Every mom and baby is different and a routine that proposes to be a one fits all is not realistic. Here are guidelines for different routines at different ages:

Routines for newborns
Your newborn is too little to have a fixed routine and routines at this age generally do more harm than good. Here are the principles:

• Don’t aim for routine at this stage
• Feed on demand
• Expect your baby to wake as frequently day and night
• Aim to settle your baby to sleep after an hour of awake time during the day

Routines for 2 – 4 months

Patterns begin to emerge, with your baby guiding the way; a routine may be possible in this age band:

• Feed 3-4 hourly
• At nights your baby will begin to stretch the time between feeds
• Put your baby to sleep during the day after 1 ½ hours of awake time

Read more about awake times

Routines for 4-6 months
Routines begin to emerge in earnest and most babies do well with the predictability of when to sleep and when to feed:

• Feed on schedule with flexibility – 3-4 hours between milk feeds. Solids may be introduced during this time, if your baby needs solids

Read more on introducing solids

• Introduce a consistent bedtime routine that calms your baby for sleep. Do not leave your baby’s bathroom and room during this time
• Suggested day sleep routine:

o Wake between 5 and 7am
o Wake +1 ½ hours = morning nap – 45 minutes
o Wake +1 ½ hours = late morning nap or sleep
o If this sleep short – wake +1 ½ hours = afternoon nap and another cat nap at 5pm (4 sleeps)
o If this sleep is long – wake + 2 hours = afternoon nap
o Wake from naps by 5pm
o Bedtime routine starts 1 hour before bed
o Bedtime by 6:30

Routines for 6- 9 months
At this age, routines can make the difference between a good eater and sleeper or poor habits:

• Day sleep routine:

o Wake between 5 and 7am
o Wake +2 hours = morning nap – 45 minutes
o Wake +2 hours = midday sleep
o Wake + 2 ½ hours = afternoon nap
o Wake from naps by 4:30pm
o Bedtime routine starts 1 hour before bed
o Bedtime by 6:30

Routines for 9-12 months
A good day sleep and feeding routine assists good night sleep habits:

• Day sleep routine:

o Wake between 5 and 7am
o Wake +2 ½  hours = morning nap – 45 minutes
o Wake +2 ½  hours = midday sleep
o From 9 months - drop afternoon nap
o Wake from naps by 4pm i.e. very short cat nap if needed
o Bedtime routine starts 1 hour before bed
o Bedtime by 6:30

Routines for toddlers
By now a routine should be a way of life and will free you up in many ways:

• Day sleep routine:

o 6-7am Wake
o 11:30 lunch
o 12pm – one midday sleep
o Wake from sleep by 3pm
o Bedtime routine starts 1 hour before bed
o Bedtime by 6:30- 7pm

Routines are not a priority
If you are a go-with the flow, laissez-faire type person you may not want a routine at all and that is perfectly good, particularly if you have a settled baby

Read more about baby personality

Of the 7 senses, proprioception is one of the most important when it comes to sleep.  What is proprioception? It is the sense stimulated by deep pressure and joint contraction, which we get from our joints and muscles, telling us where we are in space.  Going for a jog or having a massage is a good way to access the proprioceptive system, which explains why we sleep so well after exercise or a relaxing massage.

How does this work? In terms of sleep, proprioception is associated with the release of Serotonin, which is a vital regulator chemical in the brain.  Serotonin is not only a ‘feel good’ hormone but has also been associated with sleep through its effect on melatonin. Melatonin (the sleep neurotransmitter) is actually manufactured from Serotonin. (Food and Mood Somer, Elizabeth, M.A., R.D. 1999.) So it stands to reason that we can use proprioception to release melatonin and enhance our sleep patterns.

For a number of years, therapists working with people with sleep problems and those with sensory processing disorders, including those with autism, have used deep pressure and proprioception to enhance sleep.  Weighted blankets are the most effective way to provide pressure during sleep and have been proven to enhance sleep.

Safety
Weighted blankets act as a deep massage and help babies to sleep well but in order to be used safely, there are certain specific criteria that need to be met:
1. The weighted blanket must not overheat the baby
2. The weighted blanket must not be able to cover the babies face
3. The weighted blanket needs to be the right weight.

