Sleep in Your Baby's First Year

How much will my baby sleep in the first year?

Over the first year of life, your baby will sleep and nap a lot — from 12 up to 18 hours a day. The amount of sleep an infant gets at any one stretch of time is mostly ruled by hunger. Newborns will wake up and want to be fed about every three to four hours at first. Do not let your newborn sleep longer than five hours at a time in the first five to six weeks. Thereafter, you can keep the following general milestones in mind:

• By four months, most babies begin to show some preferences for longer sleep at night.
• By six months, many babies can go for five to six hours or more without the need to feed and will begin to "sleep through the night."
• Daytime naps reduce in number as the baby grows. A 2-month-old may nap up to four times a day, whereas an older infant may nap only one to two times a day.

Where should our newborn sleep?

Your newborn can sleep in a bassinet or a crib. This can be located in a parent’s room, a sibling’s room or in the newborn’s own room. It’s important that you have your baby sleep in a safe place. Your baby should not sleep in your bed with you. This is dangerous because of the risk of suffocation, strangulation and sudden infant death syndrome (SIDS).

You can bring the baby into your bed for feedings, but should return the baby to a crib as soon as you are done. Many experts recommend feeding your child while in a chair to avoid any injury that can happen while sleeping in a bed with the baby. Room-sharing with your baby (having the crib or bassinet in your room) is recommended, but not bed-sharing.

What is Sudden Infant Death Syndrome (SIDS)?

Sudden infant death syndrome (SIDS) is a term used to describe the sudden and unexplained death of a healthy baby. This happens when the child is put down to sleep and found dead later without an obvious cause. SIDS is the leading cause of death in babies between the ages of 1 month and 1 year. The risk of SIDS is higher when a child is between 2 months and 6 months of ages. It is also more common in boys than girls.

Experts don’t know why SIDS happens.

It’s important to reduce the risk of SIDS by following certain guidelines. These guidelines include:

• Following the “back to sleep” rule. Place your baby on his or her back for both naptime and to sleep at night.
• Place your baby alone on a firm mattress in a crib with slats that are no greater than 2 and 3/8 inches apart.
• Do not place your baby on a waterbed, sofa, soft mattress, pillow or other surface to sleep. The baby’s crib is the best and safest place to sleep.
• Keep your baby’s head and face free and clear of blankets or any other coverings inside the crib. If you decide to use a blanket, it must be tucked in around the mattress and must be no higher than chest high against your baby.
• Create a clutter-free environment in your baby’s crib. Remove pillows, quilts and comforters, plush toys and any other objects from the crib — these could interfere with your baby’s breathing. Make sure there are no objects with cords, ties, sharp corners or edges.
• It’s important to create a smoke-free environment for your baby. Make sure your child is not exposed to any passive tobacco or smoke exposure as this has been shown to increase risk for SIDS. Smokers should smoke outside of the home and especially not anywhere near the crib area. Smoking near children can be very harmful to their health.
• Make sure the room temperature is about the same for your baby as it is for an average adult.
• Remove all hanging toys from the crib at about 5 months of age. This is typically the age when your baby will begin to be able to pull himself/herself up in the crib. These items need to be out of your child’s reach from this point on.
• Place your baby on his/her stomach while awake during the daytime. Often called “tummy time,” this is exercise for your baby. Time on the stomach can help develop your baby’s muscles and eyes, as well as help prevent flattened areas on the back of the head.
• Consider using a pacifier. Using a pacifier has been linked to reduced SIDS rates.

Should I wake up with my baby every time they wake up at night?

During the first 12 months, babies develop quickly, and their sleep patterns change rapidly. It’s important to understand that all babies briefly awaken several times (up to six) a night. Some babies are able to soothe themselves back to sleep after they wake up. Other babies learn to signal their parents for help (rocking, holding, cuddling) to settle them back to sleep if they wake up in the middle of the night. However, it is best to let the newborn comfort himself or herself back to sleep rather than develop a need or association with a parent or guardian.

What are some ways to help my newborn sleep well?

There are a few ways you can help your baby become a better sleeper, including:

• Shifting your baby’s sleep cycle. By the time your baby is around 2 to 3 months of age, you can encouraging them to sleep more at night. Newborns frequently have their days and nights reversed. The awake/sleep cycle is also directed by the need to feed. When your baby needs to feed during the night, keep the lights dim and reserve stimulating interaction for the daytime hours. Eventually, this will help develop a more consistent sleep/wake schedule. Also, try not to cut back on nap time. This will result in your baby being overtired and lacking a good night’s sleep.
• Understanding your baby’s signals. Many babies will show certain signals of being tired. These can include things like becoming fussy, crying, tugging on body parts, yawning and rubbing eyes. Putting your baby to bed when he/she is showing these signs usually allows them to fall asleep more quickly. It also begins to establish a bedtime routine. Most experts recommend putting your baby to bed while he/she is still awake, but drowsy. This way, the baby will learn how to go to sleep on his/her own and learn not to associate your presence with falling asleep.
• Establishing a bedtime routine. You baby may respond well to a near bedtime routine. Parts of your routine can include bathing, rocking, reading, quiet talking, singing, playing soft music, cuddling and gentle massage. Even though your baby might not understand these signals yet, setting up these bedtime drills now can help establish a regular bedtime routine in the future. Avoid making bedtime feedings a part of the routine after about 6 months of age. Try to introduce a security object (a stuffed animal, blanket or a knotted t-shirt with your body odor on it) around age 1 year. This object, if accepted by the baby, may help the baby soothe himself/herself at night. Make sure the bedroom environment is quiet, cool, dark and comfortable for sleeping. A nightlight or area light on the very lowest dimmer setting is fine.
• Knowing your baby may move a lot while sleeping. Your child may sound like he/she is awake, but is actually still asleep. You’ll see smiling, sucking, twitching, jerking and all kinds of motions — these are all normal aspects of sleep. However, if he/she cries for several minutes, it’s time to check on him/her. Your baby may be cold, wet, hungry, or even sick, and need your care.

When should I seek a doctor's help?

Contact your healthcare provider if:

• Your baby seems to be extremely fussy/irritable or cannot be soothed – he/she may have a medical problem such as colic or reflux (backward flow of content from the stomach into the food pipe).
• Your baby appears to have a breathing problem.
• Your baby has a difficult time being awakened from sleep.
• Your baby is uninterested in feeding or persistently shies away from activity.