Parents of infants know that some of the most common questions they field from friends and family are about one thing: their babies’ sleep. “Is she sleeping through the night?”, “what’s the bedtime routine?”, and “is the baby sleeping separately?”
“My mission is to make parents less stressed about those questions,” says Marie-Hélène Pennestri, a developmental psychologist at McGill University.
Sleep seems to play an important role in cognitive skill development, according to a number of studies. For example, one study found that infants who napped for at least 30 minutes after learning new information remembered it better a day later than those who had no nap. Other studies find that infant sleep, particularly daytime naps, can help with language learning.
“We know that in general it’s associated with better mental health, physical health, cognition, you name it,” says Pennestri, who seeks to understand the importance of the cycle of sleeping and waking in infants and parental expectations.
While sleep is crucial at any stage of life, Pennestri’s recent research has shown that there’s no one perfect routine for any given infant. Studies investigating the effect of specific sleep patterns and routines in infancy on different aspects of development have had mixed results. Pennestri and her team recently dug into 22 papers investigating the effect of specific sleep patterns and routines in infancy on cognitive and motor development, but the papers didn’t say anything conclusive.
Although there’s no one simple answer to what “ideal sleep” in infants looks like, there are some recommendations researchers give to quell common parental anxieties.
Most babies don’t sleep through the night
Think “good sleeper” and what likely comes to mind is an infant who conks out for the entire night.It turns out good sleepers are few and far between.
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Pennestri and her team wanted to understand how variable sleep can be even within an individual infant. In one study, they tracked night-to-night changes in sleep patterns and found that out of 44 infants, only three slept for six hours continuously for the whole 13 day experiment. Infants in the study varied widely in the number of nights they slept through and very few had a predictable sleep pattern.
“There's a lot of variability and differences between different infants,” emphasizes Pennestri. “Parents have sufficient stress, they don't need to compare themselves and put more pressure.”
What likely matters more is the total number of hours a baby sleeps throughout a 24 hour period, and even that number varies dramatically between and within infants. While the recommended range from the National Sleep Foundation is 12 to 15 hours for infants, they recognize that anywhere from 10 to 18 hours may be appropriate. If an infant’s sleep is outside of that range, then parents should talk to a pediatrician.
Pennstri also suggests going to the pediatrician if your infant is snoring or doesn’t seem awake or alert during the day. These could be signs that something abnormal may be happening.
Building a routine
Just like for adults, healthy sleep for infants requires a healthy sleep routine, and there are some helpful guidelines parents can keep in mind when building a bedtime routine.
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“This routine can already be started when the infant is just a few weeks old and should follow the same order each night,” says Mirja Quante, a neonatologist at the University of Tübingen in Germany.
Across cultures, bedtime routines seem to boost children’s moods and increase their emotional and behavioral regulation. Calming activities like singing, taking a bath, or reading a story all fit the bedtime routine bill, and some components, like massages, can also help with bonding and reduce parents’ stress, too.
While there are quite a few options for pre-bedtime activities, the “routine should be short and very predictable,” says Pennestri. If there’s not enough time for a bath every night, find something more reliable to do right before bedtime.
“Parents should start to put their infant down when it is drowsy but still awake to practice the skill to fall asleep by itself when the infant is about three months old,” advises Quante. She suggests using tools from the Pediatric Sleep Council to build and solidify your infant’s sleep routine.
Apps like Napper aren’t scientifically tested but have also become popular among parents for tracking their baby’s sleep patterns and predicting when they’ll be ready for a nap.
To Bedshare or not to bedshare
One of the most controversial topics around infant sleep is sleeping on the same surface as an infant, aka “bedsharing.” That’s because it comes with some pretty serious risks.
Compared to sleeping separately, bedsharing can increase the risk of suffocation, strangulation, and falling—all of which can lead to sudden unexpected infant death syndrome (SUID). Any unexpected death of an infant under one year old falls into this category, and the nature of these deaths make their causes difficult to clearly define. In 2022, there were about 3,700 cases of SUID in the U.S.The American Academy of Pediatrics (AAP), which sets United States guidelines supporting child wellbeing, does not recommend the practice.
Despite the risks, some parents still choose to bedshare. One study surveyed parents from 2009 to 2015 and found that the majority of U.S. parents bedshare at least some of the time, despite the strict guidelines set by the AAP. However, nearly 40 percent of those bedsharing used unsafe practices to do so.
And some experts haven’t written off bedsharing entirely. “In certain circumstances, bedsharing can definitely be unsafe, but I don't think that bedsharing by itself is inherently unsafe,” says Elaine Barry, developmental psychologist at Penn State Fayette.
Despite its risks, bedsharing is a relatively popular practice around the world. Barry and anthropologist James McKenna found that parents bedshare for a variety of reasons, including ease of breastfeeding, comfort for mother or infant, and better sleep for infant or parent.
Barry says that while she’s not sure if she would define herself as an advocate for bedsharing, “what I’m an advocate for is for parents to safely do what they want to do,” she says. “So I do believe we should not have such strong recommendations against bed sharing.”
While some pediatricians may feel uncomfortable giving recommendations for safe bedsharing, other resources, including some developed by McKenna, aim to help parents who want to co-sleep do so safely. These include using a firm mattress and keeping stuffed animals or pillows away from the infant.
Listening to parental instincts
While the reading list for new parents is endless, Barry emphasizes the importance of listening to yourself and your own instincts.
“The best parenting advice isn't really in a book or an article. I think it's listening to what the baby needs and feeling confident and capable of providing that,” she says. “And I think in our current culture, we are not in a place where we make parents feel competent and capable.”