The Baby Sense Weighted Sleepy sac is the best way to ensure these three safety criteria are met for babies under 6 month of age:
1. The cover of the weighted sleepy sac is 100% cotton. The fill, although heavy is not bulky and therefore more likely to allow breathability.
2. The weighted blanket for under 6 months of age is inserted into a sleeping bag outer, preventing the blanket from being pulled over the baby’s face or the baby from slipping under the blanket.
3. Most importantly, each blanket inner is carefully measured to ensure appropriate weighting for babies from a month of age.

Every week I have moms sitting in my consulting rooms to get help for their baby’s sleep. Today was no different, an 11 month old little chap, lets call him Nicholas who was not sleeping longer than 30 minutes at each sleep during the day and at night was waking hourly before 11pm and after 1am woke every 45 minutes. His poor mom is beyond tired and was justifiably desperate. She had heard that she had two options open to her, and was desperately hoping I would have another solution:

• Get in a sleep trainer who she had heard about, to sleep train her baby
• Live with the sleep deprivation until Nicholas was two when hopefully he would sleep through

I had a different plan. We started by ruling out the possible causes for night wakings:

1. We made sure Nicholas was having three meals a day that included a good portion of protein. I added to this, two snacks with protein and a bottle of juice with Barley Green power.
2. To ensure Nicholas was healthy, I asked his mom to take him to the doctor to check his ears for Glue ear, which often goes undetected and can wreck havoc with sleep. In addition I put him on a Probiotic because he had gastro not too long ago.
3. Nicholas is a busy boy and I recommended that his mom make sure he has at least 15 minutes of swinging in the late afternoon, so that he didn’t need to be rocked to sleep (which she was doing 15 times a night)
4. At 11 months old, Nicholas is ready for a more rigid day sleep schedule and I recommended that he sleep at 9:30 in the morning and at 1pm, with half a bottle before the 1pm sleep.
5. Nicholas needed to form an attachment to a ‘doodoo’ blanky of some sort and use his dummy (pacifier) independently at night. I advised his mom to focus on this for 4 days before starting any sleep training.

Having ruled out the possible issues with Nicholas, it came down to the bad habit of rocking him to sleep for every sleep and through out the night. To teach Nicholas a new and more functional way of falling asleep, I told his mom about a gentle way to sleep coach – by sitting with Nicholas as he learns to use his ‘doodoo’ and dummy to settle to sleep independently.

Nothing is easy as a parent and sleep problems rank up there with the most stressful things you can go through. The key is to rule out the basic issues, to have a plan to sleep coach that allows you to be calm and consistent.

You are tired, too tired to read a tome on how to get more sleep and all you want is a quick fix for your baby’s sleep. If things are going awry, here are 15 quick fixes to try that really will make a difference. 

1. Swaddle your newborn until 12 weeks of age for every sleep. This inhibits the startle reflex and prevents cat napping.

2. If your 7 month old is waking more than once at night, increase the protein in his diet to 2-3T per meal. Protein is found in meat, dairy, chicken, beans, lentils, nuts, eggs and fish.

3. If your baby under three months of age wakes twice at night, feed him rather than putting the dummy/pacifier in. You are likely to start a soother habit if you don’t meet the basic needs of a feed. Babies may need a night feed until on full solids at 6 months of age.

4. Use white noise to keep your baby in a deeper state of sleep. Buy a white noise CD or play the radio tuned to no station – static.

5. After 6 months of age, turn off your baby monitor if your baby’s room is fairly close to your room. You don’t need to hear and respond to every toss and turn and if your baby really needs you – you will hear him!

6. Follow a bedtime routine strictly until 18 months. Start with a bath and end with a soothing massage or lullaby.

7. Don’t let your little one sleep later than 4:30pm if over 6 months of age, otherwise he won’t want to settle to sleep by 6:30 or 7pm, which is the ideal bedtime for this age.

8. Don’t take your baby or toddler from the nursery after bath. Take him to his room, read a story, feed and then a lullaby and to bed.

