying on their back, for example, do not bring their feet to their chest
- Still need you to support their head
- Still need you to help turn their head when lying on their back
- Find it difficult to stand, for example:
- Can’t stand with support
- Doesn’t try to pull themselves up to stand
- Can’t move a toy from one hand to the other
- Doesn’t use both hands to hold larger things
9-12 months
9-12 MONTHS
Contact your health visitor or GP if your baby is 9-12 months and they…
- Have lost skills which they could do before
- Feel very stiff, for example:
- Hold their arms and legs in the same position, such as always pulling their arm to their chest, or always crossing their legs
- Find it difficult to change their position on their own
- You find it difficult to move your baby’s arms or legs, making it tricky to change their nappy or clothes
- Feel very floppy when they are awake
- Move their arms and legs in repetitive, jerky, or strange ways
- Use one side of their body more than the other, for example:
- Lean to the side when they sit
- Use one arm to pull to stand more than the other
- Rarely use one of their arms to pick up toys, or eat and drink.
- Rarely kick one leg compared to the other
- Find it difficult to sit, for example:
- Only sit with support
- Lean on their hand when sitting
- When they sit their back is very curved
- Can’t move a toy from one hand to the other
- Don’t use both hands to hold larger things
- Don’t point to objects
- Can’t crawl, or find it hard, for example, drags one leg behind them
- Find it difficult to stand, for example:
- Can’t pull themselves up to stand
- Find it hard to pull themselves up. For example, they only use their arms and don’t push with their legs
- Can’t stand with support
2 months
Your Baby By Two Months
Social/Emotional Milestones
- Calms down when spoken to or picked up
- Looks at your face
- Seems happy to see you when you walk up to her
- Smiles when you talk to or smile at her
Language/Communication Milestones
- Makes sounds other than crying
- Reacts to loud sounds
Cognitive Milestones (learning, thinking, problem-solving)
- Watches you as you move
- Looks at a toy for several seconds
Movement/Physical Development Milestones
- Holds head up when on tummy
- Moves both arms and both legs
- Opens hands briefly
4 months
Your Baby By Four Months
Social/Emotional Milestones
- Smiles on his own to get your attention
- Chuckles (not yet a full laugh) when you try to make him laugh
- Looks at you, moves, or makes sounds to get or keep your attention
Language/Communication Milestones
- Makes sounds like “oooo”, “aahh” (cooing)
- Makes sounds back when you talk to him
- Turns head towards the sound of your voice
Cognitive Milestones (learning, thinking, problem-solving
- If hungry, opens mouth when he sees breast or bottle
- Looks at her hands with interest
Movement/Physical Development Milestones
- Holds head steady without support when you are holding him
- Holds a toy when you put it in his hand
- Uses his arm to swing at toys
- Brings hands to mouth
- Pushes up onto elbows/forearms when on tummy
6 months
Your Baby By Six Months
Social/Emotional Milestones
- Knows familiar people
- Likes to look at self in a mirror
- Laughs
Language/Communication Milestones
- Takes turns making sounds with you
- Blows “raspberries” (sticks tongue out and blows)
- Makes squealing noises
Cognitive Milestones (learning, thinking, problem-solving)
- Puts things in her mouth to explore them
- Reaches to grab a toy she wants
- Closes lips to show she doesn’t want more food
Movement/Physical Development Milestones
- Rolls from tummy to back
- Pushes up with straight arms when on tummy
- Leans on hands to support herself when sitting
9 months
Your Baby By Nine Months
Social/Emotional Milestones
- Is shy, clingy, or fearful around strangers
- Shows several facial expressions, like happy, sad, angry, and surprised
- Looks when you call her name
- Reacts when you leave (looks, reaches for you, or cries)
- Smiles or laughs when you play peek-a-boo
Language/Communication Milestones
- Makes a lot of different sounds like “mamamama” and “bababababa”
- Lifts arms up to be picked up
Cognitive Milestones (learning, thinking, problem-solving)
- Looks for objects when dropped out of sight (like his spoon or toy)
- Bangs two things together
Movement/Physical Development Milestones
- Gets to a sitting position by herself
- Moves things from one hand to her other hand
- Uses fingers to “rake” food towards himself
- Sits without support
1 year
Your Baby By One Year
Social/Emotional Milestones
- Plays games with you, like pat-a-cake
Language/Communication Milestones
- Waves “bye-bye”
- Calls a parent “mama” or “dada” or another special name
- Understands “no” (pauses briefly or stops when you say it)
Cognitive Milestones (learning, thinking, problem-solving)
- Puts something in a container, like a block in a cup
- Looks for things he sees you hide, like a toy under a blanket
Movement/Physical Development Milestones
- Pulls up to stand
- Walks, holding on to furniture
- Drinks from a cup without a lid, as you hold it
- Picks things up between thumb and pointer finger, like small bits of food
GREEN
AMBER
RED
Advice and Guidance
It's recommended that babies up to 3 months get 14-17 hours of sleep per day (24 hour period). This includes daytime naps.
