Babies and Sleep

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Most of a baby’s first year of life is spent sleeping. Throughout that first year, parents often wonder how much their baby should sleep, when they should sleep, what to do when they don’t sleep, and when they will finally sleep through the night.

It can take time for new parents to adjust to their baby’s sleep schedule, and there is much to learn along the way. We discuss a wide range of sleep information for the first year of a baby’s life, including sleep guidelines, sleeping through the night, sleep training, sleep regressions, and safe sleep.

THE SLEEP DOCTOR’S

Top 5 Tips for New Parents

• 1 Alternate responsibilities with your partner each night.
• 2 Avoid stimulants like alcohol and caffeine late in the day.
• 3 Try to incorporate healthy sleep habits into your bedtime routine.
• 4 Ask for help when you need it so you can get some rest or recharge.
• 5 Accept that sleep regressions happen and imperfect sleep is normal.

It is just as important to take care of your own wellness and ensure that you get enough rest to care for your child.

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A baby’s sleep needs change over the first year of their life. Experts have established sleep guidelines based on a baby’s age, but all babies are unique, and their sleep needs can be different depending on their temperament, weight, and other factors.

Newborns (0-3 months): Newborns typically sleep 14 to 17 hours in total during a 24-hour period. Their sleep and wake times may be broken up into smaller periods, such as staying awake for one to three hours at a time and sleeping two to four hours.

Infants (4-11 months): Infants generally sleep between 12 and 15 hours in a 24-hour day. Babies start sleeping for longer periods of time between 3 and 4 months of age. They may also take one to four naps a day, each lasting 30 minutes to two hours.

Sleep Needs of Newborns (0 to 3 Months)

Newborn babies have unstable sleeping patterns until around 3 months old. Newborns generally sleep for two to four hours at a time and stay awake for one to three hours. Because newborns’ sleep cycles can vary greatly, there is no need to be alarmed if they do not follow a specific pattern.

Since newborns feed at all hours, how long they sleep can depend on how frequently they need to eat. Breastfed babies tend to feed about every two hours, while formula-fed babies can go up to three hours between bottles. Newborns may feed more, and therefore sleep less, when they are going through growth spurts.

A baby’s circadian rhythm also begins to develop at 2 or 3 months. Circadian rhythms are internal changes that occur in the body during a 24-hour period, most often aligned with the presence or absence of light. As these rhythms develop, babies start recognizing that they should be asleep at night and awake during the day.

Premature babies born before 37 weeks require more sleep than full-term babies, with premature newborns sleeping as much as 90% of each day. They also tend to sleep more lightly and move more while they sleep.

Sleep Needs of Infants (4 to 11 Months)

Infants from 4 to 11 months old should be sleeping 12 to 15 hours in total each day, including both nighttime sleep and daytime naps. However, what is considered a normal amount of sleep can still vary from baby to baby.

While babies’ sleep cycles may still depend on their feeding schedules, the development of their circadian rhythms helps them sleep for longer periods of time. By 4 months, a baby may sleep for up to eight hours consecutively. Though sleep duration can vary, babies may sleep up to 10 hours at a time by the time they reach 6 to 9 months old, with some sleeping 12 consecutive hours.

It is normal for babies under 12 months old to take up to four naps each day. Babies’ naps typically last from half an hour to two hours long.

When Will Your Baby Sleep Through the Night?

At 6 months old, many babies sleep for at least six uninterrupted hours at night. But this may not occur every night, and it is not true of all babies. Some babies may begin sleeping through the night as early as 4 months. Meanwhile, as many as half of all babies older than 6 months still wake up at night at some point.

New parents are understandably eager for the day when their baby sleeps through the night. This is often seen as an important milestone in a baby’s development. However, if a baby of any age still wakes up during the night, this should not be taken as a sign that they are developing abnormally, either mentally or physically.

It sometimes may feel like there is nothing you can do to help your baby fall asleep, but there are helpful steps you can take. Keep in mind that babies do not usually develop stable sleep cycles before they are 3 months old, so some of these tips may be more helpful for older babies.

• Develop a bedtime routine: Having a regular bedtime routine can help babies fall asleep, sleep longer, and have better quality sleep. A bedtime routine can include feeding, cuddling, and rocking or walking with the baby.

• Lay your baby down before they fall asleep: Babies who go to bed drowsy but not completely asleep learn to fall asleep by themselves.

• Watch for tiredness cues: Babies may cry, rub their eyes, or become fussy when they are sleepy. These cues indicate that it is time for a nap or bedtime.

• Do not immediately respond to every noise: Older babies who make noise do not always need to be fed or changed. Allow them a few minutes to calm themselves before checking in.

• Create a dark, quiet environment: Keeping a baby’s room quiet and dark at night helps them sleep and decreases the chance of them waking up.

• Swaddle your baby: Most helpful for newborns, swaddling can help your baby sleep better and longer. The American Academy of Pediatrics provides safe sleep guidelines for swaddling newborns.

