Your Baby and Toddler's Sleep When Sick

There are many guarantees in your child’s life and one of the biggest guarantees is that at some point, your child is going to get sick. The average child under age 2 will come down with an illness 6 times/year. And if your child attends daycare, that number could be doubled. Depending on the severity of the illness, a child’s sleep can really derail when they are feeling under the weather. Many parents struggle to know what to do when their child is sick - do all the rules go out the window? Do we still try to remain consistent? What should we be flexible with and where should we draw a hard line? Enter - this post! While it certainly is impossible to give a concrete game plan for your child when they are ill as it absolutely depends on the severity of the illness, this post is meant to give you a framework to work with so that hopefully you can rebound more easily when your child is back to full-strength. Happy reading!

Why do illnesses impact sleep?

As I always tell families, when dealing with a sick baby or toddler, we have to consider that their psychological needs need to be met as well. We want them to know that if they are unwell, we will be there to help them through it. Trouble arises when we need to introduce certain sleep associations to help them sleep when they aren’t feeling well [rocking, holding, nursing, bottle, etc.] as while these associations may not be inherently ‘bad’, especially when your child is needing support, the expectation of these associations continuing even once they are feeling better can be very high, especially with a toddler. As I’m sure you’ve experienced, it can be very difficult to sleep with a sore throat, cough, fever, ear ache, etc. and children need help managing these symptoms, but the key is that the day your child is better, we need to get back to our normal schedule/routine. Bigger issues arise when we allow the new habits to linger past the healthy point as more often than not, even if we’ve had to bring in all the big guns to help your child sleep, it should only take around 3-5 days to get back on track if we do so in a timely manner. If weeks have gone by since your child was sick and you are still supporting heavily to sleep, a bigger sleep training endeavor may be required.

Which rules should we try to follow?

Just because your child is sick, it does not automatically mean that all rules are out the window. Many children can maintain the same sleep habits when sick [and some even sleep harder/more easily/longer!] so it’s always important to give your child a chance first before we add extra support. Some rules to try and follow include:

• If your child is an independent sleeper, aim to still put them down awake for all sleep times and see if they are able to manage without extra support. Keep reading to find out what to do if this is not the case.

• If your child sleeps in a crib/their own bed, try to keep this consistent [vs. bringing them into your bed - this can be a very difficult association to remove, especially with toddlers!] If you would like to monitor your child more closely, consider making a bed on the floor of their room for yourself.

• If extra support is needed, try to intervene as minimally as possible at first, adding extra help as required. This means still waiting at night during any wakings, trying to comfort them in their crib first before moving to a pick-up if needed, and trying to save extra feeds as a last resort unless dehydration is suspected. Check out the information below for an actionable game plan for bedtime, naps, and the middle of the night!

Which rules are okay to break?

While not all rules go out the window when your kiddo is unwell, there are some rules that we certainly want to break in the spirit of giving your child the best chance possible to ward off their illness. These rules include:

• Waking them at a certain time in the morning [let your child sleep as long as they need!]

• Waking them at a certain time from their naps [let your child sleep as long as they need!]

• Following any sort of schedule [waketimes, by the clock, etc.] When your child looks tired, let them sleep/help them to sleep.

• Worrying about feeding too close to sleep or any sort of feeding schedule through the day - your child needs plenty of rest and plenty of fluids.

How else can we help our babies/toddlers when they are unwell?

• A nightly warm bath [especially helpful if you can run a hot shower first with the door closed to steam up the room for congesion]. If your child has a fever, a lukewarm bath [not cold!] would be ideal.

• Using a humidifier/vaporizer for congestion/cough. My favorite can be found here!

• A massage before bedtime can help with any body aches.

• A nasal aspirator [or ‘snot sucker’ as we like to call it] is worth its weight in gold. I literally do not know how any family can survive without one of these! Definitely one of my most highly recommended baby products.

• Offering medication as needed [especially 30 minutes before bedtime]. Wondering about which to use? Advil/Motrin [ibuprofen] are anti-inflammatories so will be especially helpful for illnesses with inflammation [croup, teething], and for higher fevers. It also lasts longer than its counterpart but should only be used in babies 6+ months of age. Tylenol [acetaminophen] would be the better option for stomach pain/upset and can be used for babies under 6 months. As always, make sure you are using the correct dosage and consulting your pediatrician with any questions or concerns. Parents should not hesitate to contact the pediatrician if a child continues to have a persistent fever.

Managing sleep during illness is never easy, even when a child isn't severely ill. All children have different tolerance levels for illness and some can seem to be impacted by even a minor cold. If all else fails, do what you need to do and don't worry about creating bad habits. And if you are in need of support to help get your healthy child back on track, do not hesitate to reach out!

