When you bring a newborn home, it can be difficult to get into a routine. Feeding is irregular, sleep is irregular, and so your schedule will be irregular. In these irregular cycles and as baby grows, parents often wonder if their infant is getting enough sleep.

Rather than focusing on how much sleep baby is getting at a time, the American Academy of Pediatrics endorses these guidelines from the American Academy of Sleep Medicine for total number of sleep hours for infants and children in a 24-hour period.

Up until 4 months of age, newborns sleep on average 16-17 hours per day. This sleep can be quite broken up, as they tend to wake up every two to four hours, day or night, and may only sleep one to two hours at a time. In those first few months, follow baby’s cues for feeding and sleep cycles. Many parents find it very helpful to try to sleep when baby sleeps. Don't feel guilty for doing this; don't try to get “one more thing done.” You're following their pattern, so as their pattern becomes more regular, usually by the 3 to 5 months old, then you’ll naturally adjust to their schedule. 

Newborns are occasionally known to mix up their days and nights. Most babies learn day from night as a gradual process in the first months. By 3 to 4 months of age, most babies are sleeping much more at night than during the day, and while there's no quick fix for day-night reversal, you can help your little ones develop good sleep habits by being more active during the day and more calm and quiet at night. This could include having them sleep a dark room and a using a soft gentle voice at night when you want to let your newborn know that it would be a good time to sleep or go back to sleep.  

From 4 months old up until their first birthday, infants may still require as many as 16 hours of sleep a day. Most babies will develop regular sleep cycles by around 6 months of age, but even then, it is developmentally normal for babies to wake up frequently overnight. A “good sleeper” is a baby that wakes up frequently but can get back to sleep on their own relatively quickly. 

Consider these adjustments around 4 weeks old to help your baby develop a sleep routine*: 

• Gently guide baby toward longer stretches of time between feedings, so less snacking. 
• Begin keeping baby awake for at least 10 minutes following each feeding during the day. This sets them up for a more regular sleeping pattern down the road. 
• Begin a bedtime routine around the last feeding of the day. 
• Allow baby to fuss a bit before picking up to be sure that baby is fully awake and hungry, especially during the night. Know that it's normal for baby to fuss for a minute or two, and you can wait that long to be sure that your infant is truly awake and needs to be fed. 

Routines and repetition are very comforting for infants. Many parents find that a bedtime routine not only offers a sense of security for the infant, but also improves their sleep quality. A bedtime routine may be as simple as a short bath followed by feeding, reading and rocking, and then placing baby to bed on their back. 

If you have specific question about your child’s sleep, contact a Prevea Pediatrician.

*adapted from Loving by Leading by Den Trumbull, MD.