How can I get my baby to sleep through the night?

Sleep problems

You are not alone if you are having difficulty getting your baby to sleep all night. About a quarter of children under five have sleep problems, particularly refusing to go to bed or waking in the night, and the two often go together (True et al 2002).

If your baby is constantly waking in the night it can disturb your own sleep patterns and you may find it much harder to cope with tasks the next day. Disturbed sleep because your baby has sleep problems may make you prone to depression (Hiscock and Wake 2002, Lam et al 2005, Dennis and Ross 2005. As your child grows, it's important to sort out sleep difficulties, because of the pressure sleep troubles puts on your mental and physical well-being, your relationships with your partner and between you and your child (True et al 2002).

There are different sleep strategies, from crying it out at one end of the spectrum to bed sharing at the other. It's up to you and your partner to decide which one best suits your family.

Sleep strategies

The following tactics can help your baby to sleep well from as early as six weeks. But remember, whichever approach you take, consistency is key:

• Make daytime feeds social and lively and night-time feeds quiet. That way you’ll help them set their body clock so they can learn the difference between day and night.
• Give them a chance to fall asleep on their own from about six to eight weeks. Put then down when they're sleepy, but still awake. Some experts advise against rocking or breastfeeding babies to sleep, even at this age, because your baby may come to depend on it (True et al 2002). It's up to you to decide what's best.
• Set a bedtime routine. Keep it short and simple: bath, diaper and pajamas, and a story or song. Finish the bedtime ritual in your baby's bedroom. It's important they learn their room is a nice place to be.
• Let them cry it out. This is suitable once your baby is four or five months old. If they're crying after you've put them down, go to them. Pat them gently and tell them everything's fine, but it's time for sleep. Be gentle, but firm. Leave the room. Wait for a set interval, anything from two to five minutes, then check again. Do this repeatedly until they fall asleep, extending the time between each visit.
• Cuddle up. If you plan to have your baby sleeping in your bed, comfort and rock them so they are ready for sleep as part of their bedtime routine. Lie down together and cuddle them, pretending to sleep, firmly letting them know it's bedtime.
• Share the role of comforter with your partner, so both of you can help your baby fall back to sleep. Once your baby is old enough to do without night-time feeding, they can learn to be comforted by your partner. They might stop needing anyone when they learn there's no food coming!
• Tune in to your baby’s needs: During the day, make them feel secure by spending time connecting with them. If they wake in the night, try to work out why. Is their diaper full, are their pajamas comfortable, have they got a cold?

If your baby is still waking after you've tucked them in bear in mind that their age will have a lot to do with how well they settle, and you may have to be adaptable according to their stage of development.

Sleep problems by age: newborn to three months

Babies at the start of this age range sleep for short periods and wake often in the night. You'll have interrupted nights for the first few weeks. But you can start work now on sleep habits that will pay dividends later.

• If they fall asleep while eating or being carried, lay them down in a designated sleeping place, such as a crib, bassinet or a pack and play. If they're awake during daytime, encourage that wakefulness, and socialize with them. By distinguishing between asleep and wakeful periods, you'll help them associate sleep with a proper sleeping place.
• For the first two or three weeks, it's possible that swaddling your baby might soothe them. For some it's the trigger for sleep, but others don't enjoy it.

Sleep problems by age: three to six months

• If you have moved your baby to a crib, they may be finding it difficult to adjust. Read about ways to make the transition to their crib easier.
• If your baby just won't settle, despite all your efforts, it's fine to give them a soother to help them drift off. Bear in mind, though, that if they wake and can't find it, you might be back to where you started.
• Don't be tempted to start your baby on solids before they're ready to help them sleep. It is not recommended to feed your baby solids before they are six months old.
• Make sure your baby is not staying up too late. An over-tired baby can make for a difficult bedtime.

Sleep problems by age: six to nine months

About this age, babies who have never had sleep problems may start waking up at night because of separation anxiety. When they wake in the night, they miss you and worry you won't return.

Problems may also be linked with your baby reaching milestones in their physical and mental development. About now, they are learning to sit up, roll over, crawl, and even pull themselves up to a standing position.

• If they're waking in the night to practice their exciting new skill of sitting up, you'll need to teach them how to lie down again. Then stick to your chosen routine for getting them back to sleep.
• Your baby's sudden burst in development isn't the same as a growth spurt, so feeding them during the night won't help them sleep better. In fact, it may prolong the problem and make it worse. They'll learn to depend on feeding to fall asleep.
• Your baby's sleep may also be disturbed because they are teething. If they don't seem to be in pain, stick to your regular sleep routine. But if their gums are hurting, massage them gently with one finger or give them something cold to chew on. If things get really bad, give them the correct dose of infant acetaminophen for their pain.
• If your baby is going to bed after 8:30 pm and begins to wake during the night, you may be surprised to find that they're much more likely to sleep through the night if you move their bedtime earlier by a half hour.

Sleep problems by age: nine to 12 months

Your baby is old enough to sleep through the night, but they may be changing their nap habits and may still be suffering from separation anxiety. Be prepared to modify your routine as they grow.

• Try moving your little one's afternoon nap to an earlier time and making it shorter. Stick with your bedtime ritual and continue to be firm about going to sleep. Let your baby know that when it's bedtime, it's bedtime. If it helps, try setting an alarm clock to go off about five minutes before it's time to go to sleep. That way the mandate is coming from an external source, not you.
• Try leaving the door to your baby's room ajar so they can hear you, and be reassured that you're nearby.

If your baby’s sleep difficulties are disrupting your sleep and you feel you can’t cope, talk to your doctor.