Newborn sleep patterns

Newborns usually sleep for around 16 hours in every 24 hours. Newborns usually sleep in short bursts through the day and night. Each sleep usually lasts 2-3 hours. Some newborns sleep for up to four hours at a time. But all babies are different, and their sleep patterns can vary a lot. The average newborn sleeps much of the day and night, waking only for feedings every few hours. It’s often hard for new parents to know how long and how often a newborn should sleep. Unfortunately, there is no set schedule at first, and many newborns have their days and nights confused. Newborns don’t know that people sleep at night. They think they are supposed to be awake at night and sleep during the day. When newborns are awake, they’re usually feeding. After feeding, your baby will probably want to go back to sleep. This means that ‘playtime’ at this age is very short.

Sleep needs for babies vary depending on their age. Newborns do sleep much of the time. But their sleep is in very short segments. As a baby grows, the total amount of sleep slowly decreases. But the length of nighttime sleep increases.

Generally, newborns sleep a total of about 8 to 9 hours in the daytime and a total of about 8 hours at night. Newborns may not sleep more than 1 to 2 hours at a time, because they have a small stomach, they must wake every few hours to eat.

Most babies don’t start sleeping through the night (6 to 8 hours) without waking until at least 3 months of age or until they weigh 12 to 13 pounds. About two-thirds of babies are able to sleep through the night on a regular basis by age 6 months. But this can vary a lot. Some babies don’t sleep through the night until closer to 1 year. In most cases, your baby will wake up and be ready to eat at least every 3 hours. How often your baby will eat depends on what he or she is being fed and his or her age. Make sure you talk with your healthcare provider to figure out if you need to wake your baby for feedings.

Watch for changes in your baby’s sleep pattern. If your baby has been sleeping consistently, and suddenly is waking more often, there may be a problem. Or your baby may be going through a growth spurt and need to eat more often. Some sleep disturbances are simply due to changes in development or because of overstimulation.

Babies are little individuals so they are all different. The information below is a general guide and your baby might be different. Try not to spend too much time comparing how your baby sleeps with other babies.

Babies also have different sleep cycles than adults. Babies spend much less time in rapid eye movement (REM) sleep (which is dream time sleep). And the cycles are shorter. The following are the usual nighttime and daytime sleep needs for newborns through 2 years old:

Table 1. Newborn baby sleep patterns

Newborn sleep cycle

Newborns have two different kinds of sleep – active sleep and quiet sleep.

During active sleep, newborns move around a lot and make noises. They can be woken easily during active sleep.

During quiet sleep, newborns are still. Their breathing is deep and regular. They’re less likely to wake during quiet sleep.

When newborns sleep, they go through sleep cycles. Each newborn sleep cycle has both active sleep and quiet sleep, and takes about 40 minutes.

At the end of each cycle, newborns wake up for a little while. When your newborn wakes, he might grizzle, groan or cry. If your baby wakes at the end of a sleep cycle, you might need to help him settle for the next sleep cycle.

Birth to three months

• Newborns sleep on and off through the day and night.
• The total sleep varies between babies — it can be from around 8 to 18 hours a day.
• They tend to sleep only in short stretches because they need to be fed and changed regularly.
• Newborns generally sleep very lightly: they spend half of their sleeping time in active sleep.
• Also, a newborn has not learnt to sleep when it is dark. They usually start to learn this rhythm of day and night when they are about 6 weeks old. You can help your newborn to learn to sleep more at night by exposing them to light and playing with them during the day, and providing a dim and quiet environment at night.

Three to six months

• At this age, your baby might have 3 daytime naps of up to 2 hours each.
• Most will sleep 14-15 hours of sleep in total a day, with some babies sleeping up to 8 hours at night.
• The amount of active sleep starts to reduce and they begin to enter quiet sleep at the beginning of their sleep cycles.
• They still tend to wake up at least once during the night.

