"Does your baby sleep through the night?" is one of
the questions new parents hear the most. And the bleary-eyed moms
and dads of newborns almost always answer: "No."
Newborn babies don't know the difference between day and
night yet - and their tiny stomachs don't hold enough breast
milk or formula to keep them satisfied for very long. They need
food every few hours, no matter what time of day or night it
is.
How Long Babies Sleep
A newborn may sleep as much as 16 hours a day (or even more),
often in stretches of 3 to 4 hours at a time. And like the sleep
all of us experience, babies have different phases of sleep:
drowsiness, REM (rapid eye movement) sleep, light sleep, deep
sleep, and very deep sleep. As babies grow, their periods of
wakefulness increase.
At first, these short stretches of 3 to 4 hours of sleep may be
frustrating for you as they interfere with your sleep pattern. Have
patience - this will change as your baby grows and begins to adapt
to the rhythms of life outside the womb.
At first, though, the need to feed will outweigh the need to
sleep. Many pediatricians recommend that a parent not let a newborn
sleep too long without
feeding
. In practical terms, that means offering a feeding to your baby
every 3 to 4 hours or so, and possibly more often for smaller or
premature babies. Breastfed infants may get hungry more frequently
than bottle-fed babies and need to nurse every 2 hours in the first
few weeks.
Where and How a Baby Should Sleep
For the first weeks of life, most parents place their
child's crib or bassinet in their own bedroom. A separate room
just seems too far away at this early point.
The American Academy of Pediatrics (AAP) and the U.S. Consumer
Product Safety Commission (CPSC) recommend against bringing
your infant to sleep in bed with you for safety reasons. Although
many cultures endorse
cosleeping
, there is a risk that the baby can suffocate or strangle, and
studies have shown that there's a higher incidence of
SIDS (sudden infant death syndrome)
in households where the baby slept in the parents' bed.
Establishing a routine right from the beginning can help. How we
sleep is based in large part on habit and what our bodies use as
the signals that it is time to sleep. Always putting your baby in
the crib for sleeping will help signal to the infant that this is
the place for sleep. Keep in mind, though, it may take a few weeks
for your baby's brain to signal the difference between night
and day. Unfortunately, there are no tricks to speed this up except
to be as consistent in your routine as possible.
Always keep sleep safety in mind. Do not place anything in the
crib or bassinet that may interfere with your baby's breathing;
this includes plush toys, pillows, and blankets. Although bumper
pads are widely used, their safety has been questioned.
One study from the CPSC found a number of accidental
deaths appeared to be related to the use of bumper pads in cribs
and bassinets. The Canadian Pediatric Society has recommended
against using crib bumpers since 2004. If you do use bumpers,
it's best to use the kind that secure at the top and
bottom.
Also avoid objects with cords or ties, and those with any kind
of sharp edge or corner. Make sure the crib you use meets current
safety standards.
The AAP recommends that healthy infants be placed on their backs
to sleep, not on their stomachs. The incidence of SIDS has
decreased by more than 50% since this recommendation was first made
in 1992. It is now also recommended that premature infants sleep
only on their backs.
It is thought that some babies sleeping on their stomachs may
have a greater tendency toward sleep obstruction and rebreathing
their own carbon dioxide because they are less likely to rouse
themselves to change head positions. Another possibility is that
they may suffocate on softer bedding if they are lying
face-down.
If your baby has a medical condition, there may be an exception
to these recommendations. Your baby's doctor can best advise
you on the right sleep position for your little one.
Encouraging Your Newborn's Sleep
You can help adjust your baby's body clock toward sleeping
at night by avoiding stimulation during nighttime feedings and
diaper changes. Try to keep the lights low and resist the urge to
play or talk with your baby. This will reinforce the message that
nighttime is for sleeping.
Overly tired infants often have more trouble sleeping than those
who've had an appropriate amount of sleep during the day. So,
keeping your baby up in hopes that he or she will sleep better at
night will not necessarily work.
Consider establishing some sort of bedtime routine (bathing,
reading, singing) to help get your baby to relax in the coming
months. Even though your newborn may be too young to get the
signals yet, setting up the bedtime drill now can keep you on the
right track later.
What if your baby is fussy? It's OK to rock, cuddle, and
sing as your baby is settling down. For the first months of your
baby's life, "spoiling" is definitely not a problem.
In fact, studies have shown that babies who are carried around
during the day have less colic and fussiness.
The first months of a baby's life can be the hardest for the
parents because you are potentially getting up every few hours to
tend to the baby. Each baby is different in terms of when he or she
will sleep through the night, and parents differ regarding when
they're comfortable with encouraging their newborn to do
so.
By 2 months most babies are sleeping 6 to 8 hours through the
night. If your baby isn't sleeping through the night by 4
months, talk with your doctor about how you can help this to
happen.
When to Call the Doctor
While most parents can expect newborns to sleep or catnap most
of the day, the range of what is normal is quite wide. Check with
your doctor if you have questions about how much (or how little)
your baby is sleeping.
You may want to talk with the doctor if your baby seems overly
irritable and cannot be adequately soothed. In addition, if your
baby is difficult to rouse from sleep and generally seems
uninterested in feeding efforts, speak to the doctor immediately
for reassurance or further medical guidance.
Reviewed by:
Steven Dowshen, MD
Date reviewed: August 2008
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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