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.
Is it normal for babies to wake at night?
- Yes. It is normal for babies to wake during the night. Some babies sleep much more than others. Some sleep for long periods, others in short bursts. Some soon sleep through the night, some don't for a long time. Your baby will have their own pattern of waking and sleeping, and it's unlikely to be the same as other babies you know.
- It may help to remember that all babies over 5 months of age wake 4-6 times during the night, as they come to the end of each sleep cycle. This is normal, and also occurs with older children and adults. It's the falling back to sleep that can be difficult.
Do babies and young children automatically fall into a good sleeping pattern?
- No. All babies and children need to be supported to develop a good sleep routine and good sleeping habits. It is a process that will take time and can’t be achieved in a few days. This can be a struggle, especially when you are sleep deprived and feel constantly tired yourself. All babies are different and will start sleeping through at different times. There also needs to be a degree of flexibility around sleep routines.
What routines and habits promote good sleep
- Fortunately, there are many practical ways to develop and improve your child’s sleeping routine and habits. Tips for newborns are below.
Newborns (0-3 months)
- For newborns, 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.
- Newborns sleep a total of 14 to 17 hours across a 24 hour period, on an irregular schedule with periods of one to three hours spent awake. The sleep period may last a few minutes to several hours. During sleep, they are often active, twitching their arms and legs, smiling, sucking and generally appearing restless.
- Newborns express their need to sleep in different ways. Some fuss, cry or rub their eyes.
- It is best to put babies down to sleep when they are drowsy, but not asleep. They are more likely to fall asleep quickly and eventually learn how to get themselves to sleep.
Newborns 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. As evening approaches, the environment can be quieter and lighting dimmer with less activity.
Sleep tips for newborns:
- Observe newborn’s sleep patterns and identify signs of sleepiness.
- Put newborn in a cot or Moses basket (even during the day) when they are drowsy, and not asleep, to encourage self-settling.
- Encourage night time sleep; as evening approaches try to make the environment quieter and lighting dimmer with less activity.
All babies cry and it can be upsetting and frustrating. Not every baby is easy to calm but that doesn’t mean you are doing anything wrong. For tips on infant crying and how to cope see ICON and/or talk to your health visitor.
Safer sleep tips:
- Simple steps can be taken to ensure that your baby sleeps in a safe environment, which will reduce the risk of sudden infant death syndrome (SIDS), commonly known as cot death. Following these Every Sleep Counts tips can give you the peace of mind to enjoy this special time.
- This advice is based on strong scientific evidence and should be followed for all sleep periods, not just at night.
- The safest place for babies to sleep is close to their parents’ bed but in their own bed in the same room for at least the first six months
- Never co-sleep on a sofa/armchair
- Never co-sleep if you have smoked or have used alcohol, medication or drugs
- Put babies on their back for every sleep
- Maintain a clear and flat sleep space
- Keep babies smoke free day and night
- Support breastfeeding
Click here for more information about safe sleep and co-sleeping advice
Daytime naps advice:
- Daytime naps provide much needed downtime that aids the important physical and mental development that happens in early childhood
- They help keep babies and young children from becoming overtired, which can affect their moods and make it harder for them to fall asleep at night.
- They also give parents a break during the day and time to tackle household chores or just unwind.
There's no single rule about how much daytime sleep kids need. It depends on their age, the child, and the sleep kids need. It depends on their age, the child and the sleep total during a 24-hour period. For example, one toddley may sleep 13 hours at night with only some daytime catnapping, while another gets 9 hours at night but takes a solid 2-hour nap each afternoon. If your child is napping 'on the go' (for example in the car) try to ensure that this is balanced by daytime sleep in their own bed at home so that they get good quality daytime sleep over the course of a week.
It's recommended that infants from 4 months - 1 year get 12-15 hours of sleep per day (24 hour period). This includes daytime naps.
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.
Babies from 6-12 months usually have two naps a day, which may last 20 minutes for some babies and for others a few hours.
Is it normal for babies to wake at night?
- Yes. It is normal for babies to wake during the night. Some babies sleep much more than others. Some sleep for long periods, others in short bursts. Some soon sleep through the night, some don't for a long time. Your baby will have their own pattern of waking and sleeping, and it's unlikely to be the same as other babies you know.