Six to 12 months

• From about 6 months old, your baby’s sleep patterns are more like yours.
• At this age, babies sleep an average of about 13 hours in total a day. They tend to sleep the longest period at night, averaging about 11 hours.
• Your baby will start dropping their number of daytime naps to about 2. Their naps are usually about 1 to 2 hours.
• In general, babies may wake up less frequently during the night because they don’t need to be fed as often.
• Most babies will wake only once during the night and need settling back to sleep. Some will still wake up more often.
• At this age, babies may start to worry about being away from their parent or carer. This may make it longer for babies to fall asleep and may temporarily increase night wakings.
• Regular daytime and bedtime routines may help your baby to fall and stay asleep.

After 12 months

From 12 months old, babies tend to sleep better. As they approach their first birthday, babies tend to sleep longer, wake up less often, take a nap once or twice during the day and sleep more at night. By the time they turn one year old, babies are likely to be sleeping 8 to 12 hours a night, waking only once or twice in that time.

At night newborn sleep and waking

In the first few months, it’s common for newborns to wake several times a night for feeds.

Between one and three months, your baby will probably start waking less often and have a longer period of sleep at night.

By the time your baby is around three months old, she might regularly be having a longer sleep at night – for example, around 4-5 hours. But up until six months of age, many babies still need feeds at night and help to settle.

If your baby is premature or low birth weight, your paediatrician or child and family health nurse might recommend that you let him sleep for only a certain amount of time at night before you wake him for a feed.

Normal baby sleep versus adult sleep

Babies under 1 are naturally lighter sleepers compared with adults. They spend more of their sleeping time in ‘active sleep’ instead of ‘quiet sleep’.

In active sleep, babies breathe shallowly and twitch their arms and legs. Their eyes flutter under their eyelids. Babies can be easily woken up from active sleep.

By comparison, adults and adolescents tend to have more quiet sleep, where they lie still and breathe deeply.

Everybody has a cycle, where their sleep varies from light to deep. Adults’ sleep cycles are usually about 90 minutes. Babies’ sleep cycles are usually about 40 minutes, so they tend to wake up more often.

Stages of newborn sleep

Sleep patterns in newborns are different from those in older children and adults. For newborns, sleep is about equally divided between rapid eye movement (REM) and non-REM sleep and follows these stages:

• Stage 1: Drowsiness, in which the baby starts to fall asleep.
• Stage 2: REM sleep (also referred to as active sleep), in which the baby may twitch or jerk her arms or legs, and her eyes move under her closed eyelids. Breathing is often irregular and may stop for 5 to 10 seconds—a condition called normal periodic breathing of infancy—then start again with a burst of rapid breathing at the rate of 50 to 60 breaths a minute for 10 to 15 seconds, followed by regular breathing until the cycle repeats itself. The baby’s skin color does not change with the pauses in breathing and there is no cause for concern (in contrast with apnea). Babies generally outgrow periodic breathing by about the middle of the first year.
• Stage 3: Light sleep, in which breathing becomes more regular and sleep becomes less active.
• Stages 4 and 5: Deep non-REM sleep (also referred to as quiet sleep). Twitching and other movements cease, and the baby falls into sleep that becomes progressively deeper. During these stages, the baby may be more difficult to awake.

Preemie sleep patterns

Don’t expect your preterm baby to sleep through the night for many months. Unlike a term baby, who might sleep a full 6 to 8 hours at night by 4 months of age, your baby may not accomplish this task until 6 to 8 months or later.

During this transition period, play with your baby during daytime awake periods. Keep night feedings as quiet and as businesslike as possible, with minimal or soft lighting. This will help your baby learn the difference between day and night and may help you get much-needed sleep at appropriate hours. But remember, it may take several weeks before your baby gets her days and nights straight.

Following a routine

Babies vary in how easily they settle down to sleep. Follow the same steps each time you put your baby down to sleep to help her learn a personal going-to-sleep routine. At first, you’ll probably jump up and go to your baby at the first crying sound. But as you get to know each other and as you notice your baby’s self-comforting skills, you need to allow your baby to console herself and go back to sleep on her own.

Self-comforting

Self-comforting is an important skill for your baby. Beginning early to teach your baby to fall asleep on her own will ease you through the later developmental stage (at 6–9 months corrected age) when sleep problems may emerge once again.

Setting the mood for sleep

To help your baby rest, try playing the radio softly or placing a ticking clock in the room for those first few weeks at home. In addition, a soft night-light may be reassuring to you both. Let your baby suck on her fist or a pacifier if this seems calming.

