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.
What are the sleep patterns of a newborn?
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 over-stimulation.
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.
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
- Looking away
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.
Infant Sleep Apnea – Diagnosis
You may need to take your infant to a doctor who is a sleep specialist. If so, you should schedule an appointment at Alaska Sleep Clinic, an accredited sleep disorders center. ASC not only specializes in pediatric sleep but we are one of only two sleep centers in Alaska with a Pediatric Medical Director. Dr. Harry Yuan will review your infant’s history and symptoms. If needed, the doctor will schedule your infant for an overnight sleep study. This kind of study is called a polysomnogram. It is the best way to evaluate your child’s sleep. With the results of this study the doctor will be able to develop an individual treatment plan for your child.
It is also important to know if there is something else that is causing your child’s sleep problems. A sleep specialist can look for other conditions that may be involved. These include:
- Another sleep disorder
- A medical condition
- Medication use
- A mental health disorder
The doctor will need to know if your child was born premature or full-term. He or she will also need to know your child’s weight at birth. Inform the doctor of any complications that you or your baby had during or after delivery. Describe the problems you have observed and when you first noticed them.
An infant who has persistent breathing problems during sleep may need an overnight sleep study. This study is called a polysomnogram. It charts your child’s brain waves, heartbeat, and breathing during sleep. It also records arm and leg movements. The sleep study will reveal the nature of your infant’s breathing problem. It also will show the severity of the problem. The study requires your child to spend the night at the sleep center. A parent or guardian also will need to stay at the sleep center with the child.
Infants with infant sleep apnea may need a machine to provide breathing support. They also may need treatment with medications. Both of these options tend to be short-term treatments.
Infant sleep apnea tends to go away as the child grows and matures. Ninety-eight percent of preterm infants will be free of symptoms by 40 weeks after conception. The problem is more likely to persist longer in infants who were born less than 28 weeks after conception.
Any medical condition that causes infant sleep apnea or makes it worse also needs to be treated. The treatment will depend on the nature of the medical problem.
Long-term complications are rare for most children with infant sleep apnea. Problems are more likely for infants who need frequent resuscitation. Health problems also are more common if the infant sleep apnea is related to another severe medical condition. The great news for parents is that many times, when sleep apnea is properly diagnosed and treated, a child can grow into a healthy adult with no sleep issues.