Normalizing infant sleep
Reviewed by Dr. Laurie Jones
There’s something beautiful about watching a newborn baby sleep, especially after a feeding or a long period of crying. You may feel a blissful moment of peace (and accomplishment, let’s be honest) as your baby rests. In your first three postpartum months, any sleep you can find (for you or your baby) is welcome and rewarding.
It’s commonly understood that newborns need a lot of sleep. (Eat-sleep-cry-poop, right?) But the nature of infant sleep—what it can look and sound like, and how best to facilitate it—may feel confusing or downright daunting, as you begin your motherhood adventure.
Even if you’ve spent a lot of time around newborns, your baby’s sleeping preferences and patterns likely won’t match your expectations. Not to worry. Chances are, like everything else that seems strange or unfamiliar about parenting, it’s all probably perfectly normal—and bound to change!
Nature of infant sleep
One of the first things you might notice, once you’ve brought your baby home, is the noises he or she makes when sleeping. You may at first think that you are hearing a small animal growling, giggling, burbling, or screeching. And thanks to your elevated levels of the hormone oxytocin, which are associated with excessive alertness, these sounds may alarm you and prompt you to wonder if your baby is OK. (The answer is most likely yes.)
Babies make funny noises, but most of them aren't cause for alarm. Get familiar with these sounds.
“New parents’ brains are wired for hyper alertness,” says Emily Varnam, a midwife assistant and birth and postpartum doula, and infant sleep sounds can be downright jarring.
Infants often are quite active while sleeping. They may flutter their eyelids, grunt, stretch their limbs, breathe rapidly, or even cry, before returning to a quiet stillness. Unbeknownst to new parents, they did some of these things while sleeping in the womb too.
“Babies have active and quiet periods in utero,” says Dr. Laurie Jones, a pediatrician and founder of Dr. MILK (Mothers Interested in Lactation Knowledge). And when your baby is born, voilà, you can finally see and hear the action you’ve been feeling.
Newborns naturally know their days from nights.
“Exposure to sunlight sets the body clock for day and night outside the womb,” Dr. Jones says. Especially during the first month, she says, taking your baby out on two 15- to 20-minute walks per day, exposing your baby's face and limbs to sunlight, is helpful in making this adjustment.
Duration of infant sleep
Newborns sleep a bit like cats. The average newborn sleeps between 16 and 18 hours a day—that’s about 70 percent of the day!—but this isn’t all detectable by the human eye. Eight to nine of those hours are at night, and the rest consists of daytime naps, snoozes, and other bits of sleep—far more during the day than you might have expected.
“Parents cannot monitor this, even if they try,” Dr. Jones says. “The actual sleep parents can observe is different from brain wave sleep through some of the lighter sleep stages.”
Dr. Jones generally advises parents to not attempt to track their babies’ sleep hours—and to try to not worry about how much sleep they’re getting.
“Infants cannot deprive themselves of sleep in any way that would hurt their body,” she says. A teenager can, but barring parental neglect in a dangerous environment, “infants and younger children will get the brain sleep their body needs to grow and thrive on their own, without any parental intervention.”
In general, newborns in good health sleep no fewer than 11 hours and no more than 19 hours per day. If your baby’s sleep hours in a 24-hour window are well outside either end of this 11- to 19-hour range, check for signs of illness:
- Take your baby’s temperature (does he have a fever?)
- Track your baby’s daily number of stools and/or wet diapers. For each day of life, a void and a stool are added until you reach day 5. From day 5 through day 30, you can expect about six to eight urine discharges, and six to eight stools, per day.
- Note how your baby responds to sleep, feedings, or being held (is she inconsolable?)
If in doubt, don’t hesitate to call your pediatrician, who likely will want to check on your baby’s body, including weight, length, ears, and lungs.
“It doesn’t matter how many times you ask for reassurance—it’s OK to ask those things, because you aren't crazy. Babies aren’t invincible,” midwife Varnam says. Your pediatrician wants to help you understand what’s normal—and what may not be. You are the best witness of your baby’s behavior, even if you aren’t 100 percent sure of what you’re experiencing.
You can immediately train your infant to sleep through the night.