What are the signs of newborn baby sleep problems?

Once a baby begins to regularly sleep through the night, parents are often unhappy when the baby starts to wake up at night again. This often happens at about 6 months old. This is often a normal part of development called separation anxiety. This is when a baby does not understand that separations are short-term (temporary). Babies may also start to have trouble going to sleep because of separation anxiety. Or because they are overstimulated or overtired.

Common responses of babies having these night awakenings or trouble going to sleep may include the following:

• Waking and crying one or more times in the night after sleeping through the night
• Crying when you leave the room
• Refusing to go to sleep without a parent nearby
• Clinging to the parent at separation

Sleep problems may also happen with illness. Talk with your baby’s healthcare provider if your baby begins having trouble going to sleep or staying asleep, especially if this is a new pattern.

Helping your baby sleep

Babies may not be able to form their own sleeping and waking patterns, especially in going to sleep. Surprisingly, not all babies know how to put themselves to sleep. And not all babies can go back to sleep if they are awakened in the night. When it is time for bed, many parents want to rock or breastfeed a baby to help him or her fall asleep. Creating a bedtime routine is a good idea. But don’t let your baby fall asleep in your arms. This may become a pattern. And your baby may begin to expect to be in your arms in order to fall asleep. When your baby briefly wakes up during a sleep cycle, they may not be able to go back to sleep on their own.

You can help your baby sleep by knowing the signs of sleep readiness, teaching him or her to fall asleep on his or her own, and providing the right environment for comfortable and safe sleep.

Babies who feel secure are better able to handle separations, especially at night. Cuddling and comforting your baby during the day can help him or her feel more secure. Other ways to help your baby learn to sleep include:

• Allowing time for naps each day as needed for your baby’s age.
• Not having any stimulation or activity close to bedtime.
• Creating a bedtime routine, such as bath, reading books, and rocking.
• Playing soft music while your baby is getting sleepy.
• Offering a transitional object that your baby can take to bed. This may be a small blanket or a soft toy. But don’t do this before your baby is old enough. Your baby should be able to roll and sit. This will prevent the risk of suffocation.
• Tucking your baby into bed when he or she is drowsy, but before going to sleep.
• Comforting and reassuring your baby when he or she is afraid.
• For night awakenings, comfort and reassure your baby by patting and soothing. Don’t take your baby out of bed.
• If your baby cries, wait a few minutes, then return and reassure with patting and soothing. Then say goodnight and leave. Repeat as needed.
• Being consistent with the routine and your responses.

How can you help your baby fall asleep?

Not all babies know how to put themselves to sleep. When it’s time for bed, many parents want to rock their baby to sleep. Newborns and younger infants will fall asleep while breastfeeding. Having a routine at bedtime is a good idea. But if an older baby falls asleep while eating or in your arms, this may become a pattern. Your baby may then start to expect to be in your arms to fall asleep. When your baby briefly awakens during a sleep cycle, he or she may not be able to go back to sleep on his or her own.

After the newborn period, most experts recommend allowing your baby to become sleepy in your arms, then placing him or her in the bed while still awake. This way your baby learns how to go to sleep on his or her own. Playing soft music while your baby is getting sleepy is also a good way to help create a bedtime routine.

What are the signs of your baby’s sleep readiness?

You can help your baby sleep by recognizing signs of sleep readiness, teaching him or her to fall asleep on his own, and comforting him or her with awakenings.

Your baby may show signs of being ready for sleep when you see the following signs:

• Rubbing eyes
• Yawning
• Looking away
• Fussing

Alert phases of a newborn

Babies are also different in how alert they are during the time they are awake.

Quiet alert phase

When a newborn wakes up at the end of the sleep cycle, there is typically a quiet alert phase. This is a time when the baby is very still, but awake and taking in the environment. During the quiet alert time, babies may look or stare at objects, and respond to sounds and motion. This phase usually progresses to the active alert phase. This is when the baby is attentive to sounds and sights, and moves actively.

