The importance of good sleep at child care and beyond

Childhood obesity is a big issue for Kiwi kids. One in three two- to four-year-olds are overweight or obese, with many more at risk of becoming overweight because of poverty and other socio-economic factors.

There is good news, though, because new research by the University of Auckland has looked at the relationship between children’s sleep and weight, and found that an extra hour of sleep each night can dramatically cut a preschooler’s risk of obesity.

Here we look at the research in more detail and see how early childhood education (ECE) services ensure babies, toddlers and preschoolers get enough good quality sleep during the child care day.   

What does the University of Auckland research tell us?

This study involved researchers examining data from the Growing Up in New Zealand study, which is the largest longitudinal study of child development in the country.

The researchers wanted to learn how vulnerable preschoolers could maintain a healthy body weight, despite being exposed to obesity-risk factors, such as:

• Experiencing family stress, insecurity and chronic poverty;

• Being fed low-cost, nutrient-poor foods; and

• Having limited opportunities for physical activity in their neighbourhood.

Sleep was found to be a key factor in protecting at-risk preschoolers from becoming overweight or obese, and researchers found that even an extra hour of sleep at night can reduce a vulnerable preschoooler’s risk of obesity by 25 per cent.

Other studies have found that shorter night-time sleep duration increases the risk of children becoming obese, and there’s no doubt that adequate sleep is essential for all children.

What quantity of sleep do young children need?

Sleep doesn’t just help with children’s body weight. It plays a role in the proper functioning of all body systems, and an age-appropriate amount of good quality sleep is crucial for young children’s physical health, emotional well-being, positive behaviour, and ability to learn, problem-solve and focus.

It’s important to build healthy sleep routines at home and at child care, and although individual children and different ages needs varying quantities of sleep, the Ministry of Health recommends these total hours of sleep:

Age	Recommended	May be appropriate
Newborn (0 to 3 months)	14 to 17 hours	11 to 13 hours or 18 to 19 hours
Infant (4 to 11 months)	12 to 15 hours	10 to 11 hours or 16 to 18 hours
Toddler (1 to 2 years)	11 to 14 hours	9 to 10 hours or 15 to 16 hours
Preschool (3 to 4 years)	10 to 13 hours	8 to 9 hours or 14 hours
5-year-olds	9 to 11 hours	7 to 8 hours or 12 hours

These hours will be spread across the night and day for younger children, and ECE services support quality and quantity when it comes to sleep practices.

What are ECE services’ obligations around children’s sleep?

Under their licensing criteria, centre-based ECE services have clear obligations around sleep monitoring, sleep furniture spacing and storage of sleep furniture and bedding.

When it comes to monitoring, educators must:

• Ensure children don’t have access to food or drink while in bed;

• Check children for ‘warmth, breathing and general wellbeing at least every five to 10 minutes, or more frequently according to individual needs’; and
• Record each child’s sleep times and the checks made by adults during that time.

Cots, beds, stretchers and mattresses must be arranged and spaced to protect children’s safety and wellbeing, which means:

• Adults must have clear access to at least one long side of the sleeping furniture or item;
• The area around each child should allow ‘sufficient air movement to minimise the risk of spreading illness’;
• Children should be able to safely sit or stand when they wake up; and
• Sleep furniture and items that aren’t permanently set up need to be ‘hygienically stored’ when not in use.

The licensing criteria also require that:

• Sleep furniture and items should be safely designed and allow children to lie flat;
• Mattress coverings must be hygienically clean to stop the spread of infection;
• Children should have clean, warm bedding;
• At sessional services, there must be a designated space for children under two to restfully sleep at any time. The space must be located and designed to:

• Minimise fluctuations in temperature, noise and lighting levels;
• Allow adequate supervision by adults; and
• Provide enough cots, beds, stretchers and mattresses to go around, with at least one piece of sleep furniture or item for every five children under the age of two.

• At all-day services, under twos must have a designated sleep space like the one at sessional services. The cot:child ratio at all-day services requires one sleep piece of sleep furniture or item for every two children under the age of two.
• At sessional services, children aged two and over must have a safe and comfortable place to sleep or rest; and
• At all-day services, ages two and over must have adequate furniture or items for sleep, along with a space to sleep or rest ‘for a reasonable period of time each day.’ If the sleeping/resting space is part of an activity space, then there must be alternative activity spaces for children who aren’t sleeping or resting.

Kōhanga reo have similar sleep obligations to centre-based ECE services.

Home-based ECE services have the same obligations around monitoring children’s sleep and the spacing, design and cleanliness of sleep furniture and items. Their criteria around sleep facilities is different, though, with home-based services required to provide a space for the restful sleep of any child who needs it, at any time, regardless of age.

This single, all-ages criteria recognises that educators can more easily individualise children’s sleep because of the small group sizes and family atmosphere at home-based ECE services.

How do ECE services ensure children are getting enough sleep at care?

By meeting their obligations around sleep, ECE services provide a safe, healthy and comfortable sleeping environment for young children.

Educators also use sleep and rest strategies to help children feel safe, secure and well-rested. Day-to-day:

• They look for, and respond to, children’s sleep cues (e.g. rubbing their eyes, yawning, disengaging from activities, crying, seeking comfort from carers and finding it hard to regulate their behaviour);
• Educators acknowledge children’s emotions, feelings and fears, and take steps to minimise children’s distress or discomfort;
• When they see clear signs of tiredness, educators offer children a place to sleep or rest;
• They ensure that sleeping children are not disrupted;
• They offer non-sleeping children quiet activities that rest their minds, if not their bodies;
• They understand that young children (especially babies and toddlers) settle confidently when they’ve formed a bond with familiar carers; and
• Last but not least, educators work with families to ensure little ones are getting all the sleep they need. For example, an educator might suggest that a comfort item is brought in each day to help a toddler sleep, or work with parents to mimic a baby’s home sleep routine at care.

At the end of the day, sleep is vital for everyone’s health and wellbeing. Young children need lots of good quality sleep to learn, develop and thrive, and the prevention of childhood obesity is just one good reason to promote solid sleep practices at home and at care. 

References

Growing Up in New Zealand

Ministry of Health

Further reading

CareforKids.co.nz: What are the sleep needs of young children?