NEW YORK (Reuters Health) - - Inconsistent childcare arrangements can affect toddlers’ sleep at night, a new study suggests.

Consistent childcare arrangements - even complicated ones - didn’t seem to affect young children’s nighttime sleep. But when the pattern changed over time, toddlers didn’t sleep as well, study leader Jen-Hao Chen told Reuters Health in an email.

“The first three to five years of life are critical for children’s development of a single, consolidated sleep,” said Chen, a researcher at Howard University in Washington, DC.

As reported in Sleep Health, online August 10, Chen analyzed data from a large Australian study of more than 3,400 children whose mothers answered survey questions when the children were nine months old and again when they were two-and-a-half years old.

The questions covered childcare experiences such as time spent in childcare centers, time with relatives and time with non-relatives, as well as use of multiple childcare settings.

Among children who attended childcare in both infancy and toddlerhood, sleep did not appear to be affected by childcare arrangements - as long as the same childcare configuration was maintained.

Children with complicated care arrangements were not at higher risk for shorter nighttime sleep duration, difficulty falling sleep, restless sleep, or waking up during the night compared to children with single arrangements during infancy and toddlerhood.

However, if childcare configuration changed - for example, from a single arrangement to multiple arrangements, or vice versa - then the children slept less during the night than children who didn’t use childcare, said Chen.

Chen said he hopes the findings increase parents’ awareness of how their selection of childcare arrangements may have implications for children’s sleep patterns.

“Parents consider many issues such as costs, infrastructure, location, quality of childcare setting when choosing childcare. How childcare settings handle napping and sleep, however, is often not (considered) an important issue,” he said.

Parents may want to learn more about how nap and sleep activities are practiced in various childcare settings, Chen added. Then they can select a combination of childcare settings with minimal influence on children’s nighttime sleep.

Dr. Iqbal Rashid, a pediatric sleep specialist from the David Geffen School of Medicine at UCLA in Los Angeles who was not involved in the study, said the report provides “good longitudinal data from a national representative sample of complex childcare experience.”

However, said Rashid, it’s difficult to know why the kids had trouble falling asleep. The study can’t rule out other possible reasons such as problems at home.

“They could have a pet in the house that wasn’t sleeping . . . was the child co-sleeping with the parents? The home environment . . . did the parents have smoking in the house or other things that sort of influence the child’s sleep? That’s a very subjective assessment to make,” he told Reuters Health by phone.

As for helping kids get to sleep, Rashid said there’s no ‘one size fits all,’ but it’s important to have a consistent bedtime and reduce screen time before bed.

Rashid added that a simple routine such as a simple changing and feeding before bed is important for babies so that they learn to soothe themselves to sleep.

“That is the most important thing because every child, everybody wakes up multiple times at night and if they do wake up they should be able to soothe themselves back to sleep,” he said.

If babies are comfortable sleeping at the very beginning of the night, when they do wake up in the middle of the night they know how to fall asleep over again, said Rashid.

“But if the mother is rocking the child, singing them songs and stuff like that, then whenever the child wakes up in the middle of the night then the child would need the same associations to fall asleep again, he said.

SOURCE: bit.ly/2vLKZZC

Sleep Health 2017.