Crying phase

After the quiet alert phase is a crying phase. The baby’s body moves erratically, and he or she may cry loudly. Babies can easily be overstimulated during the crying phase. It’s usually best to find a way of calming the baby and the environment. Holding your baby close or wrapping your baby snugly in a blanket (swaddling) may help calm a crying baby.

It’s usually best to feed babies before they reach the crying phase. During the crying phase, they can be so upset that they may refuse the breast or bottle. In newborns, crying is a late sign of hunger.

Reducing the risk for sudden infant death syndrome (SIDS) and other sleep-related infant deaths

Here are recommendations from the American Academy of Pediatrics on how to reduce the risk for SIDS and sleep-related deaths from birth to 1 year old:

• Have your baby immunized. An infant who is fully immunized may reduce his or her risk for SIDS.
• Breastfeed your baby. The American Academy of Pediatrics recommends breastmilk only for at least 6 months.
• Place your baby on their back for all sleep and naps until they are 1 year old. This can reduce the risk for SIDS, breathing in food or a foreign object (aspiration), and choking. Never place your baby on their side or stomach for sleep or naps. If your baby is awake, give your child time on their tummy as long as you are watching. This can reduce the chance that your child will develop a flat head.
• Always talk with your baby’s healthcare provider before raising the head of the crib if your baby has been diagnosed with gastroesophageal reflux.
• Offer your baby a pacifier for sleeping or naps. If your baby is breastfeeding, don’t use a pacifier until breastfeeding has been fully established.
• Use a firm mattress that is covered by a tightly fitted sheet. This can prevent gaps between the mattress and the sides of a crib, a play yard, or a bassinet. That can reduce the risk of the baby getting stuck between the mattress and the sides (entrapment). It can also reduce the risk of suffocation and SIDS.
• Share your room instead of your bed with your baby. Putting your baby in bed with you raises the risk for strangulation, suffocation, entrapment, and SIDS. Bed sharing is not recommended for twins or other multiples. The American Academy of Pediatrics recommends that infants sleep in the same room as their parents, close to their parents’ bed. But babies should be in a separate bed or crib appropriate for infants. This sleeping arrangement is recommended ideally for the baby’s first year. But it should at least be maintained for the first 6 months.
• Don’t use infant seats, car seats, strollers, infant carriers, and infant swings for routine sleep and daily naps. These may lead to blockage of an infant’s airway or suffocation.
• Don’t put infants on a couch or armchair for sleep. Sleeping on a couch or armchair puts the baby at a much higher risk of death, including SIDS.
• Don’t use illegal drugs and alcohol, and don’t smoke during pregnancy or after birth. Keep your baby away from others who are smoking and places where others smoke.
• Don’t overbundle, overdress, or cover your baby’s face or head. This will prevent them from getting overheated, reducing the risk for SIDS.
• Don’t use loose bedding or soft objects (bumper pads, pillows, comforters, blankets) in your baby’s crib or bassinet. This can help prevent suffocation, strangulation, entrapment, or SIDS.
• Don’t use home cardiorespiratory monitors and commercial devices (wedges, positioners, and special mattresses) to help reduce the risk for SIDS and sleep-related infant deaths. These devices have never been shown to reduce the risk of SIDS. In rare cases, they have caused infant deaths.
• Always place cribs, bassinets, and play yards in places with no dangling cords, wires, or window coverings. This can reduce the risk for strangulation.

Caution on swaddling

Swaddling means wrapping newborn babies snugly in a blanket to keep their arms and legs from flailing. This can make a baby feel safe and help him or her fall asleep. You can buy a special swaddling blanket designed to make swaddling easier.

But don’t use swaddling if your baby is 2 months or older, or if your baby can roll over on his or her own. Swaddling may raise the risk for SIDS (sudden infant death syndrome) if the swaddled baby rolls onto his or her stomach.

When you swaddle, give your baby enough room to move his or her hips and legs. The legs should be able to bend up and out at the hips. Don’t place your baby’s legs so that they are held together and straight down. This raises the risk that the hip joints won’t grow and develop correctly. This can cause a problem called hip dysplasia and dislocation.

Also be careful of swaddling your baby if the weather is warm or hot. Using a thick blanket in warm weather can make your baby overheat. Instead use a lighter blanket or sheet to swaddle the baby.