Newborn Sleep Patterns

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 newborns mostly remain on a twenty-four hour clock — and when they are first home from hospital they often think they are supposed to be awake at night and sleep during the day.

Generally, newborns sleep about 7-8 hours in the daytime and about 8 hours at night. Most babies do not begin sleeping through the night (6 to 8 hours) without waking until at least 3 months of age. However, this varies considerably and some babies may not sleep through the night until closer to 1 year. 

Newborns and young infants have a small stomach and must wake every few hours to feed. In most cases, your baby will awaken and be ready to feed about every 2-4 hours. How often your baby feeds depends on what he or she is being fed and his or her age and weight. 

Watch for changes in your baby's sleep pattern. If your baby has been sleeping consistently, and suddenly is waking, there may be a change, such as teething or an unsettled tummy. Some sleep disturbances are simply due to changes in development or because of overstimulation and/or overtiredness.

What are the sleep states of a newborn?

Babies, like adults, have various stages and depths of sleep. Depending on the stage, the baby may actively move or lie very still. Infant sleep patterns begin forming during the last months of pregnancy—active sleep first, then quiet sleep by about the eighth month. 

There are two types of sleep:

• REM (rapid eye movement sleep). This is a light sleep when dreams occur and the eyes move rapidly back and forth behind closed eyelids. Although babies may spend about 15-16 hours each day sleeping, about half of this is in REM sleep. Older children and adults sleep fewer hours and spend much less time in REM sleep.

• Non-REM sleep has 4 stages:

        Stage 1: drowsiness, eyes droop, may open and close, dozing

        Stage 2: light sleep, the baby moves and may startle or jump with sounds

        Stage 3: deep sleep, the baby is quiet and does not move

        Stage 4: very deep sleep, the baby is quiet and does not move

A baby enters stage 1 at the beginning of the sleep cycle, then moves into stage 2, then 3, then 4, then back to 3, then 2, then to REM. These cycles may occur several times during sleep. Babies may awaken as they pass from deep sleep to light sleep and may have difficulty going back to sleep in the first few months.

What are the different alert phases of a newborn?

Babies also have differences in how alert they are during the time they are awake. When a newborn awakens at the end of the sleep cycles, 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 in which the baby is attentive to sounds and sights, and moves actively. 

After this 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 a baby close or swaddling (wrapping snugly in a blanket) 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.

Helping your baby sleep

Babies may not be able to establish their own sleeping and waking patterns, especially in going to sleep. You can help your baby sleep by:

• recognising signs of sleep readiness and acting quickly

• ensuring tummy is full 

• allowing a short time for down-regulation and connection prior to bed

• teaching him/her to fall asleep on his or her own

• providing the right environment for comfortable and safe sleep

• providing company when needed and leaving when not needed

What are the signs of sleep readiness?

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

• quietening following vocalising

• becoming ‘chatty’ following quiet period

• hiccups

• lunging at your breast, as if to feed

• unable to hold your gaze

• reddened eyebrow area

• irritability/ jerky movements

• yawning

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 feel the need to rock or breastfeed a baby to sleep. Establishing a routine at bedtime may be a good idea, and this could simply be a feed, a brief period of cuddle, staring or song to down-regulate together in your arms, kiss and ‘good night’ as you place in the cot. A favourite toy to keep company, dummy if needed and quietly leave the room. 

When the baby briefly awakens during a sleep cycle, he or she may not be able to go back to sleep on his or her own.

Most sleep consultants recommend allowing a baby to become sleepy in your arms, then placing him or her in the bed whilst still awake. Sit beside the cot with your hands on your baby, allow your baby to see your face, close your eyes and ‘shhhhhhhh’ if crying, remembering to reduce your long shhhhh volume in line with your baby’s cry. You may need to remain until he or she is asleep, so make yourself comfortable.

What sleeping positions are best for a newborn?

Research has found a link between sudden unexplained death of an infant (SUDI) and babies who sleep on their stomach (in the prone position).

Experts now agree that putting a baby to sleep or down for a nap on his or her back is the safest position. Side-sleeping has a higher risk for SUDI than back sleeping. Other reports have found soft surfaces, loose bedding, and overheating with too many blankets also increase the risk for SUDI. When infants are put to sleep on their stomach and they also sleep on soft bedding, the risk for SUDI is even higher. Smoking by the mother is also a risk for SUDI, as are poor prenatal care and prematurity. 

Back sleeping also appears to be safer for other reasons. There is no evidence that babies are more likely to vomit or spit up while sleeping on their back. In fact, choking may be more likely in the prone position.

Regardless of the timing, teaching your baby/child to down-regulate and utilise some soothing strategies of their own will be of great benefit to them throughout the lifespan