Sleep…how wonderful it is. You will come to appreciate it more and more during your baby’s infancy, particularly uninterrupted sleep. But we are supposed to be talking about your baby’s sleep, not yours… Of course, getting your baby to sleep well is essential for you to get enough sleep. Getting enough sleep is quite important for mom’s health and the health of the entire family.

Sleep is a major concern for many parents, both in the newborn period and very often during the next few months. While this book will cover newborn sleep, much more information is available in our Infant Sleep Guide on our website.

It may seem strange, but sleep is also one of the main safety issues with babies. It is important not only for everyone’s sanity, but where and how your baby sleeps is an essential part of keeping your baby healthy and safe.

Normal newborn sleep patterns

Newborns sleep about 14-18 hours a day at first, in mostly short periods every hour or two. They eat about every 3-4 hours. At first, your baby will probably sleep between most feedings during the day. Eat-sleep-pee-poop-repeat. They are not really naps at this point; for the most part, if a newborn is not eating, she is probably sleeping.

This will change pretty quickly. You will notice that your baby is awake more between feeds. Your baby may sleep better between some feedings and not as well or at all between others. Your baby may start to sleep longer between feedings at night. Your baby will likely settle into more of a routine, and this is a good thing. There are ways you can help your baby do that.

You may have to wake your baby up sometimes if it is time for a feeding. It is usually a good idea to do this; too much sleeping during the day and your baby may not sleep as well at night. You should also wake your baby in the morning when it is time to start the day; sometimes babies are sleeping through the night, but their night is from 3 am to 10 am. They can get their days and nights mixed up, and this does not fit in with most parents’ schedules!

Most babies can sleep through almost anything. However, some startle easily and wake themselves up; temperament also plays a role (see section on Temperament).

Understanding newborn sleep

Types of sleep

There are two basic types of sleep: REM (rapid eye movement) dreaming sleep, and non-REM sleep, which has several stages of lighter and deeper sleep.

  • REM sleep: active, making noise, dreaming, moving
  • Non-REM sleep: deeper sleep, relaxed, quiet

Infants spend more than half their sleep in REM sleep! That means a sleeping baby can be noisy and moving around. Older babies, children and adults spend only 20% of sleep in REM. REM sleep is the first part of sleep for newborns and infants until about 4-6 months old, then it changes to starting with non-REM sleep. Also around 4-6 months old, non-REM sleep becomes more organized into 4 stages.

Sleep cycles

Everyone at every age moves back and forth between types of sleep and lighter and deeper sleep. For older infants, children and adults, the sleep cycle is about 90 minutes. For babies, it is about 60 minutes. That means that every hour, your baby will be in a much lighter stage of sleep. They may be almost awake, then fall back asleep again.

Newborn adjustments

Your baby has been living in a dark, warm, quiet, cushioned environment for 9 months. In the womb, there was not really night and day. No feedings. No hunger. No gas. No wet or dirty diapers. Now, suddenly, there is light, and noise, day and night, and feedings. Your baby has a lot to adjust to!

I really don’t know why we don’t think about it, but for some reason we all expect babies to fit in with this rhythm pretty quickly. We all expect them to wake at night to eat, but we don’t expect them to completely reverse their days and nights! We don’t appreciate the adjustment they have to make.

The other thing many parents fail to realize is that babies have to learn just about everything, including how to fall asleep. Sleep habits and routines are learned. And you can teach good habits to your baby!

What this all means

  1. Your baby will make noise and move around while still asleep. Moving and making noise does not always mean it is time to feed your baby or get her up or move her or check on her.
  2. Your baby will be in stages of very light sleep and may even cry a little or act half-awake. You can wait to see if your baby falls back asleep or is really waking up. You don’t need to respond right away.
  3. You baby has to adjust! Be patient! The first few weeks can be rough, but they will get better, especially if you do the right things. This stage will pass! In fact, most babies can sleep through the night by 4-6 months old.
  4. Sleep changes in babies around 4-6 months old, which is the time they need to start a bedtime routine and learn good sleep habits
  5. Your baby has to learn how to fall asleep, stay asleep, and other good sleep habits. That means that it is your job, as the parent, to teach your baby and develop in him the right habits.
  6. Baby monitors or keeping baby in your room too long can be unhelpful because it causes you to respond to normal noises or light sleep stage.

Healthy sleep habits: never too early!

