Babies and sleep: The ultimate guide
Whoever came up with expression “slept like a baby” to describe a restful slumber likely didn’t raise an infant.
In this ultimate guide, tuck into the details about sleep and babies, including how much they should sleep, their sleep and alert cycles, signs of trouble and more.
How much should a baby sleep?
A baby’s sleep needs varies by age, says Dr. Reshmi Basu, a pediatrician in the CHOC Primary Care Network. While newborns sleep much of the time, their slumber occurs in very short segments. As a baby grows, the total amount of sleep slowly decreases, but the length of nighttime sleep increases.
Generally, babies don’t have regular sleep cycles until they are about 6 months old. Newborns typically sleep a total of about eight to nine hours in the daytime and a total of about eight hours at night. But because they have small stomachs, they must wake every few hours to eat.
While this varies a lot, most babies don’t start sleeping through the night (six to eight hours) until at least 3 months of age. Some babies don’t sleep through the night until closer to 1 year.
In most cases, a baby will wake up to eat at least every three hours. How often a baby eats depends on what they are being fed and their age. Consult with your pediatrician to determine if a baby ought to be woken for feedings.
The following are the usual sleep needs per 24 hours for newborns through 2 years old:
- Newborns to first few months: 16 to 17 hours
- 4 to 12 months: 12 to 16 hours
- 1 to 2 years: 11 to 14 hours
What are babies’ sleep and alert cycles?
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.
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 they 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 the baby close or wrapping them snugly in a blanket 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.
Parents should watch for changes in a baby’s sleep pattern, Dr. Basu recommends. If the baby has been sleeping consistently but suddenly is waking more often, there may be a problem. The baby may also 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.
How long should babies be awake for?
While every baby is different, here’s a guide for knowing how long a baby might typically stay awake before going down for a nap or the night:
|Birth – 6 weeks||45 – 60 minutes|
|2 months||1 hour|
|3 months||1 – 1 ½ hours|
|4 months||1 ¼ – 1 ¾ hours|
|5 months||1 ½ – 2 ¼ hours|
|6 months||2 – 2 ½ hours|
|7 months||2 ¼ – 2 ¾ hours|
|8 months||2 ¼ – 3 hours|
|9 months||2 ½ – 3 hours|
|10 months||3 – 3 ½ hours|
|11 months||3 – 4 hours|
|12 months||3 – 4 hours|
|12 – 18 months (2 naps)||3 – 4 hours|
|12 – 18 months (1 nap)||4 ½ – 6 hours|
|18 – 24 months (1 nap)||5 – 6 hours|
|2 – 3 years (1 nap)||5 ½ – 7 hours (before nap)|
|3 – 4 years (1 nap)||6 – 8 hours (before nap)|
What are the symptoms of sleep problems in a baby?
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, says Dr. Basu. This is when a baby does not understand that separations from their parents are temporary. Babies may also start to have trouble going to sleep because of separation anxiety. They might also be 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. Dr. Basu recommends parents speak with their pediatrician should their baby begin having trouble going to sleep or staying asleep, especially if this is a new pattern.
What are signs that my baby is tired?
You can help your baby sleep by recognizing signs of sleep readiness, teaching them to fall asleep on their own, and comforting them with awakenings. Your baby may show signs of being ready for sleep by:
- Rubbing eyes
- Looking away
How can I help my baby fall asleep?
Babies may not be able to create their own sleeping and waking patterns. Not all babies know how to put themselves to sleep, and not all babies can get themselves back to sleep once awakened at night.
Here are things parents can do to help babies learn how to fall and stay asleep:
- Allowing time for naps each day as needed for the 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 the baby is getting sleepy.
- Tucking the baby into bed when they are drowsy, but before going to sleep.
- Comforting and reassuring the baby when they are afraid.
- For night awakenings, comfort and reassure the baby by patting and soothing. Don’t take them out of bed.
- If the 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 responses.
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, Dr. Basu says.
How can I help my baby sleep safely?
Safe sleep is critically important. Here are recommendations from the American Academy of Pediatrics (AAP) on how to reduce the risk for sudden infant death syndrome (SIDS) and other sleep-related infant deaths from birth to 1 year old:
First, know the ABCs of safe baby sleep:
- A is for alone. Put baby to sleep alone in their crib. Keep soft items like toys, crib bumpers and blankets out of the crib.
- B is for back. Make sure to lay a baby down to sleep on their back. “Back to sleep” is safest to reduce risk of SIDS.
- C is for crib. Babies should sleep on a firm surface such as a crib, bassinet or portable crib that meets safety standards.
Here are some other ways to ensure safety:
- Maintain a proper vaccination schedule. An infant who is fully immunized may reduce their risk for SIDS.
- Place the 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 a baby on their side or stomach for sleep or naps.
- Always talk with a pediatrician before raising the head of the crib if the baby has been diagnosed with gastroesophageal reflux.
- Offer the baby a pacifier for sleeping or naps.
- 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, play yard or a bassinet. That can reduce the risk of the baby getting stuck between the mattress and the sides. It can also reduce the risk of suffocation and SIDS.
- The AAP recommends that infants sleep in the same room as their parents, close to their parents’ bed, but in a separate bed or crib appropriate for infants. This sleeping arrangement is recommended ideally for the baby’s first year, but it should be maintained for at least 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 a baby away from others who are smoking and places where others smoke.
- Don’t over bundle, overdress or cover a baby’s face or head.
- Don’t use loose bedding or soft objects (bumper pads, pillows, comforters, blankets) in a baby’s crib or bassinet.
- 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 not been shown to reduce the risk of SIDS. In rare cases, they have caused infant deaths.
- Always place cribs, bassinets, and play yards away from dangling cords, wires or window coverings. This can reduce the risk for strangulation.
How can I swaddle my baby safely?
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. Special swaddling blankets are available for purchase to help make swaddling easier.
Parents shouldn’t swaddle a baby if they are age 2 months or older, or if the baby can roll over on their own. Swaddling may raise the risk for SIDS if the swaddled baby rolls onto their stomach.
When swaddling, parents should give the baby enough room to move their hips and legs, Dr. Basu says. The legs should be able to bend up and out at the hips. Don’t place the 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 a baby if the weather is warm or hot. Using a thick blanket in warm weather can make a baby overheat. Instead use a lighter blanket or sheet to swaddle the baby.
Here is a step-by-step guide for swaddling, as well as a video from a CHOC neonatal nurse offering quick tips to calm a baby.