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Night Waking: What's normal?

by Alissa Pemberton

BSc (Midwifery), IBCLC & Holistic Sleep Coach

www.motherandmilk.co.uk


Night waking is a huge topic of conversation amongst parents, and is often the issue many parents approach me about when enquiring about sleep support, but take a quick look online or in any one of the 'bestselling' parenting books and you'll find completely different information on what's actually normal for night waking! It may surprise you to know that even as adults, we wake in the night. For most of us these arousals are brief, we are safe in the same environment we went to sleep and therefore we fall back to sleep again. If there is a need to be attended to - we're able to do this ourselves, or rationalise it away so it doesn't have significant impact on sleep. For our little ones - the situation is very different. They may feel pain, discomfort or fear which they can't deal with themselves, or just a genuine physical or emotional need which requires our support. Whilst frequent night wakings are difficult as parents - how do we know when it's actually a problem. Like everything the 'normal range' for night waking is very much a broad spectrum. Studies by Brown & Harries (2015) showed that nightwaking for 6-12 month olds varied from none up to 7 wakings per night, although the average was around 2. One study by Burnham et al. (2005) found that night wakings in the 1-3 month range were around 3 per night, only decreasing to an average of 2.6-3 night wakings by 12 months, but time spent to resettle became less. Some research also suggests that around 30% of 18 month olds are still waking at least once overnight, many 2-3+ times so we know that night waking remains normal beyond the first year.


Is it more important how frequently they're waking overnight or how long they're awake for? The concern from many parents (and perpetuated by many sleep consultants) is that frequent night waking may be damaging to their child as they're 'missing out' on valuable amounts of sleep. The same is often said by so called sleep experts regarding feeding overnight. However we know that infants and young children can breastfeed whilst asleep, and often breastfeeding provides the quickest and easiest measure to get them back to sleep, so this is not necessarily in itself a problem. Some classifications such as Sadeh (2004) which is used by many sleep consultants and medical professionals as an assessment tool for sleep indicates that more than 3 night wakings between 6-30 months, or less than 9 hours of total sleep in 24 hours is cause for concern. However there are many issues with this

a) using the same criteria for a 6 month old as a 30 month old is likely to result in unnecessary referrals at the younger end of the spectrum, when we know research suggests that 3 night wakings at this age is normal.

b) what constitutes troublesome night waking needs to be determined based on the impact it's having on a child, their development and their family. For some, more frequent wakes if they're cosleeping for instance and their child is able to easily feed back to sleep without disturbing mum may not be a problem. But for other families 3 night wakings, where it's taking 30-45 mins + to get the child back to sleep may be more problematic, even though it's normal.


0-6 months old During this period frequent waking is common. Newborns will often wake 5+ times during the night, often beginning to decrease around 3 months of age. Around 4 months coinciding with a transition in how infants fall asleep, sleep problems are common and increases in night waking between 3-6 months can occur.

6-12 months old The majority (around 80%) of babies in this range will still be waking during the night. On average around 3 times per night.

12-18 months old

Night waking usually begins to naturally reduce from the newborn period, but around 2-3 night wakings are still common.

18 months + Night waking of 1-2 times per night is common for around 30% of children. The remainder are likely to be sleeping a stretch of 10-11 hours per night.


So as a parent what can I do? We know night waking is influenced by mode of falling asleep, daytime sleep and overtiredness, environmental factors, hunger and emotional need. Starting at the beginning and eliminating each of these factors is an important place to start. Always start with your child's routine first - look at optimising day sleep and timing bedtime right.

You can then begin to eliminate the environmental, and physical needs which may be impacting the frequency of their night waking. You can access our free guide to help you do this via the link here


The following table will give you an idea of the overall amount of sleep you can expect for your child based on their age. If you're concerned about night waking try taking a look at the balance of their day and night sleep, and their overall sleep in 24 hours to see if there is a deficit which is cause for concern.

Age

Number of Naps

Total Day Sleep

Total Night Sleep

​0-3 months

Varies - spread evenly through the day

Around 14-17 hours in 24 hours

-

3-6 months

4

4-5

9-10

6-9 months

3

3-4

10-11

9-16 months

2

2-3

10-11

16-24 months

1

2-3

10-11

2 - 2 1/2 years

up to 1

up to 2

10-12

2 1/2 - 3 years

0-1

up to 2

10-12



Night waking is not only normal, but common in children of all ages. Though frequency naturally tends to decrease over the years and the majority of children by age three are sleeping a period of 10-11 hours overnight.




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