Never put your baby in bed with bottle; keep feeding and sleeping as separate activities. It can cause sleep problems if they are not kept separate. It is also not as safe, and is not good for your baby’s mouth or teeth once they arrive.

To encourage your child to sleep well at night, start to train her once she is a few weeks old and is feeding and growing well. You want to lie her down as she is getting drowsy during the day and let her learn to self-comfort and to put herself to sleep. If you always rock, hold, or feed your baby to sleep, this will become a habit and your child will wake up at night and cry even once she does not need to eat at night. She won’t know how to go back to sleep without whatever she is in the habit of having to fall asleep. To avoid this, teach her to put herself to sleep once she is a few weeks old.

Sleep location

Your baby will sleep in many locations; in fact, babies seem to be able to sleep anywhere. She will fall asleep in your arms, lying on your chest, while eating, in the stroller, swing, and car seat. But for the most part, you will have one particular place where your baby sleeps. Current recommendations are for the baby to sleep in your room for the first 6-12 months.

Your room

One very convenient option is to have your baby sleep in your room. This makes feeding at night easier. There are some bassinets that can attach to your bed, making feeding, especially breastfeeding, even easier. This removes the dangers of co-sleeping noted above. If your baby sleeps in your room, you should be aware that babies make a lot of noises while they sleep. They also partially wake up and stir, without necessarily needing to feed. Some parents find it hard to sleep with the baby making these noises, but it does not bother others. Many parents find it comforting to have the baby nearby and to be able to hear that the baby is breathing normally.

Sleeping in your room may reduce the risk of sleep related death and SIDS by up to 50%. Current sleep guidelines recommend sleeping in your room for the first 12 months or at least for the first 6 months of life. Current breastfeeding guidelines also recommend sleeping in the room with you.

Baby’s room

Some parents choose to have the baby sleep in a separate room right from the start. Most parents who choose this option use a baby monitor to hear what is going on in the baby’s room. Baby apnea monitors are NOT recommended. Sleeping in a separate room is associated with a higher rate of SIDS, especially during the first 4-6 months of life, though back sleeping and other safe sleep practices may lower this risk. If you choose this option, be sure to follow all of the safe sleep guidelines.

Sleep area

Babies can sleep in a crib or bassinet in either the parent room or their own room.

They now make side car bassinets that are at bed level and go right next to the bed; they may have a side that opens onto the bed. This makes breastfeeding easier at night, as well as bottle feeding and general baby care, but provides a safe area for the baby to sleep.

They also now make small baskets to place in the bed next to you that provide a safe area for the baby to sleep. This is much more common in other countries. Note that there is NOT research yet on side car bassinets or bed baskets as to safety.

Crib and bassinet safety

  • Be sure that your baby’s crib, bassinet, or other area meets current safety standards and has not been recalled. This is especially important if the crib is used; many older cribs are not safe.
  • Drop-side cribs are not safe and are no longer recommended or manufactured in the United States.
  • Make sure the crib, bassinet or play area has all its parts, that it is put together correctly, and that no parts are broken or sharp.
  • There should be no gap between the mattress or sleep surface and sides of the crib or sleep area. Allow no more than a width of 2 adult fingers between the crib mattress and frame.
  • Bars on cribs should be no more than 2 3/8 inches apart. Avoid hanging ribbons or ties from the crib.

Infant sleepers

Warning! Most infant sleepers were recalled in late 2019-early 2020 due to numerous infant deaths. Do not allow your baby to sleep in an infant sleeper or any other non-safe sleep space.

Swaddling

As discussed in the section on Fussy Babies, swaddling is often suggested as a means of helping fussy babies, or any baby, sleep. It may help some babies. It is generally safe as long as guidelines are followed. Never swaddle a baby 2 months old or older.

You can use a blanket for swaddling, but you can now also buy swaddle sacks or wraps that are easier to use and may be safer.

You can swaddle with arms in or arms out, depending on your baby’s preference. Younger babies may prefer to have arms in.

Safe swaddling

  • Swaddled baby must sleep on its back
  • Legs must be free to move, pulled up into more of a frog-leg position, not forced to be straight
  • Can fit 2-3 fingers between blanket or wrap and the baby’s chest, not too tight
  • Do not swaddle after baby turns 2 months old, or if baby starts rolling over sooner
  • Make sure your baby is not getting too hot and overheated