When I see babies and young children for well visits, I get many questions about sleep and napping needs. A newborn enters the world sleeping about 20 hours in a 24 hour period. Basically, this means they are usually awake to eat, then fade back to sleep again after eating. As your infant grows, they are able to have longer "awake and alert" periods as their bodies adapt to the daylight and darkness of a diurnal schedule. Sleep is important to both babies and children for many reasons. Growth hormone is mainly produced during sleep, and the immune system benefits from regular sleep intervals. During sleep, the brain processes information important in the development of memory and organizes the data that children absorb in the hours that they are awake. Regular sleep aids development, according to sleep coach Kim West, who has written a book, "The Sleep Lady's Good Night, Sleep Tight: Gentle Proven Solutions to Help Your Child Sleep Well and Wake Up Happy". Sleep deprivation, on the other hand, is linked in many studies to an increased risk of obesity. Babies who sleep fewer than 12 hours total per day have double the risk of being overweight for their age.
Sleep and nap needs vary by age. For the first two months of life, an infant will sleep 18-20 hours per day, with 3-4 naps per day totaling 6-7 hours. Between 2 and 6 months, napping intervals decrease to 3 naps per day for about 5 hours. Younger infants generally will wake every 3 hours or so to eat, but by 3-4 months of age, they are able to space out feedings and can often sleep for a longer stretch of 5-6 hours at night.
Tips for this age: limit "on the go" napping and try to establish a routine of putting your child down for a nap in a dark, quiet room in a crib or bassinet. Do this at least twice a day at regular intervals.
For older infants, 6-12 months old, a transition occurs in which they usually establish a routine of 2-3 naps a day for a total of 3 hours or so. These "big naps" should be 60-90 minutes each. This is a good age to start a bedtime and pre-nap routine for your child. Nap time should still occur in a dark, quiet place. Children at this age need to acquire the skills to be able to calm themselves to sleep, so it is important to put them in the crib when they are still awake (putting them down sleepy is ok, putting them down asleep is not).
For 12-18 month olds, naps usually occur twice a day for a total of two to two and a half hours. By 18 months, many children are ready to transition to one nap a day in the afternoon. Look for clues at 15-18 months that your child may be ready to do this: taking longer to fall asleep in the morning or taking a long nap in the morning and not being able to fall asleep in the afternoon. You can help make the switch by gradually pushing the morning nap time later and later by 30 minute intervals until you end up with the nap occurring after lunch. Once you get to this point, your child will probably sleep for a good 2-3 hours.
By age 3, most children have shortened the afternoon nap to 60-90 minutes. If your child is resistant to napping, it is important to offer "quiet time" for an hour in the afternoon. Some children won't sleep every day, but it important for them to have designated time to do so. Your child's brain is wired to recognize a missed nap by stimulating the production of cortisol, our body's "stress hormone". This is why some kids seem "wired" on days that they miss naps!
By age 4-5, most children have given up afternoon napping, though may still do well with quiet time/optional nap time in the afternoon. It is important to not let preschoolers nap too long or too late, as this may interfere with night time sleep. There should be at least 4-5 hours between when your child wakes up from their nap and bedtime.
Having a regular routine for napping, and allowing your child the time they need to "practice" this skill, are both important parts of establishing nutritive sleep.
