The average newborn sleeps much of the day and night, waking only for feedings every few hours. It is 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 - they think they are supposed to be awake at night and sleep in the daytime.
Generally, newborns sleep about eight to nine hours in the daytime and about eight hours at night. Most babies do not begin sleeping through the night (six to eight hours) without waking until at least three months of age, or until they weigh 12 to 13 pounds. However, this is very variable and some babies do not sleep through the night until closer to one year. Newborns and young infants have a small stomach and must wake every few hours to eat. In most cases, your baby will awaken and be ready to eat about every three 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 doctor to determine if it is necessary to wake a baby for feedings.
Watch for changes in your baby's sleep pattern. If your baby has been sleeping consistently, and suddenly is waking, there may be a problem such as an ear infection. Some sleep disturbances are simply due to changes in development or because of overstimulation.
Never put a baby to bed with a bottle propped for feeding. This is a dangerous practice that can lead to ear infections and choking.
Babies, like adults, have various stages and depths of sleep. Depending on the stage, the baby may actively move or lie very still. Infant sleep patterns begin forming during the last months of pregnancy--active sleep first, then quiet sleep by about the eighth month. There are two types of sleep:
A baby enters stage 1 at the beginning of the sleep cycle, then moves into stage 2, then 3, then 4, then back to 3, then 2, then to REM. These cycles may occur several times during sleep. Babies may awaken as they pass from deep sleep to light sleep and may have difficulty going back to sleep in the first few months.
Babies also have differences in how alert they are during the time they are awake. When a newborn awakens at the end of the sleep cycles, 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 in which the baby is attentive to sounds and sights, but moves actively. After this 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 is usually best to find a way of calming the baby and the environment. Holding a baby close or swaddling (wrapping snugly in a blanket) may help calm a crying baby.
It is 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.
Babies may not be able to establish their own sleeping and waking patterns, especially in going to sleep. You can help your baby sleep by recognizing 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.
Your baby may show signs of being ready for sleep when you see the following signs:
Although it is surprising, not all babies know how to put themselves to sleep. When it is time for bed, many parents want to rock or breastfeed a baby to help him/her fall asleep. Establishing a routine like this at bedtime is a good idea. However, be sure that the baby does not fall asleep in your arms. This may become a pattern and the baby may begin to expect to be in your arms in order to fall asleep. When the baby briefly awakens during a sleep cycle, he/she may not be able to go back to sleep on his own.
Most experts recommend allowing a baby to become sleepy in your arms, then placing him/her in the bed while still awake. This way the baby learns how to go to sleep on his own. Playing soft music while your baby is getting sleepy is also a good way to help establish a bedtime routine.
Research has found a link between sudden infant death syndrome (SIDS) and babies who sleep on their stomach (in the prone position).
Experts now agree that putting a baby to sleep or down for a nap on his or her back is the safest position. Side-sleeping has a higher risk for SIDS than back sleeping. Other reports have found soft surfaces, loose bedding, and overheating with too many blankets also increase the risk for SIDS. When infants are put to sleep on their stomachs and they also sleep on soft bedding, the risk for SIDS is even higher. Smoking by the mother is also a risk for SIDS, as are poor prenatal care and prematurity. Since the American Academy of Pediatrics (AAP) made the "back-to-sleep" recommendation in 1992, the SIDS rate has dropped more than 50 percent.
Back sleeping also appears to be safer for other reasons. There is no evidence that babies are more likely to vomit or spit up while sleeping on their back. In fact, choking may be more likely in the prone position.
A task force of The U.S. Consumer Product Safety Commission, the AAP, and the National Institute of Child Health and Human Development, offer the following recommendations for infant bedding:
The AAP recommends that parents room share but not bed share. The report advises the following:
To prevent overheating, the report recommends that the infant should be lightly clothed for sleep and the room temperature kept comfortable for a lightly clothed adult. Avoid over-bundling, and check the baby's skin to make sure it is not hot to the touch.
Additional research has found that infants should not be put to sleep on a sofa, alone or with another person, as this practice increases the risk for SIDS.
While babies should sleep on their back, other positions can be used during the time babies are awake and under supervision. Babies can be placed on their stomach while awake to help develop muscles and eyes and to help prevent flattened areas on the back of the head.
Additional recommendations from the AAP to reduce the risk for SIDS and and other sleep-related deaths in infants from birth to 1 year:
Click here to view the
Online Resources of Normal Newborn