---

Pam Edwards is a Certified Infant & Child Sleep Consultant and founder of Wee Bee Dreaming Pediatric Sleep Consulting, based out of Kamloops, B.C. Healthy sleep is addicting and she has made it her life mission to help families all across the world get the sleep they deserve - a good night's sleep doesn't have to be a dream!

Low Sleep Needs Babies & Toddlers

We all have that friend. The one with the 9 month old baby that takes two 2 hour naps and then sleeps 12 hours straight at night. Or the one with a 2 year old that takes a 3 hour nap and sleeps 7pm-7am. Comparison is the thief of joy, and when we start comparing our low sleep needs babies to these high sleep needs children, it can be difficult not to feel like we are failing somehow. But here’s the thing - children have different sleep needs. Just the same as adults that can function on 6 hours of sleep but I feel groggy after only 8 hours! While these high sleep needs children exist, having a child with low sleep needs is a reality for many! Read on below to find out what it means to have a low sleep needs child, how you can tell if this is your child, and how to manage sleep if you were blessed with a kiddo that just doesn’t need as much sleep!

What does it mean to have low sleep needs?

Simply put, a lower sleep needs child will have a daily sleep requirement that is lower than the ‘average’ child. This number is typically at least 30-60 minutes lower than the lower range of average. Some signs that your child may have lower sleep needs than average include:

• Seeming happy and content with less sleep

• Dropping naps earlier than the recommended averages

• Catnapping, especially waking happy from catnaps

• Flexible when naps/bedtime are late [i.e., does not seem to impact sleep in a negative way]

• Do not show many sleepy cues

• Easy to wake in the morning/from naps

• Early wake-ups [i.e., before 6:00am/less than 11 hours of sleep], especially happy early wakings

• Extended nightwakings where the child is happy/quiet [also called ‘split nights’]

How can I tell if my child has low sleep needs?

Aside from the above signs, kids with lower sleep needs tend to have longer-than-average waketimes [i.e., the amount of time they are awake in between sleep times]. They tend to handle these longer waketimes quite well, meaning they aren’t getting fussy before sleep times and are sleeping well despite the extended time. To break it down by age, longer than average waketimes looks like:

Waketimes are > 2 hours at 4 months

Waketimes are > 2.25 hours at 5 months

Waketimes are > 2.5 hours at 6 months

Waketimes are > 2.75 hours at 7 months

Waketimes are > 3.5 hours at 8 months

Waketimes are > 3.75 hours at 9 months

Waketimes are > 4 hours at 10-12 months

In addition to these extended waketimes, kids with lower sleep needs may also:

• Need less than the standard 11-12 hours of sleep at night

• Often take short naps that they wake happy from, despite being at the long end of waketimes

• Take longer than 20 minutes to fall asleep for naps/bedtime, despite being at the long end of waketimes

• Have sleep habits that overall, just seem ‘hard’ [presumably this may be because we are trying to get them to sleep more than they need to]. Parents may report that their children just seem like ‘bad’ sleepers or that there is a lot of protesting/crying around sleep times

How much sleep do lower sleep needs children need?

While sleep needs requirements can vary greatly with babies and children, averages do exist. Lower sleep needs children will seem to be content with sleep totals that are less than these averages [note that these below numbers reflect total sleep in a 24 hour period - naps and nighttime inclusive]:

4 months:
High end = 16+ hours
Average = 15.5 hours
Low end = 15 hours or less

5 months:
High end = 15.5+ hours
Average = 15 hours
Low end = 14.5 hours or less

6 months:
High end = 15+ hours
Average = 14.5 hours
Low end = 14 hours or less

7/8 months:
High end = 15+ hours
Average = 14-14.5 hours
Low end = 13.5 hours or less

9-11 months:
High end = 14.5+ hours
Average = 14 hours
Low end = 13.5 hours or less

12-14 months:
High end = 14+ hours
Average = 13.5-13.75 hours
Low end = 13 hours or less

15-18 months:
High end = 14+ hours
Average = 13-13.5 hours
Low end = 12.5 hours or less

19-23 months:
High end = 13+ hours
Average = 12-12.5 hours
Low end = 11.5 hours or less

2 years of age:
High end = 13+ hours
Average = 12-12.5 hours
Low end = 11.5 hours or less

3 years of age:
High end = 12.5+ hours
Average = 11-12 hours
Low end = 10.5 hours or less

4 years of age:
High end = 12.5+ hours
Average = 10-12 hours
Low end = 9.5 hours or less

While lower sleep needs children seem to be satisfied with their lower sleep totals, if your child is clocking less than average sleep but often exhibits signs of overtiredness, it’s possible that they may actually need more sleep than they are managing, but there could be some external factors preventing them from obtaining sufficient sleep [parent-led sleep associations, too-long waketimes, sleep environment that is not conducive to sleep, too many naps on the go, too-late of a bedtime, etc.] Some of the signs that your child may not be sleeping enough include:

