Understanding Infant and Toddler Sleep

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Co-authored by Sarah MacLaughlin, LSW

One of the toughest things about being a caregiver to a baby or young child is the lack of sleep. Sleep is almost universally named as a top source of stress for caregivers of infants, and for some families, sleep does not improve much as the baby grows. Lack of sleep not only affects the caregiver's well-being and mental health, but it can also impact the baby’s development, mental and emotional health, as well as fussiness and behavior—not to mention the toll it can take on the entire family.

Sleep is a skill, one that is learned slowly over time for most. Understanding infant sleep patterns, how much sleep young children need at different ages, and ways to help foster healthy sleep are all helpful for tired caregivers. Here are more tips for approaching this sensitive topic and helping caregivers cope.

• Work to ensure that caregivers are actually ready to address sleep, even if they have clearly conveyed they are having trouble in this area. It’s still important to check in before launching with advice. Say something like, “It sounds like sleep is causing some stress. Would you like to discuss this and hear some information about babies’ sleep needs, patterns, and perhaps some suggestions that could lead to relief?”
• Start with normalizing the stress and distress that comes with sleep deprivation. Nearly all caregivers experience some issues related to their baby’s sleep. And surely all caregivers lose sleep. Validating a “both/and” perspective can help. The caregiver of a baby who isn’t sleeping enough can both love their baby (and be a “good enough” caregiver) and feel absolutely exhausted.
• Ask the family about their goals so you can make relevant suggestions. Factual information about sleep needs for babies on an age-by-age basis can be quite helpful. Caregivers may not know that their newborn can easily confuse daytime and nighttime or that their sleep cycles can be wildly inconsistent. It’s possible they don’t realize that their 4- to 12-month-old needs 12-16 hours of sleep or that their 1- to 2-year-old might still need up to 14 hours of sleep a day (including naps) (Jenco, 2016). Knowing what to expect can make navigating baby’s sleep less stressful.
• Suggest additional care strategies for primary caregivers. Remind them that they are as important as their baby. Caregivers that ignore their own needs are likely to experience even more stress. It could be helpful for caregivers to brainstorm potential supports in their family and community, or plan for more shared care with their coparent/partner so that both caregivers get some rest.
• Normalize the struggle that baby is having with sleep, too. Try to frame this time as a phase and potential pivot point for learning new skills. If caregivers would like suggestions for supporting baby’s sleep abilities, offer them reminders about routines (4 B’s: bath time, brush teeth/wipe gums, read a book, go to bed), strategies for helping baby build sleep skills (e.g., bedtime fading, graduated extinction), ensuring responsive caregiving, and keeping baby active and stimulated during the day (e.g., play time, face-to-face time, tummy time).

If caregivers aren’t ready for advice about sleep strategies or decline your suggestions, you can always simply offer reminders about safe and healthy sleep practices: putting baby to sleep on their back, in a flat, empty crib, bassinet or bedside sleeper and sharing a room (but not a bed) with baby for the first year (AAP, 2023). It is also advised that babies and toddlers do not have screens in their bedrooms.

Infant sleep challenges are a given. And while we can’t always completely solve them, there is relief on the horizon, and great power in a compassionate, listening ear.