We know how much you want to reach that “sleep through the night” milestone, but as Dr. Jones explains it, “there’s a disconnect between the medical definition and cultural norms. The medical definition is five hours of continuous sleep, but culturally, it usually means 10 to 12 hours.”
“You might witness a five-hour stretch at 8 weeks,” Dr. Jones says. “Some babies hit that sooner, some later. Some don’t sleep a full 10 hours until after 12 months. But if you’re feeling the need to sleep-train under 3 months, you don’t have enough help.”
When to start establishing routines
As parents, it’s tempting to want to impose our sleep desires on our babies—adults need sleep too! But babies will do what babies do, and that’s sleep, eat, cry, and need diaper changes. It’s all good.
“Parents really can’t enforce routines on infants before their brain will let them. You observe the infant for their routine,” Dr. Jones says.
Once you start observing some patterns, it is easier to gently introduce routines, rhythms, and sleep associations. There’s definitely some value to the process. Dr. Jones says a bedtime routine should be simple, dependable, and easily repeatable.
“It can be three to four simple steps. Babies do like a predictable sequence to create positive, dependable sleep associations,” she says, particularly at night. “This helps them connect the dots so when there are partial awakenings, the same associations will help them get back to sleep. Maybe it’s a quiet, dark room with a sound machine. Maybe it’s soft music and singing a song to your baby beforehand. Keep it short and sweet.” And make it your own—you’ll experiment and intuitively find out what works for your baby.
Once you have started to introduce elements of a routine, you might be wondering if there are some general benchmarks for when baby sleep becomes a little more predictable—or when it’s time to differentiate between daytime and nighttime routines.
“Around 3 to 4 months is the earliest time that daytime naps become predictable. But even if you identify these times, you may not be able to live your life around these naps,” Dr. Jones says. You inevitably will need to break from any established routine to run errands or take care of older siblings, she says. Don’t stress; this is OK. Your baby will get enough sleep.
Babies need perfect daytime naps in their crib at home in a darkened room. Otherwise, they develop bad nighttime sleep habits.
However, in terms of observable sleep, if the nap is taking place in your infant’s dedicated sleep space, and they’re going for several hours at a clip, you might wonder if you should wake up your baby. “Sometimes that third nap [or whatever the last nap of the day is for your baby] can bump into bedtime,” says Dr. Jones. In those cases, she suggests waking babies up at least two hours before you want to put them down to sleep at night. “Otherwise you will be forcing them to sleep, and they won’t be ready, but if you deprive them completely of that third nap, they will have the most horrible bewitching hours,” she says. Withholding that third nap entirely, then, is not a great idea for your baby—or you.
See our guide on sleep zones to learn more about the best and safest places for your baby to catch some zzzs.
EXPLORE SAFE SLEEPING
Safety first
Infants are generally good at getting the sleep they need. In short, your job is to not get in the way. Because most newborns can and will sleep just about anywhere (and sleep disorders are rare), focus not so much on sleep optimization as on sleep safety.
Here are some of the more common safe sleeping zones to consider setting up for your baby, as well as some scenarios to avoid at all costs.
A bassinet (like a portable crib) is a bed designed specifically for babies from birth to six months. The height is often adjustable to help you put your baby within arm's reach of your bed at night. Because they’re portable, bassinets can be a good option for daytime napping in other areas—and crucially, they provide a contained, flat surface.
“We overestimate the softness an infant needs for sleep,” says Dr. Laurie Jones, a pediatrician and founder of Dr. MILK (Mothers Interested in Lactation Knowledge). “Simple and firm is always better.”
A baby box is a simple bassinet made of strong cardboard. Originating in Finland, it’s fitted with a mattress and heralded for being safe, affordable, and portable.
“We have to ‘de-program’ ourselves from our modern consumption culture that says, ‘The more stuff you buy and put near baby, the more you love your baby, and the safer your baby will sleep,’” Dr. Jones says. “The opposite is true; the more stark and simple the sleep environment, the safer for the young infant.”
A crib is a dedicated infant bed with high slatted sides. While many cribs are rectangular and fitted with a standard mattress size, some are oval or circular, and some transition into a toddler bed.
“Whether your baby takes the breast or bottle, they should be on a firm, flat sleep surface, ideally in the same room with parents for the first months,” Dr. Jones says. “Try to make it to six months to move your baby to a crib, and ideally past four months.”