• Showing an overall lack of interest in people or their environment

• Lots of yawning, ear pulling, and eye rubbing throughout their awake time

• Red eyebrows or ‘bags’ under their eyes

• Nightwakings [especially those within 4 hours of bedtime] where they are crying

• Waking crying from short naps

• Early wake-ups where they are upset/crying

• Excessive clinginess

• Lower frustration or pain threshold

• Frequent outburts/tantrums

• Overactivity [thanks to cortisol & adrenaline]

• Falling asleep anytime they are in motion

• Night terrors [in toddlers] or frequent sleep-cries [in babies]

If my child has lower sleep needs, what can I do?

As they say, the first step is acceptance! Accept that your child having lower sleep needs is no reflection on your parenting, or anything you have done/haven’t done. It’s just biology! Trying to force sleep on a child that is not sleepy will be frustrating for everyone, so let go of any expectations or any comparisons but also make sure to:

• Keep a close eye on the clock since sleepy cues alone aren’t reliable with low sleep needs children. Kids with low sleep needs can still become overtired if we push them too far, so make sure you are still being mindful of waketimes [albeit they may be longer than average, as per above!] to ensure they are still receiving the minimum amount of sleep.

• Keep in mind that they may hit nap transitions earlier than average. For example:

  Dropping to 3 naps at 4 months or earlier
  Dropping to 2 naps at 5/6 months of age
  Dropping to 1 nap at 11/12 months of age
  Dropping naps entirely before the age of 3

• Be mindful of any resistance you are seeing around sleep times [nap refusals, trouble setting at bedtime, early wake-ups] and don’t be afraid to try longer waketimes or later bedtimes if you are seeing a lot of resistance to sleep.

• Keep a sleep log! Look closely at your child’s mood before sleep times, their mood after sleep times [i.e., do they wake immediately happy/quiet? Fussing/crying?], and total sleep. Use the chart below to determine if you may need to extend some waketimes, and if you suspect your baby has lower sleep needs, try not to worry that it seems they are longer than ‘average’. If waketimes during the day are longer but your child is still sleeping well at night, you may just have a low sleep needs baby.
  
  

Are there any benefits to having a low sleep needs child?

As a mom of 3 high sleep needs children, I can tell you that the grass isn’t always greener! Having a child with higher sleep needs is great when they are able to get the sleep they need, but it can also make things much more challenging during the times when they aren’t able to [whether it’s late bedtimes due to family functions, travelling, sleepovers with friends, etc.] Children with lower sleep needs are often able to handle variability in their schedules with greater ease. The odd late bedtime [or even several late bedtimes in a row!], skipped/late naps, and frequent naps on the go may not even phase them.

While there are obvious benefits, having a child with lower sleep needs can also be a bit more challenging as it can be difficult to pinpoint optimal timing of sleep without obvious sleepy cues, therefore we have to watch the clock more closely. Also, standard guidelines for sleep on the internet may not apply to your child and that can make it hard not to compare to other babies that may be napping longer or sleeping longer or later in the morning.

Sample Schedules for Low Sleep Needs Children

See here for sample schedules for average sleep needs children!

4/5 months

6:30am – wake up, change, feed, play
8:15am - down for nap #1 [1.75 hours of waketime]
8:30am-9:30am – nap #1, change feed, play
11:45am - down for nap#2 [2.25 hours of waketime]
12:00pm-1:00pm – nap #2, change, feed, play
3:15pm - down for nap #3 [2.25 hours of waketime]
3:30pm-4:00pm – nap #3, change, feed, play
5:45pm - bedtime routine begins w/ a feed first
5:55pm - bath, massage, jammies, book, song
6:15pm - down for the night [2.25 hours of waketime]
6:30pm – asleep for the night
12:00am – potential nightfeed #1 [5-6 hours from bedtime feed]
4:00am – potential nightfeed #2 [3.5-4 hours from last feed]

2.5 hours in naps + 11 hours at night = 13.5 hours total sleep

6/7 months

6:30am – wake up, change, feed, play
8:00am - breakfast solids
8:45am - down for nap #1 [2.25 hours of waketime]
9:00am-10:00am – nap #1, change, feed, play
11:30am - lunch solids
12:15pm - down for nap #2 [2.25 hours of waketime]
12:30pm-1:15pm – nap #2, change, feed, play
3:45pm - down for nap#3 [2.5 hours of waketime]
4:00pm-4:30pm – nap #3, change, feed, play
6:30pm - bedtime routine begins w/ a feed first
6:40pm - bath, massage, jammies, book, song
7:00pm - down for the night [2.5 hours of waketime]
7:15pm – asleep for the night
2:00am – potential nightfeed [7-8 hours from bedtime feed]

