Questions about your baby’s sleep needs can really keep a new parent up at night. Should you wake baby for feedings? How can you help your baby start sleeping through the night? Is co-sleeping safe?
To find the answers to these questions, WebMD went to Jennifer Shu, MD, an Atlanta pediatrician, medical editor of HealthyChildren.org, and co-author of Heading Home with Your Newborn: From Birth to Reality. She shared her thoughts on these and other top concerns parents have about their new baby’s sleep needs.
When should my baby start sleeping through the night?
Some babies sleep through the night within a week or two of being born. But most have their days and nights backward at first, sleeping more in the day and less at night.
Most babies will start sleeping at night at about four months of age. You won’t get an uninterrupted stretch of the baby sleeping 10-12 hours, but you will get about five hours and then another good uninterrupted stretch after a night feeding.
Don’t worry if your baby is four months old and still isn’t sleeping that long. You can help her along by letting her sleep at night, not waking her to feed, and by keeping things dark and quiet. Save the exciting, fun things until daytime.
How much nap time does my baby need?
Normally when babies are first born, everything is eat, sleep, eat, sleep, so you don’t really count any of that sleeping as naps. But somewhere between one and six months of age, babies tend to settle into a three-naps-a-day pattern, where each nap can last an hour or two, before going to a one-nap-a-day pattern after their first birthday. Most kids lose their need for naps by about 5 years of age.
Should I wake my baby for feedings?
I don’t recommend waking babies for nighttime feedings, because you want them to sleep. However, I would suggest you wake them for night feedings in their first couple of weeks if they haven’t yet gained back their birth weight -- babies tend to lose 10% of their weight after they’re born. Also, if they’re sleeping more in the day than the night, I do suggest waking them so they don’t go more than four hours without eating.
Overall, I suggest not waking babies at night so they can find their own sleep schedule. And you generally don’t have to wake them in the day either, because most will wake on their own. If you notice that the baby is sleeping for longer stretches during the day, then I wouldstart waking them in the day, so they don’t get night and day mixed up.
Should I stick to a strict sleeping schedule?
I think you should give your baby the opportunity to have a routine, and I like for babies to have down time to relax in their own crib.
Try to have some semblance of a routine and schedule, but it doesn’t have to be right down to the minute.
How can I get my baby to start sleeping through the night?
Keep it dark and quiet, and have a routine every evening that consists of quiet time -- maybe a bath, reading a book, or brushing baby’s teeth if they have any yet. Get them calm and drowsy before putting them in their crib, and be consistent, put them down the same way each time. In the middle of the night, shorten your routine and rock or pat your baby for just a minute or so before putting her back to sleep.
You don’t want baby to fall asleep while you’re feeding or rocking them, though, because you want them to figure out how to put themselves to sleep. Should you wake them if they do fall asleep then? No, especially not in the first month; it’s impossible to avoid falling asleep during feedings and rockings when they’re that young. But after the first month, put them to sleep drowsy…if they’re falling asleep when you’re nursing, for example, stop nursing and put them to sleep. If they’re falling asleep too soon, try starting your calming, quiet routine sooner.
The other thing you want to do is to make sure the baby isn’t overtired when you put her to bed. Don’t wait until the baby is really fussy; try to stay a step ahead and look for the signs she’s getting sleepy before she’s cranky.
It’s also helpful to know that once babies get to the point where they’re eating more in the daytime they don’t need to wake and eat at night. But don’t overfeed the baby to encourage her to sleep through the night. Some parents try to push more formula, breast milk, or baby food on the baby right before sleep and that can backfire because the baby might not settle in well, just like you when you’ve eaten too much at Thanksgiving dinner. Wait until your baby settles into a pattern where he naturally eats more in the daytime.
Should I let my baby cry himself to sleep?
It depends on the baby and it depends on the age. The method of crying it out has been the most studied and it works for many babies, but you should talk to your pediatrician about whether it’s right for yours. Some babies get tired and go to sleep after crying, but some just get angrier. So, where crying it out works for many babies, it doesn’t work for all of them. And there’s some babies who just need to wake up and feed and then they’ll go back to bed. Instead of denying the feeding, and having the crying, it’s best to feed them.
Generally, after four months or so you’ll find that the baby probably won’t need to eat as much at night, so if they're waking up and crying and falling asleep as soon as they get the breast or bottle you’ll know they’re not hungry, but if they’re waking and ravenously finishing the breast or bottle they still need to be fed at night. A rule of thumb: If it’s been one or two hours since you put them to bed they probably don’t need to be fed, but if it’s been more than three or four hours they probably are hungry.
Is bringing my baby to bed with me -- co-sleeping – safe?
Co-sleeping isn’t recommended because of what we know about sleep safety. There’s more of a risk of smothering, SIDS, and of falls off the adult bed when there’s bedsharing.
If you’re breastfeeding often and you want the baby close, one option is to use a bedside co-sleeper. It looks like a crib with a missing side, and you can put it right next to the adult bed, and raise it up to the bed’s height, but an adult can’t accidentally roll over on the baby. If you’re feeding baby often, you can also consider putting a bassinet, cradle, or crib nearby.
What’s the safest way to put my baby to bed?
Always put your baby on his back to sleep, never on his side or tummy. There’s a higher risk of SIDS if they’re on their tummy or their side (they can roll onto their stomach if they’re lying on their side). And be sure that childcare providers, grandparents, and so on, know to put the baby on his back because there’s also a higher risk of SIDS if a baby is usually put to sleep on his back but suddenly gets put to sleep on his tummy.
Finally, be sure to give your baby a lot of tummy time when he’s awake. Tummy time helps promote physical development -- generally babies don’t roll or crawl as soon if they don’t get tummy time, for example. And if you’re worried about SIDS, you want them to have a stronger head and neck so they can [lift] their face up if it gets covered. Also, babies can actually end up with lopsided heads, or bald spots from rubbing the back of their head on the mattress, if they spend too much time on their back. These aren’t dangerous, but if babies spend more time on their tummy it’ll relieve some of the friction and pressure.