9. Turn off the TV – TV especially after 4pm affects sleep habits.

10. Turn off the night light for babies under 18 months and turn on the night light for toddler over 18 months – when imagination develops and nightmares and fears set in.

11. Leave your hand on your newborn for 15 minutes after you put him down to sleep until the hypnagogic startle passes.

12. Drop a day sleep at 14 months to one sleep a day at 12-2pm.

13. During the day try to only let your baby have one sleep on the run – all other sleeps in the nursery so he gets used to falling asleep in his sleep zone.

14. Make sure your little one has taken to a ‘doodoo’ blanky or security object by 6 months of age – they are lifesavers for years to come.

15. Deworm your toddler  (older than18 months) if he is restless at night or waking and staying awake for hours in the middle of the night.

16. 15 minutes of movement for all babies and toddlers in the late afternoon – use a swing or walk in a sling

17. Use high quality nappies/diapers at night so that you don’t have to get up for a wet baby.

18. From 4 months of age aim to have your baby settle himself to sleep.

19. Use a sleeping bag from 5 months of age, when babies start to kick off their blankets.

20. Use block out lining on the windows to darken the room – this will encourage later waking.

The routine debate rages on in most parents’ minds. Do babies need a routine? Can it be gentle and baby-centric?  Is a flexible routine is better than a regimented one? Ask these questions to any baby expert and you will get a myriad of answers. Ask a parent and the responses will be even more diverse.

Like adults, babies have their in-built time clocks and physical needs, however these needs differ substantially from their parents. Where adults only need eight hours sleep a night, babies need anywhere from 18 or 20 hours for a newborn to 14 hours for a toddler, per 24-hour cycle.

Where babies’ sleep habits differ most from adults is that they have period of time we call awake times, which are intervals in which they can be happily awake. During this time they will be happy and interactive, learning from their environment. If this period is stretched, in other words the baby is kept awake for longer than his ideal awake time, he will become needy, easily over stimulated and generally irritable. In addition to this he will not naturally fall into a sleepy state and thus will be more difficult to get to sleep.

Where rigid, prescribed routines go wrong is that the baby is forced to sleep at his mother’s convenience or at a predetermined time each day. If this time happens to be before his ‘awake time’ is up, he won’t want to fall asleep. But more commonly it is once he is overtired and the natural lull in his states has been missed. So being overtired and needy he is significantly more difficult to get to sleep.

An example of a rigid routine that is a recipe for an irritable baby and highly anxious mother is one where a two week old baby must have a morning sleep at 9am, having woken at 7am. This would mean he must stay awake for two hours. The ideal ‘awake time’ for newborns is 45 minutes to an hour at the most. Waiting two hours, just to stick to a predetermined time makes no sense, as newborns literally can’t cope being awake this long. Furthermore, the baby may have woken at 6am in which case it would be a three-hour stretch which is a recipe for a very irritable baby.

A baby-centric approach would be to have the guidelines of ‘awake time’ for each developmental age, as found in the Babysense Secret and then more importantly to learn to read the baby’s signals. Practically this would entail the mom watching the clock to see what time her baby woke and then make sure to watch that her baby goes down according to his ‘awake times’. In addition to this she would watch for her own specific baby’s signals. Signals that a baby is tired include rubbing eyes, sucking hands, touching ears, looking into space, drowsy eyes or many other self-soothing strategies. When her baby shows the signs of drowsiness, he should be put down to sleep.

In this way, the baby dictates his sleep times in two ways: firstly according to developmental norms and then according to his own capacity for interactions, by signaling when he is tired. Being tuned to her own baby’s needs will help a mom to put her baby down more easily and in that way establish healthy day sleep routines.