Babywearing is as old as parenthood itself, and it brings many benefits, including bonding. Because babies like closeness with their parents, babywearing can be a helpful way to get them to sleep—all while you or your partner go about other household chores, help siblings, or head out on a walk.
“You cannot spoil babies by holding or wearing them,” says Chris Raines, a perinatal psychiatric nurse practitioner. “Some babies need that attachment.” With a baby carrier, she adds, “you can continue to do the things you need to do.”
A pram is a type of stroller designed specifically for newborns. Shaped like a bassinet, it allows young babies to sleep on their backs on a firm, flat surface, and look back up at the person pushing the stroller.
Many modern strollers now come with a pram setting, allowing a newborn to start sleeping flat and transition to a more upright position. The motion of a stroller can help lull your baby to sleep while you get a little exercise and fresh air.
Let’s be real: Whether or not it’s your goal, your baby will sometimes fall asleep being held. If you have the time and aren’t sleepy yourself, that’s fine! Your baby gets biological benefits from close contact, including bonding and brain development.
If it’s not practical to hold your baby during a nap, but you want to sustain that closeness, you (or a caregiver) can try babywearing. “The mother thinks she has to do all the holding that a village used to do,” Dr. Jones says. “But it's not all on you.”
The motion and white noise of a drive or stroll can lull babies to sleep. While it might be tempting to keep your sleeping baby in a car seat after removing the seat from its base or stroller adapter, a baby’s airways can become compromised when the seat leaves its correct angle.
“Car seats are not a safe place for an infant to sleep when not restrained and aligned properly,” Dr. Jones says. Letting your baby nap for up to an hour in a car or stroller is OK, but when a car seat is placed on another surface, it’s no longer safe for sleeping.
Just as there are safe places for babies to sleep, there are some to avoid:
- Near anyone smoking
- On anyone sleeping or impaired (taking pain or sleep meds or using drugs)
- In a swing—these were designed for alert infants (babies should be moved for naps)
- Any place a baby can fall, like a couch, adult bed, or nursing pillow
- On any surface that cannot support a baby’s back
- Within reach of loose material, like blankets and bumpers
- On the floor, if within reach of pets, siblings, or small objects
- Anywhere a caretaker cannot hear or otherwise observe them
Growth spurts
If there’s one thing you can count on as a mom, it’s the fact that once you’ve figured something out with your baby, it’s likely to change. That’s because your baby is constantly changing.
During growth spurts, which usually last a couple days, and often occur when your baby is 2 to 3 weeks old, 6 weeks old, and 3 months old, your baby will be hungrier and waking more often to feed. These spurts aren’t exactly linear or 100 percent predictable—and they may not be easy to detect.
“All bets are off during the first 4 to 6 weeks,” Dr. Jones says. “It’s like one continuous growth spurt.”
How to respond to crying
There are many reasons why babies wake up crying. Sometimes they are hungry, sometimes they need a diaper change, sometimes they need help releasing some gas, and sometimes they just want to be held.
“Sometimes they cry and wake up just to make sure you’re still there,” Dr. Jones says. Other times, they’re in the middle of a sleep cycle, and it may resolve itself. But most cries require a response.
“For infants under 3 months, you have got to respond. They’re still a little bit of a stranger, like your freshman year roommate. How long did it take you to get to know them?” Dr. Jones says.
As newborns’ vision develops, they identify their close adults by sounds and smells, and they cry to express any type of need. Meanwhile, it takes parents a while to learn their baby’s cues or figure out ways to soothe their baby. This is a learning curve every parent experiences.
The light at the end of the tunnel
Given these ongoing growth spurts and what feels like never-ending unpredictability, it may sound confusing to say that after intently observing your baby during the first few months, looking for cues to help establish routines, things become a little easier. Around month 3 or 4, daytime naps start to become more predictable, Dr. Jones says.
“The 4-month checkup is the easiest checkup. Everybody’s settled. There’s nothing to cover on my little sheet,” she says of the common pediatric appointment. At this point, the fussy stage is likely over, the mom has probably returned to work or school, and the baby, who hasn’t yet started crawling or otherwise moving around, doesn’t yet need solid foods, she adds. “It’s the happy zone.”
Additional resources
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