What to Know About Sleep Hygiene for Babies, Toddlers, and the Whole Family

There are few questions for new parents that conjure as much anxiety as “How’s the baby sleeping?” Sleep is elusive in those early days and can continue to be throughout the developmental leaps and dreaded sleep regressions — and even stretch into the toddler years once they’ve transitioned to a bed. At the same time, banking some sleep is essential to putting our best foot forward as parents, partners, and humans. However, finding the right recipe for sleep is no easy task.

In the age of information, sifting through all of the advice out there can be a full-time job. That’s where Dr. Craig Canapari comes in. Sleep begets sleep not only for children but for parents too — and Dr. Canapari has made a career out of securing it for families, as a pediatric sleep specialist and the director of the Yale Pediatric Sleep Center. He also wrote a book on it, titled It's Never Too Late to Sleep Train: The Low-Stress Way to High-Quality Sleep for Babies, Kids, and Parents.  

“So much of the work that my colleagues and I do in pediatric sleep medicine is actually to benefit the parents as well as the children, especially young children,” Dr. Canapari says on the “Can We Get Some Sleep?” episode of Munchkin’s StrollerCoaster podcast. “We find that they can make up sleep if they miss it – they can sleep in the stroller or what have you – but parents don't really have that luxury. Sometimes what we do is give permission to parents to make changes in the routines of their household so that they can sleep better because, the fact is, if you sleep better, you're a better parent and your child benefits.”

So how can we all achieve better sleep? Dr. Canapari has some recommendations, and it all starts with understanding your child’s sleep needs.

Not every baby or child will need the same amount of sleep.

“There is a lot of child-to-child variability,” Dr. Canapari explains. “Some kids need more sleep than others. So, if your child needs more sleep in infancy, they're probably going to be a child that needs a little bit more sleep. If your child sleeps 18 hours a day in infancy, guess what? They probably sleep through the night fairly quickly and naps aren't a problem. But if your child is on the shorter end of the spectrum, it can be very challenging. They're going to need attention from you. But, in adolescence, the short sleep kids have it great: They tolerate the extremely early times they must get up for high school and the long sleep kids struggle.”

Keep in mind that a baby’s sleep needs are constantly changing.

“Regardless of what your child's individual sleep needs are, understanding how their sleep is going to evolve in infancy is super important,” Dr. Canapari says. “It's a moving target and we see in the first year of life, some babies go from sleeping 20 hours a day to 14 hours a day in 12 months. So, right when you think you figured it out as a parent — like, ‘My kid takes X number of naps at this time’ — it changes. And it still continues to change as children get older, just at a slower rate.

There are going to be some bumps along the way.

“Some parents almost get PTSD; they finally get their kid’s sleep issues ironed out. Things are great,” says Dr. Canapari. “They have one bad night of sleep, and they are almost imagining going back to a period where the child had not slept for three or four months. Even though, to be frank, everybody's entitled to a bad night of sleep once in a while.”

Sleep training doesn’t inherently mean letting a baby cry it out.

“Sleep training just refers to any number of behavioral interventions you can do to help your child sleep better and to help you sleep better,” Dr. Canapari explains. “The problem with the term is it's strongly associated with one sleep training technique, which is called extinction or popularly cry it out. Extinction sleep training, or cry it out, simply means if you are trying to teach your child to sleep independently, you will place your child down where they sleep and walk away. In the classic form of unmodified extinction sleep training, you just leave your child to fuss or cry until he or she falls asleep.”

“In modified extinction, which is what Dr. Ferber popularized, you go in and check at set intervals to see how your child is doing,” Dr. Canapari continues. “And a check is a very finite interaction. You go into the room and say ‘I love you. It's time to go to sleep. Good night,’ and you leave the room. You don't pick up your child. It should be a very short intervention. Those interventions are really for the parents. This works very well for kids that are six months to 12 months of age. I don't really recommend it for older kids. If it doesn't feel right to parents, there are alternative methods.”

A daily dose of sunlight goes a long way in setting up babies for sleep success.

“Before six weeks, some kids invert their days and nights, which is very painful,” Dr. Canapari says. “What parents should think about in that period is trying to get their child exposed to natural light. The most powerful cue we have for our days and nights is light exposure, like the light of the sun. The technical term is this wonderful German word: Zeitgeber, which means ‘time giver.’ That natural light will help your baby as their body clock develops and anchor their sleep to nighttime and their wakefulness to daytime.”

A consistent bedtime routine is also very important.

“There's a couple of dimensions to a great bedtime: It's consistent in time and it's consistent in place,” says Dr. Canapari. “You shouldn't be doing your bedtime routine in different places on different nights. The sequence of events should be very consistent, and it doesn't need to be elaborate. The template of bath, story, song, quick cuddle, that's all you’ve got to do.”

Caregivers should take turns doing the bedtime routine early on if possible — otherwise a preference for one caregiver can develop.

“I think another thing that's super important in infancy is having a bedtime routine involving both grownups,” says Dr. Canapari. “So often in my world, parents are like, ‘I'm the only person that can put my child down. He or she won't go down for my spouse.’ Before COVID, I'd say, ‘Why don't you take a trip for a weekend? I guarantee your spouse is probably going to figure this out.’ It's much better that everybody should be able to do it.”

Catching tired cues early on is the best way to avoid “the forbidden zone.”

“There's this interesting phenomenon that a sleep physiologist calls the forbidden zone,” says Dr. Canapari. “It's the idea that there are certain times where you're just actually not going to fall asleep and that's because of your circadian system, which really is best understood as a wakefulness system. As you move through the day, you're accumulating more and more need, so your circadian system counterbalances this by pushing out this wakefulness signal. We all get what people call a second wind at the end of the day.”

“If you ever put your kids to bed and be like, ‘I'm so tired. I'm going to go to bed now,’ and then you turn on Netflix and it's 11:30 and you're like, ‘What has happened? I am wide awake. Yes, this is my life.’ This is you heading into that sort of forbidden zone. The way this manifests in kids is its what parents call their kids being overtired. I don't think that's an accurate term. It's just they're in this forbidden zone where the bedtime is likely a little bit later than they biologically need. They're getting that wakefulness burst. One mom said this to me perfectly. She's said, ‘My kid needs to be in bed at 7:30 or he's up till nine.’”

Bedtime can also be adjustable.

“As long as they settle, you don't need to intervene,” says Dr. Canapari. “For parents who are every night having these knockdown drag out fights about bedtime, looking at the timing of it is a really good idea. You could likely go earlier or later depending on your child's sleep needs. If you find you have a toddler or an elementary schooler that you need to wake up in the morning, that will imply their bedtime is a little bit too late. Moving bedtime 30 or 45 minutes earlier might just do the trick.”

For adults, it’s important to block out enough hours for sleep each night.

“Everybody owes it to themselves to try to get a good night of sleep, right,” says Dr. Canapari. “Not every night is going to be perfect but ensure that you have the technical terms of sleep opportunity; that you have enough hours blocked for you to get enough sleep time. For grownups, that's seven to nine hours of sleep. It is like a critical biological function. Yet a lot of modern society has been built around the idea of, ‘Well, if you need extra time, you can take it out of your sleep time.’ We may get up early to go to the gym or stay up late to finish a work project. Once in a while, you can do those things, but you really must design your life around getting enough sleep.”

Well-rested parents are in the best position to help their children become well-rested.

“Every child deserves good sleep,” says Dr. Canapari. “It's a cornerstone of health and well-being, and it's often something that gets forgotten. The upside is simple. When you improve a child's sleep, you're really improving the life of everyone in the family and that's a great feeling.”