QUESTION

I'm having problems with my 14month old baby girl at night....for the past 3-4 weeks she's been waking up at 2-3am crying and we cannot calm her down unless we show her videos on our iPads or cellphones to distract her....this lasts for about an hour or more until she is eventually too tired to watch and then falls asleep again. I don't believe it's night terrors as she is fully awake in her cot when I go to her room.Could it just be nightmares as she is developing an active imagination? For the past 3-4 weeks she has also been sleeping much later...between 9pm-10pm. She doesn't seem tired before then. She used to sleep at 7pm.She has 2 naps a day for about an hour but not all days.Please could you give me advice on how to prevent her early-morning cries

ANSWER

Start by establishing a firm day-sleep routine – one midday sleep from 12 to 2 and then bedtime at 7pm latest. Start the bedtime routine earlier to give her time to get drowsy. I would also deworm her and give her an iron and magnesium supplement, particularly if she is a fussy eater.  Have a night light in her room or leave the passage light on. Keep her in her cot at this age. When she wakes, do not offer anything other than a little cuddle – no iPad, and nothing to eat. Be consistent and loving.

Are you anxious the minute your baby goes to sleep that you may not hear her cry for comfort or food? Have you found yourself standing over her crib checking that she is breathing on your way to bed at night? Or felt that cold sweat as you awake from a dead sleep at 2am to rush through and check your little one is all right? If you have, you are in good company. We all want to be sure we meet our baby’s needs timeously and that our babies are safe as they sleep at night.

There are a variety of baby monitors; some baby monitors only monitor sounds and cries, while others monitor breathing.

Different Types

• A sound monitor using a radio transmitter, when placed near your baby this transmitter will broadcast the sounds she makes. By keeping the corresponding radio transmitter near you, you will be alerted and can respond when your baby cries.
• A video baby monitor, shows you your baby as she sleeps so when she cries, you can see if there is a specific need or if she is simply calling out in her dreams.
• A smart phone Ap – these new recently emerging systems alert you on your smart phone, if your baby wakes and needs you. Some even feature video coverage.
• Breathing monitor. To monitor breathing, these systems may use a mat, placed under the baby to perceive the breaths or may use a clip-on device that monitors the movement of the tummy against the nappy (diaper) with each breath. An alarm sounds if your baby has not breathed for a while.

The benefits
Baby monitors hold value in many cases including:

• You can hear your baby when she needs you or needs a feed at night even if you are quite a distance from her room
• If your baby is ill or was born premature you may be advised to monitor her breathing or to respond rapidly if she calls for you.
• If your baby suffers sleep apnea (abnormal pauses in breathing whilst asleep) a breathing monitor becomes an essential tool to warn you if your baby stops breathing.

The downside
While baby monitors do hold value they also do come up for criticism:

• Parents may become more anxious, especially if a breathing monitor has frequent false alarms. In this case, the parent is woken more than they should be and becomes overly concerned.
• In the long run, some research has indicated that baby monitors contribute to poor sleep habits as parents become hypervigilant and respond to their baby’s every sound, which means your baby may not sleep well at night and has less chance of learning to self settle when in light sleep states at night.
• Monitors may also give a false sense of security; leading parents to feel they do not have to self monitor their babies if the baby monitor is on.

In a nutshell
Like all parenting choices, this one is up to you but the following are sense-able guidelines:

1. Do use a breathing monitor if your baby has sleep apnea or has a history of breathing problems.
2. Baby breathing monitors are expensive and may be an unnecessary outlay. It is not necessary for healthy babies to have their breathing monitored, unless you are instructed to do so by her doctor.
3. Sound monitors hold value if your baby’s room or sleep space is far from your living space. Use a sound monitor to hear when she cries.
4. If your bedroom is right next door to your baby’s sleep space, it is not necessary to use a sound monitor once you go to bed– you will hear your baby if she cries and will wake up.
5. If you can hear your baby’s cry without a monitor, don’t use one as this will over alert you to the noisy baby sounds she makes, to which you need not respond.
6. If you choose to use a (sound) baby monitor and you hear your baby, respond by listening first. Decide if the sounds are sleepy sounds and niggles or if she crying and in need of intervention. If there is no urgent need, don’t go to her for 5 minutes – this allows your little one to learn to settle herself at night.

QUESTION

I'm wondering if the dummy (pacifier) is making my little one (4 month old) not get a  restful nap. She needs it to fall asleep but wakes 30mins and 45mins for her dummy. She rarely naps for more then 30-45mins and usually wakes up cranky, like she wants to sleep more but can't. She doesn't seem rested after a nap.