It may help to remember that all babies over 5 months of age wake 4-6 times during the night, as they come to the end of each sleep cycle. This is normal, and also occurs with older children and adults. It's the falling back to sleep that can be difficult.
Do babies and young children automatically fall into a good sleeping pattern?
No. All babies and children need to be supported to develop a good sleep routine and good sleeping habits. It is a process that will take time and can’t be achieved in a few days. This can be a struggle, especially when you are sleep deprived and feel constantly tired yourself. All babies are different and will start sleeping through at different times. There also needs to be a degree of flexibility around sleep routines.
What routines and habits promote good sleep?
- Fortunately, there are many practical ways to develop and improve your child’s sleeping routine and habits. Tips for infants 4-11 months are below.
- Infants typically sleep 12-15 hours during the night and take 30 minute to two-hour naps, one to four times a day – fewer as they reach age one.
- After a calming bedtime routine, children benefit from being allowed to settle to sleep on their own while awake but drowsy. If children learn to settle independently they will be more likely to self soothe back to sleep after natural night wakenings.
As your baby grows their sleep habits will change, though starting to establish a bedtime routine early on can help support these changes. During the second half of the year, infants may experience separation anxiety, which may disrupt their sleep. Illness and increased motor development may also disrupt sleep.
Sleep Tips for Infants
- Develop regular daytime and bedtime schedules; maintain consistent sleep and wake times
- Create a consistent and enjoyable bedtime routine.
- Establish a regular 'sleep friendly' environment (see advice below).
- Encourage your baby to fall asleep independently i.e. while awake but drowsy.
- See the safer sleep tips on the sleep advice for newborns page (above).
All babies cry and it can be upsetting and frustrating. Not every baby is easy to calm but that doesn’t mean you are doing anything wrong. For tips on infant crying and how to cope see ICON and/or talk to your health visitor.
Daytime naps advice:
- Daytime naps provide much needed downtime that aids the important physical and mental development that happens in early childhood
- They help keep babies and young children from becoming overtired, which can affect their moods and make it harder for them to fall asleep at night.
- They also give parents a break during the day and time to tackle household chores or just unwind.
There's no single rule about how much daytime sleep kids need. It depends on their age, the child, and the sleep total during a 24-hour period. For example, one toddler may sleep 13 hours at night with only some daytime catnapping, while another gets 9 hours at night but takes a solid 2-hour nap each afternoon. If your child is napping 'on the go' (for example in the car) try to ensure that this is balanced by daytime sleep in their own bed at home so that they get good quality daytime sleep over the course of a week.
Example of a good bedtime routine:
Every baby and child is different and you can adapt the following bedtime routine to meet your baby’s/child’s needs. Babies may require a shorter bedtime routine. You will wish to offer your baby a 'top-up' feed as part of the routine.
Start the 'journey to bed' an hour before bedtime using signals such as end of a favourite game.
6.00pm: Bath time – bathing and brushing teeth
6.15pm: Change into bedtime clothes
6.30pm: Story time. If they are not interested in stories to begin with you could try gentle songs/nursery rhymes. Story time can be extended as a child gets older.
6.45pm: Settle into bed, cuddle time, and goodnight. Some parents find it helpful to sing the same nursery rhyme/song every night as a signal that it’s time to go to sleep.
Avoid return to daytime activities (e.g. not returning downstairs after their bath).
Transitional objects (soft toys) are helpful to many young children as part of positive sleep association.
Example of a 'sleep friendly' environment:
The safest place to sleep is in a cot or cot bed with all sides up.
Babies should sleep on a firm and flat mattress, and the sleeping area should be clear of toys, cot bumpers and duvets; at home and when staying with family and friends.
Place baby to sleep on their back for every sleep, with face and head clear of blankets and other soft items.
Babies need to be a comfortable temperature. A room temperature of 16-20°C – with light bedding or a lightweight, well-fitting baby sleep bag– is comfortable and safe for sleeping babies.
Ideally lights off, or at least dimmed. LEDs emit much more blue light than white bulbs and therefore have a greater impact on quality sleep, so ensure these are switched off.
There does not need to be silence, and it can be helpful for your baby to get used to some noise, though noise needs to be at a level that it does not disrupt sleep.
A smoke free environment is safest for babies and children.
My child is tired, so why won’t they sleep?
If a child is happy, comfortable, and tired, problems falling asleep are likely to be behavioural (such as bedtime resistance) or environmental (such as noise).
I’ve tried all of the above and my baby is still waking frequently!
- Some babies take longer than others to respond to a routine and settle into good sleep habits. Look after yourself. Almost all adults find interrupted sleep makes them feel tired and irritable, and relationships can suffer. For further advice see the useful resources section below.
Self care and Prevention
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Related Conditions
Related Information
Further Information
