Sleeping

Newborns sleep a lot during the first month of life. Your child may sleep anywhere from 12 to 20 hours per day with an average of 16 hours per day. The duration of this sleep is variable, from 15 minutes to 5 or 6 hours.

Most newborns awaken 1 to 3 times during the night in the first 3 months of life and the majority of infants can be expected to sleep through the night by 4 to 6 months of age. Many parents (and grandparents!) assume that these nighttime awakenings are related to their infant's need to eat. This may be part of the problem in the first 2 months, but there is much more to it.

Infants awaken several times during the night because they have an immature sleeping pattern. Two general patterns exist:

REM Sleep: This is an "active sleep" pattern in which babies display a lot of movement, restlessness, twitching, irregular breathing and brief awakenings. Infants may go through this pattern 2 - 4 times a night, resulting in a nighttime awakening at the end of each REM sleep pattern. Newborns have this pattern during 50% of their sleeping time (adults have 25%). No wonder babies wake up so much at night! Fortunately, this pattern decreases by age 3 - 4 months, allowing most children (and parents) to sleep through the night.

NON-REM Sleep: A "Quiet Sleep" pattern in which infants display less movement, a regular breathing pattern, and a deeper sleep in which it seems to be very difficult to awaken your baby.

Although most children learn to sleep through the night on their own, here are a few tips to follow to try to avoid future sleep problems:

Before 4 Months:

1. Keep 'em Cozy. Your newborn has been used to 9 months of close quarters while she was growing inside you. Keep her comfortable by swaddling her, using a small bassinet or crib, and keeping the room at about 68° to 72°F. Caution: don't overbundle, and don't use sheepskins, waterbeds or down comforters because of the risk of suffocation.
   
2. Give 'em their own space. Many parents prefer to have the child's bassinet in their own room. While this may calm your fears, you will wake up to every movement when your baby is going through REM sleep. Try to move your baby to her own room by one month of age.
   
3. Put your baby in the crib while awake. Let your baby learn to fall asleep without you. Crying for 15 to 20 minutes is not unusual. If necessary, rock her, but put her in the crib before she falls asleep. Background noise may also help to signal nap times or bed time. Try a radio, air conditioner, a musical toy, tapes of uterine sounds, or the white noise that comes from an unoccupied TV channel or radio frequency. Try to wean the use of noises by 4 months of age.
   
4. Establish a routine. A consistent daytime and nighttime ritual for naps and bedtime is extremely important. If your hectic schedule does not permit this, try to always be home for the same naptime every day.
   
5. Hold your baby for fussy crying. Children under 4 months need to be soothed. Respond to your baby. You will not spoil her.
   
6. Be brief during nighttime feedings. Save the fun stuff (singing, playing etc.) for the daytime.
   
7. Don't awaken your child during the night to change diapers. Wet diapers can be left until the morning, unless your child has a severe diaper rash.
   

Reviewed 9/5/2009
By Daniel Feiten MD
Greenwood Pediatrics