Infant sleep amounts

Newborn Sleep Patterns | Johns Hopkins Medicine

What are the sleep patterns of a newborn?

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 during the day.

Generally, newborns sleep a total of about 8 to 9 hours in the daytime and a total of about 8 hours at night. But because they have a small stomach, they must wake every few hours to eat. Most babies don’t begin sleeping through the night (6 to 8 hours) until at least 3 months of age. 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 such as an ear infection. 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.

What are the different 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 is 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 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.

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.

Helping your baby sleep

Babies may not be able to form their own sleeping and waking patterns, especially in going to sleep. 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.

What are the signs of sleep readiness?

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

Rubbing eyes
Yawning
Looking away
Fussing

How can you help your baby fall asleep?

Not all babies know how to put themselves to sleep. When it is 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 begin to expect to be in your arms in order 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.

Sleep and Your Newborn (for Parents)

Newborns don't yet have a sense of day and night. They sleep around the clock, and because their tiny stomachs don't hold enough breast milk or formula to keep them satisfied for long, they wake often to eat — no matter what time of day or night it is.

How Long Will My Newborn Sleep?

Newborns should get 14–17 hours of sleep over a 24-hour period, says the National Sleep Foundation. Some newborns may sleep up to 18–19 hours a day.

Newborns wake every couple of hours to eat. Breastfed babies feed often, about every 2–3 hours. Bottle-fed babies tend to feed less often, about every 3–4 hours.

Newborns who sleep for longer stretches should be awakened to feed. Wake your baby every 3–4 hours to eat until he or she shows good weight gain, which usually happens within the first couple of weeks. After that, it's OK to let your baby sleep for longer periods of time at night.

The first months of a baby's life can be the hardest for parents, who might get up many times at night to tend to the baby. Each baby has a different sleep pattern. Some start to sleep "through the night" (for 5–6 hours at a time) by 2–3 months of age, but some don't.

How Should Babies Sleep?

During the first weeks of a baby's life, some parents choose to room-share. Room-sharing is when you place your baby's crib, portable crib, play yard, or bassinet in your own bedroom instead of in a separate nursery. This keeps baby nearby and helps with feeding, comforting, and monitoring at night. The American Academy of Pediatrics (AAP) recommends room-sharing without bed-sharing.

While room-sharing is safe, putting your infant to sleep in bed with you is not. Bed-sharing increases the risk of SIDS (sudden infant death syndrome) and other sleep-related deaths.

Follow these recommendations for a safe sleep environment for your little one:

Always place your baby on their back to sleep, not on the stomach or side. The rate of SIDS has gone way down since the AAP began recommending this in 1992.
Use a firm, flat sleep surface. Cover the mattress with a sheet that fits snugly.
Do not put anything else in the crib or bassinet. Keep plush toys, pillows, blankets, unfitted sheets, quilts, comforters, sheepskins, and bumper pads out of your baby's sleep area.
To avoid overheating, dress your baby for the room temperature and don't overbundle. Don't cover your baby's head while they're sleeping. Watch for signs of overheating, such as sweating or feeling hot to the touch.
Keep your baby away from smokers. Secondhand smoke increases the risk of SIDS.
Offer a pacifier to your baby at sleep time, but don’t force it. If the pacifier falls out during sleep, you don’t have to replace it. If you're breastfeeding, wait until breastfeeding is firmly established.
Watch out for other hazards, such as items with cords, ties, or ribbons that can wrap around a baby's neck, and objects with any kind of sharp edge or corner. Look around for things that your baby can touch from a seated or standing position in the crib. Hanging mobiles, wall hangings, pictures, draperies, and window blind cords could be harmful if they are within a baby's reach.
Don’t let your baby fall asleep on a product that isn’t specifically designed for sleeping babies, such as a sitting device (like a car seat), a feeding pillow (like the Boppy pillow), or an infant lounger (like the Dock-a-Tot, Podster, and Bummzie).
Don’t use products or devices that claim to lower the risk of SIDS, such as sleep positioners (like wedges or incliners) or monitors that can detect a baby’s heart rate and breathing pattern. No known products can actually do this.
Don’t use weighted blankets, sleepers, or swaddles on or around your baby.
Make sure that all sleep surfaces and products you use to help your baby sleep have been approved by the U.S. Consumer Product Safety Commission (CPSC) and meet federal safety standards.

Helping Your Newborn Sleep

Newborns follow their own schedule. Over the next couple of weeks to months, you and your baby will begin to settle into a routine.

It may take a few weeks for your baby's brain to know the difference between night and day. Unfortunately, there are no tricks to speed this up, but it helps to keep things quiet and calm during middle-of-the-night feedings and diaper changes. Try to keep the lights low and resist the urge to play with or talk to your baby. This will send the message that nighttime is for sleeping. If possible, let your baby fall asleep in the crib at night so your little one learns that it's the place for sleep.

Don't try to keep your baby up during the day in the hopes that your little one will sleep better at night. Overly tired infants often have more trouble sleeping at night than those who've had enough sleep during the day.

If your newborn is fussy it's OK to rock, cuddle, and sing as your baby settles down. Swaddling (wrapping the baby in a light blanket) can also help to soothe a crying baby. If you swaddle your baby and they start trying to roll over, that is a sign that you can stop swaddling. For the first months of your baby's life, "spoiling" is definitely not a problem. In fact, newborns who are held or carried during the day tend to have less colic and fussiness.

When Should I Call the Doctor?

While most parents can expect their newborn to sleep or catnap a lot during the day, the range of what is normal is quite wide. If you have questions about your baby's sleep, talk with your doctor.