Does she just need to develop her linking of sleep cycles? Or is the dummy the problem. She also wakes through the night for her dummy.

ANSWER

Dummies (pacifiers) are a lifesaver but can create habits and difficulties if managed badly.  Your baby’s day sleeps being 30-45 minutes have nothing to do with the dummy, this is often the norm for little ones. I would check if she doesn’t have reflux as this can cause sleep cycles to be very short (30 min or less) but most probably it is just a stage and she will start joining sleep cycles again as she approaches 6 months and had a sleep after a lunch. You can try to lengthen her midday sleep by offering a milk feed before it until she has lunch at midday and by playing white noise during her sleeps.

As far as the night wakings for the dummy goes – I would feed her if more than 3 hours have passed since the last feed as she may be entering a new phase of needing a little more nutrition and is thus waking at night. If you dummy her when she is in fact hungry, she will start to wake for the dummy as a habit. I would look at introducing solids at this stage if she is waking frequently at night.

QUESTION

My 3.5yr old son wakes up at 3am every morning.  He wants milkshake (Purity Goodies) and then stays awake till 5am.  Thereafter he sleeps till 10am. He will go to bed at 20h30 at night.

I want to solve this problem as Dad needs to rest for work the next day. I am also worried that 2yr old girl will start it too.  She sleeps well at the moment and no problem with early hours wake up with her.

ANSWER
Firstly on a health level, a milkshake at 3am is very bad for your toddler.  The milk sugar will rot his teeth, may cause ear infections if he feeds lying down and is not healthy for his weight. Secondly it is causing a bad habit.

Over night, I would change it as follows:
1. When he calls, go to him and tell him the kitchen is closed and he cannot have the milkshake.
2. Leave the room and listen.
3. If he cries or gets up, go to him and offer him water only.
4. Establish boundaries: he can have water and he has to stay in his room. Be firm with these boundaries using the A-B-C method. To communicate this lovingly say:
a.  “I know you want milkshake” (Acknowledge him)
b.  “The kitchen is closed and you need to stay in your bed” (Boundary)
c.  “You can have water and if you stay in bed, mommy will sit with you” (Choice)
5. Follow through – if he stays in bed, you stay with him until he is asleep – no playing just sitting. If he gets out of bed, leave the room until be is back in bed.
6. Two nights of firm but loving boundaries and you will have it solved.

QUESTION

My 16-week-old little girl used to be in a great sleep routine and ate really well. Bed time was 7/7:30.

She was ill over xmas and since then we are so out if sync. I am at my wits end and exhausted. She has taken to waking only an hour after being put to sleep for the night and I've tried leaving her for a bit and feeding her but neither work and she still continues to wake throughout the night, sometimes even hourly. She isn't eating as much as she used to so I'm sure this is contributing but I can't let her to eat more. Still on a 3 HR feeding routine, sleeping after 60/90 min of awake time. Doing the exact routine I've dine since day one and have used Babysense and Sleepsense like my baby bible. I find all my waking hrs are spent concerned with her sleep and it's really starting to depress me now. She used to be a great sleeper and was actually going 7-7 with no waking until she got sick so right now I feel like I have a 7 week baby.

Please give me advice on getting her back to normal I just can't cope anymore! I am even considering getting a sleep nanny as I'm based in the UK.

ANSWER

I am so sorry that you have taken a whole lot of steps back! Firstly you need to sort her health out 100% - put her on probiotics, especially if her illness was gastro or she had antibiotics. Secondly you may need to have her ears checked out if she had a cold as the mucous may have ended up in her Eustachian tubes causing glue ear.

Once you know she is well, I would offer her a top up feed of formula or expressed breast milk at bedtime to ensure she is having enough to eat at bedtime. If she stretches three hourly or longer, it may be an age appropriate need for more nutrition and you can start solids from 17 weeks. If she continues to wake hourly, you need to rule out reflux, which can arise at this stage.

Keep her day routine as you have it – sounds great.