P3.L240: Sleep Routines and Parent Perceptions in Infants

Background: Consistent bedtime routines are associated with better sleep and well-being. However, little is known about the prevalence of both bedtime and naptime routines, routine activities, and their perceptions by parents during infancy.

Methods: Parents (67% mothers, 33% fathers) of 135 newborns (1-15 wks; mean age=8.2 wks) from the UK (70%) and US (30%) with questionnaires completed again at the first follow-up (FU1) 4 months later (mean age=5.4 mos) and again at a second follow-up (FU2) post-8 months (mean age=9.3 mos) by 106 (80%) and 103 (76%) of parents, respectively.

Results: For newborns, 62% (n=84) reported having a bedtime routine, with 49% starting a bedtime routine before 4 weeks of age. At FU1 and FU2, 81% and 89% of families engaged in a bedtime routine. The majority of parents who reported a bedtime routine indicated (“quite a bit”/“very much”) that they liked it (78% newborn, 90% FU1, 85% FU2), it was easy (70%, 79%, 78%), it helped their baby fall asleep (63%, 65%, 75%), and stay asleep (54%, 51%, 52%), as well as helped them bond with their baby (88%, 86%, 75%). For newborns, cuddling was most frequently endorsed as the favorite bedtime routine activity (43%), followed by bath (25%). The most challenging activity was changing a diaper (31%). In contrast, only 20% engaged in a naptime routine for their newborn, which increased to 38% and 43% at approximately 5 and 9 months of age. Overall, parents reported that they liked their baby’s naptime routine (54% newborn, 68% FU1, 61% FU2), it was easy (50%, 70%, 75%), it helped their baby fall asleep at naptime (35%, 55%, 68%) and sleep for longer stretches at naptime (35%, 43%, 50%), as well as helped parents bond with their baby (69%, 73%, 64%).

Conclusion: Just over half of all newborns had a bedtime routine in this sample, increasing to almost all eight months later. However, naptime routines were much less common with only 20% of families with newborns having a naptime routine and increasing to less than half throughout infancy. At all ages, parents report liking bedtime routines, that they are easy to implement, and help with bonding. Overall, naptime routines are perceived as less beneficial for naptime sleep but help with bonding. These results suggest that sleep routines, both at bedtime and naptimes, are perceived positively by parents, even in families with newborns. Pediatricians are encouraged to recommend sleep routines to all families.