Blog Post 10-Pre-sleep Routines

Healthy Sleep Habits, Happy Child
by Marc Weissbluth, M.D.

A Healthy Child Needs a Healthy Brain,
A Healthy Brain Needs Healthy Sleep.

Sleep is serious business.  If you have not already done so, please read Blog Posts 1 through 5 that describe how sleep is important and beneficial, from the point of view of the United States of America Department of the Army.  A major point, emphasized by the Army, is that more sleep produces more benefits for Soldiers.  Also, more sleep produces more benefits for children.  Even small amounts of extra sleep help (Blog Post 6).  At every age! 

Another point made by the Army is that “Soldiers [Children] best accomplish sleep extension [more sleep] by going to bed earlier.”  The Army is clear about who is in charge: “Planning for sleep is a leader [Parent] competency”

In addition, “Stress is incompatible with sleep.  Pre-sleep routines [Bed-time routines and soothing to sleep] that promote winding down prior to bedtime tend to facilitate the transition to sleep.  These routines will maximize sleep duration.  Conversely, engaging activities tend to arouse the brain and delay sleep onset.”

Bedtime routines and soothing to sleep should begin at the time when drowsy signs (Blog Post 9) first appear for daytime and nighttime sleep.


            Parents should experiment to see what soothing method works best and then try to be somewhat consistent so that your child learns to associate certain behaviors with falling asleep.  But it is not necessary that Mom and Dad have the same soothing style.  The goal of soothing is to create a calm and peaceful state compatible with transitioning to a sleep state.

                        ·  Rhythmic rocking: swings, cars, arms, rocking chairs, stroller rides, crib swaying to and fro.  Rocking motions may be gentle movements or vigorous swinging depending on what your child responds to.

                        ·  Sucking: breast, bottle, pacifier, wrist, fingers.

                        ·  Gentle pressure: swaddling, massage, soft cloth carriers.

                        ·  Sounds: lullabies, nature sounds, music, quiet talking, shushing.


            Bedtime routines help children calm down before falling asleep because they associate them with the natural state of relaxed drowsiness.   Pick and choose from the following list based on your child’s age and your personal preferences.  Try to follow the same sequence at all sleep times, because a consistent bedtime routine has been found to be a predictor of better sleep, including, specifically, fewer night wakings. Follow any routine that you feel comfortable with and stick with it.  But it is not necessary that Mom and Dad have the same bedtime routines.  For both soothing and bedtime routines, your baby will learn to associate each style with each parent.

                        ·  Bathe.

                        ·  Dress for sleep.

                        ·  Feed.

                        ·  Read books.

                        ·  Say prayers.

                        ·  Brush teeth.

                        ·  Reduce stimulation: less noise, less playing, dimmer lights.

                        ·  Bedroom: quiet, dark, not too warm.

Research published by Professor Jodi Mindell showed that:

                        ·  Within three days, instituting a new bedtime routine consisting of a bath, massage, and quiet activities (cuddling, singing, or lullaby), children fell asleep faster, had less wake time after falling asleep, and fewer night wakings.

                        ·  “Having a regular nightly bedtime routine is associated with improved sleep in young children, and that the more consistently a bedtime routine is instituted and the younger started the better.”  Furthermore, comparing whether there was a bedtime routine 0, 1-2, 3-4, 5-6, or 7 times per week, as the bedtime routine increased in frequency, sleep improved more.  In other words, bedtime routines practiced every night produce the best improvements in sleep and, in a stepwise fashion, lower “doses’ of bedtime routines produce lesser improvements.  Improvements were an earlier bedtime, falling asleep faster, fewer night wakings, and increased sleep duration. 

                        ·  Among children who had a bedtime routine every night, those who had an earlier bedtime also had even longer sleep durations.    

            The last point is important because if the bedtime is way too late, the power of bedtime routines and soothing efforts may be significantly diminished.  Early bedtimes are discussed in Blog Post 7.



·  Practice soothing to sleep and bedtime routines, every night, if possible.

·  Watch for drowsy signs. Blog Post 9.

· Respect your child’s natural sleep rhythms.  Blog Post 8.

·  Encourage an early or earlier bedtime (even a slightly earlier bedtime may produce better sleep.  Blog Post 6) especially at 6 weeks.  Blog Post 7.

∙ Recognize that a healthy brain requires healthy sleep. Blog Posts 1, 2, 3, 4, and 5.

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