2.25 hours in naps + 10.75 hours at night = 13 hours total sleep

8/9 months

6:30am – wake up, change, feed, play
9:00am - breakfast solids
9:45am - down for nap #1 [3.25 hours of waketime]
10:00am-11:00am – nap #1, change, feed, play
12:30pm - lunch solids
2:30pm - down for nap#2 [3.5 hours of waketime]
2:45pm-3:45pm – nap #2, change, feed, play
5:30pm - dinner solids
6:45pm - bedtime routine begins w/ a feed first
6:55pm - bath, massage, jammies, book, song
7:15pm - down for the night [3.5 hours of waketime]
7:30pm – asleep for the night
4:00am – potential nightfeed [9-10 hours from bedtime feed]

2 hours in naps + 10.5 hours at night = 12.5 hours total sleep

10/11 months

6:30am – wake up, change, feed, play
9:00am - breakfast solids
9:45am - down for nap #1 [3.25 hours of waketime]
10:00am-11:00am – nap #1, change, feed, play
12:30pm - lunch solids
2:45pm - down for nap#2 [3.75 hours of waketime]
3:00pm-3:45pm – nap #2, change, feed, play
6:00pm - dinner solids, milk w/ dinner
7:00pm - bedtime routine begins
7:10pm - bath, massage, jammies, book, song
7:30pm - down for the night [3.75 hours of waketime]
7:45pm – asleep for the night

1.75 hours in naps + 10.75 hours at night = 12.5 hours total sleep

12-18 months [on 1 nap]

6:30am – wake up, change, feed, play
7:00am - breakfast solids or milk w/ breakfast
9:00am - snack w/ milk or water
11:30am - lunch w/ milk
12:15pm - down for nap
12:30pm-2:30pm – nap, change, feed, play
3:00pm - snack or milk w/ snack
6:00pm - dinner w/ milk
7:15pm - bedtime routine - bath, massage, jammies, book, song
7:45pm - down for the night
8:00pm – asleep for the night

2 hour nap + 10.5 hours at night = 12.5 hours total sleep

19-23 months

6:30am – wake up
7:00am - breakfast
9:00am - snack
12:00pm - lunch
12:45pm - down for nap
1:00pm-2:30pm – nap
3:00pm - snack
6:00pm - dinner
7:45pm - bedtime routine - bath, massage, jammies, book, song
8:15pm - down for the night
8:30pm – asleep for the night

1.5 hour nap + 10 hours at night = 11.5 hours total sleep

2 years old

6:30am – wake up
7:00am - breakfast
9:00am - snack
12:00pm - lunch
1:00pm - down for nap
1:15pm-2:15pm – nap
3:00pm - snack
6:00pm - dinner
7:45pm - bedtime routine - bath, massage, jammies, book, song
8:15pm - down for the night
8:30pm – asleep for the night

1 hour nap + 10 hours at night = 11 hours total sleep

3 years old [with nap]

6:30am – wake up
7:00am - breakfast
9:00am - snack
12:00pm - lunch
1:15pm - down for nap
1:30pm-2:00pm – nap
3:00pm - snack
6:00pm - dinner
7:45pm - bedtime routine - bath, massage, jammies, book, song
8:15pm - down for the night
8:30pm – asleep for the night

30 minute nap + 10 hours at night = 10.5 hours total sleep

3 years old [without nap]

6:30am – wake up
7:00am - breakfast
9:00am - snack
12:00pm - lunch
1:30pm-2:15pm – quiet time
3:00pm - snack
6:00pm - dinner
7:15pm - bedtime routine - bath, massage, jammies, book, song
7:45pm - down for the night
8:00pm – asleep for the night

= 10.5 hours total sleep

4 years old

6:30am – wake up
7:00am - breakfast
9:00am - snack
12:00pm - lunch
1:30pm-2:15pm – quiet time
3:00pm - snack
6:00pm - dinner
8:15pm - bedtime routine - bath, massage, jammies, book, song
8:45pm - down for the night
9:00pm – asleep for the night

= 9.5 hours total sleep

Understanding and accepting that there are different sleep needs can be very freeing as a parent. Once you let go of any preconceived notions about how much your child needs to be sleeping at night or napping during the day, I hope that you’re able to relax and enjoy parenthood so much more.

If, however, your child is sleeping much less than recommended and you are feeling like it is not due to low sleep needs, please contact me and we can work together to find a solution for your family!

---

Pam Edwards is a Certified Infant & Child Sleep Consultant and founder of Wee Bee Dreaming Pediatric Sleep Consulting, based out of Kamloops, B.C. Healthy sleep is addicting and she has made it her life mission to help families all across the world get the sleep they deserve - a good night's sleep doesn't have to be a dream!