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Chapter 1 Index
A. General Information
about the well child examination B. Nutrition Issues
C. Sleep Issues |
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Normal Sleep in Children
In order to know how to give anticipatory guidance to parents about their
children’s sleep, you must learn what the normal should be. The problem is
that children vary in their sleep, prematures follow different patterns from
full term babies, and that breast fed babies sleep differently from
bottle-fed.
Summary of Ferber’s Sleep Chart for Normal Children (PIR Sept 1987)
|
Age of Child |
Daytime Sleep |
Nighttime Sleep |
Total hrs sleep/age |
|
1 week |
9 hours |
8 hours |
17 hours |
|
1 month |
8 hours |
8 hours |
16 hours |
| 3 months |
6 hours |
9 hours |
15 hours |
| 6 months |
4 hours |
10 hours |
14 hours |
| 9 months |
3 hours |
11 hours |
14 hours |
| 12 months |
3 hours |
11 hours |
14 hours |
| 18 months |
2 hours |
11 hours |
13 hours |
|
2 years |
2 hours |
11 hours |
13 hours |
|
3 years |
1 hour |
11 hours |
12 hours |
|
4 years |
none |
11 hours |
11 hours |
|
5 years |
none |
11 hours |
11 hours |
|
10 years |
none |
9 hours |
9 hours |
Sum:
Infants by 3 months of age have more of their sleep during the
night
By 6 months of age all infants should sleep through the night, but 25-40%
either continue to awaken at night or become problem wakers. This is when
the Ferber program can start. Others wait until 12 months of age to start it.
Naps: Based on the above table, most children can be expected to take
naps in the following way
|
Age of Child |
Number of naps |
|
3 mo. - 12 mo. |
2 (2 hours each) |
|
12-18 months |
1-2 (2 hrs total @ 18 m) |
|
2-3 years |
1 (1 hour total) |
|
4 years |
none |
If sleep interruptions occur after good sleeping, established consider
the following causes:
- Co-sleeping: the frequent waking of the first few months is continued
when co-sleeping occurs. In fact 10-20% of children co-sleeping at age 5
years are not sleeping through the night.
- Parental over-responsiveness: the basis of the Ferber program
- Nighttime feedings: if child goes to sleep while taking a bottle or
the breast, child is much less likely to be able to sleep for a long time.
Same for holding, rocking and offering a pacifier.
- Social stresses or difficulties with parent/parent and parent/child
interaction. Sleeplessness in a child can be a major indication of such
stresses.
- Medical disorders: colic.
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