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Dr Rahul Sen | Specialist care for birth and beyond | Sydney, Australia

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Settling techniques: newborn – 12 months

Learning how to self-settle and go to sleep is a skill babies usually gain during the first year of life.

Like most skills, it takes time and occurs at an individual rate. In the early months of life a baby has a need to be physically connected to their parents. They are in a normal state of adjustment where erratic feeding and sleeping patterns, periods of crying and unsettled behaviour are common. During this period there is a gradual development of a routine as babies adapt to their environment and develop their own rhythms.

Tired sign/cues

Tired signs are the individual signals your baby gives to let you know they are getting tired and need to sleep. These may include: facial grimacing, yawning, grizzling, frowning, sucking, staring, minimal movement or activity, turning head away, jerky movements or becoming more active, clenching fists, rubbing eyes, squirming crying/ fussiness

Responding quickly to your baby’s tired signs can stop your baby becoming overtired and distressed. This quick response helps your baby learn to self settle and prevents your baby getting into a state of distress that requires lots of effort to calm.

How much sleep does my baby need?

All babies are different which means that some babies will sleep more and some will sleep less. Most newborns 0-6 weeks will become tired after 1 hour of up time they should ideally sleep for 1½ -3 hours.

By the end of the first month the infant sleeps approximately 13-14 hours per day spread across day and night. As your baby matures the sleep requirement of 13-14 hours remains much the same with the length of time your baby sleeps at night increasing. During the day your baby will have longer wake times and up to 2-3 day sleeps. If your baby wakes up happy your baby probably has had enough sleep.

Sleep cycles

Babies are not born with a day/night rhythm. It takes time to develop their 24 hour internal clock that controls the sleep-wake cycle. The sleep-wake cycle, is the time spent going through both deep (quiet) and light (active) stages of sleep. From birth a sleep cycle is about 40 – 60 minutes with 20 – 30 minutes deep sleep within the cycle. The periods of deep sleep in each cycle, and the time to move to deep sleep, increases with age. Between each sleep –wake cycle, babies rouse/wake briefly then resettle to sleep – sometimes you may need to help your baby to resettle, this need for assistance should decrease as your baby becomes older.

ROUTINES are generally structured around three main activities: feed, play and sleep. These are regular events that occur throughout the day.

After a feed and /or play (depending on day or night) you may use a range of activities that signal to your baby that bedtime is approaching, helping your baby move to a calm state in preparation for sleep. These activities may include a quiet story, a particular song, cuddles, certain verbal phrases, bath-time and a goodnight kiss.


Settling Options

Most babies will take time to settle and consistency with your choice of options is important in helping your baby establish good sleep habits. Remember babies may protest as they learn a new way of settling.

Settling in arms (the early weeks)

Hold your baby in your arms until they fall asleep. You can use gentle rhythmic patting, rocking, stroking, talking, or softly singing prior to putting your baby into the cot. If your baby wakes after a sleep cycle you may need to resettle (as above) to ensure adequate sleep.

Hands-on settling

When you see your baby’s tired signs (cues), prepare your baby for sleep

  1. Check your baby’s nappy
  2. Wrap your baby in a light cotton sheet (optional) – taking care not to overheat
  3. Talk quietly and cuddle your baby to encourage a state of calm
  4. Position your baby on their back in the cot awake [calm/drowsy]. Ensure cot sides are up and secure
  5. Comfort your baby by: gentle ssshhh sounds, gentle rhythmic patting or rocking, or stroking staying until calm or asleep
  6. If your baby remains distressed you may need to pick your baby up for a cuddle until calm. Once calm repeat steps 4 and 5.

The length of time it takes to calm your baby will lesson as your baby learns to self settle.

Comfort settling (over 6 months)

Comfort settling provides your baby with reassurance and support while also providing an opportunity for your baby to discover their own way of going to sleep.

Use the first 5 steps above (Hands on Settling)

As your baby calms, move away from the cot or leave the room

  • Listen to your baby’s level of distress (intensity of cry)
  • If your baby remains distressed, calm your baby again and move away or leave the room
  • You may have to repeat this several times before the baby responds
  • If your baby does not respond, pick your baby up and cuddle until calm then either
    • reattempt comfort settling
    • use hands on settling until baby is asleep
    • get baby up and try again later

Parental presence (over 6 months)

You may prefer this option if your baby is over 6 months of age and has not been separated from you at sleep time.

  • Prepare your baby for sleep as per steps 1 to 5
  • Once calm lie down or sit beside the cot within sight of your baby and pretend to be asleep
  • If your baby remains awake, give a little cough or quietly ‘ssshhh time to sleep’ signalling you are still in the room
  • If your baby becomes distressed respond with the minimal action required to calm your baby and then repeat steps 4 and 5
  • Stay in the room until your baby is asleep during the day and sleep in the same room as your baby throughout the night
  • This continues for at least 1 week or until your baby has 3 consecutive nights of relatively uninterrupted sleep.
  • You can now begin to leave the room before your baby is asleep.

Unsettled periods

Crying is part of normal behaviour (your baby’s way of communicating) and can be due to:

  • hunger, thirst, being hot or cold, a wet or soiled nappy;
  • being overtired, excited or frightened ;
  • a need for comfort (to soothe your baby back into a calm state)

Your baby may have unsettled periods where they are fussing and crying for no apparent reason. If your baby is otherwise well you can consider other options. For example: offer a ‘top up’ breastfeed within 30 minutes of the last feed (babies up to 3 months); cuddle; rhythmical movement, walk using pram, sling; play some music; offer dummy; offer cooled boiled water (babies over 6 months) baby massage; or deep relaxation bath.

If your baby still finds it hard to settle a wrap may help. It is thought a wrap lessens baby’s involuntary movements giving a sense of security and promoting a state of calm. Use a light material [usually cotton] ensuring arms are above waist level and hip movement is not restricted. It is important to choose options that are safe and suit you and your baby. If your baby does not calm [during the day] after an attempt to settle and becomes too distressed, get your baby up and continue your daily routine. If your baby remains unsettled ask for help from family, friends, the Child and Family Health Nurse or local doctor.

For safety ensure the cot sides are completely raised whenever the baby is left unattended in it

There are three main ways to reduce the risk of SIDS:

  1. Put your baby on their back to sleep, from birth.
  2. Make sure your baby’s head remains uncovered during sleep.
  3. Keep your baby smoke free, before birth and after.

More information on how to reduce the risk of SIDS and sleeping your baby safely can be obtained from the SIDS and Kids website or by contacting SIDS and Kids by telephone on 1300 308 307.

© Tresillian 2000–2013