• Reduce activity: Cutting down your activity as bedtime nears can help babies calm down for sleep.

• Focus on what is needed: Nighttime feedings and diaper changes should be kept brief and as calm as possible. Once you have taken care of your baby’s immediate needs, you can put them back to bed.

• Encourage play during the day: Activity during the day encourages your baby to stay awake for longer periods of time. Having longer wake times can increase your baby’s sleep time at night.

What Is Sleep Training?

Sleep training methods are ways to help babies learn to soothe themselves and fall asleep on their own. There are several options for sleep training that parents may wish to try. Sleep training should be attempted only with babies who are at least 6 months old, as these methods are not effective for younger babies.

• Cry-it-out method: In this method, parents and caregivers allow their babies to cry themselves back to sleep when they wake up at night. Over time, this may decrease the amount that a baby cries and may help the baby learn to self-soothe.

• Controlled crying: Instead of ignoring all crying, caregivers check in with their crying baby but take a longer time to do so on each occasion. Like the cry-it-out method, this may help babies calm themselves.

• Camping out method: Caregivers who “camp out” stay in their baby’s room until the baby falls asleep, but they do not pick up or touch the baby and talk very little, even if the baby cries.

• Bedtime fading: Bedtime fading, also known as sleep fading, involves parents slowly adjusting their baby’s bedtime either earlier or later to achieve the desired bedtime.

• Scheduled awakening: A scheduled awakening involves waking a baby shortly before they would normally wake up on their own for feeding and soothing.

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Sleep regressions are disruptions in a baby’s established sleep patterns. They may develop at various points throughout a baby’s first few years and can accompany spurts in growth and development.

Sleep regressions can be disheartening to parents, especially if their baby had finally been sleeping through the night. But ups and downs in a baby’s sleep are normal and usually do not last long.

Sleep disruptions may arise at any point since babies develop along different timelines, but there are certain time frames when parents often note a step back in their child’s sleep.

• 4-month sleep regression: By 4 months old, babies are transitioning from erratic newborn sleep patterns to more organized sleep guided by circadian rhythms. This transition is not always easy for babies and can result in sleep disruptions.

• 6-month sleep regression: At 6 months, a baby’s teeth may begin to grow in, which can interfere with their sleep. Overstimulation and illness can also disrupt a 6-month-old baby’s sleep.

• 8-month sleep regression: At 8 months old, many babies develop the ability to move out of a sleeping position and may become anxious about being separated from their parents or caregivers. Ongoing teething may also contribute to sleep regression.

• 12-month sleep regression: Many of the same causes of 8-month sleep regressions can also disrupt sleep for 12-month-olds. Additionally, separation anxiety may intensify at this age.

• 18-month sleep regression: Separation anxiety may continue at 18 months, accompanied by greater independence and the increased possibility of nightmares. All of these can lead to interrupted sleep.

While riding out a baby’s sleep regression, try to stay consistent with bedtime routines. Consistency can help get them back on track and back to sleep.

Parents and caregivers understandably want to make sure their babies are safe while sleeping. There are a number of steps you can take to create a safe sleeping environment for your baby.

• Share a room: While sharing a bed with your baby is not recommended, sharing a room with your baby can help keep them safe. Try keeping their crib or sleep space in your room for at least the first six months to one year.

• Lay your baby on their back: Your baby should be placed on their back to sleep until their first birthday, even if they are able to roll onto their stomach. If your baby does roll onto their stomach, you do not need to roll them back since they are developmentally able to do that on their own.

• Keep their sleep space clear: Stuffed animals, blankets, pillows, toys, and bumper pads should not be in your baby’s bed. Their sleep space should only consist of a mattress and fitted sheet.
• Dress them for the weather: You don’t want your baby to get too warm while they are sleeping. Keep their clothes appropriate for the temperature of the room and only dress a baby in one more layer than you would dress yourself.

About The Author

Dr. Michael Breus

Clinical Psychologist, Sleep Medicine Expert

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Michael Breus, Ph.D is a Diplomate of the American Board of Sleep Medicine and a Fellow of The American Academy of Sleep Medicine and one of only 168 psychologists to pass the Sleep Medical Specialty Board without going to medical school. He holds a BA in Psychology from Skidmore College, and PhD in Clinical Psychology from The University of Georgia. Dr. Breus has been in private practice as a sleep doctor for nearly 25 years. Dr. Breus is a sought after lecturer and his knowledge is shared daily in major national media worldwide including Today, Dr. Oz, Oprah, and for fourteen years as the sleep expert on WebMD. Dr. Breus is also the bestselling author of The Power of When, The Sleep Doctor’s Diet Plan, Good Night!, and Energize!

• POSITION: Combination Sleeper
• TEMPERATURE: Hot Sleeper
• CHRONOTYPE: Wolf

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