Healthy Sleep for Babies: Make Your Little One’s Sleep Time Better for Everyone

dic 01, 2021

“When will my baby sleep through the night?” My postpartum patient and her newborn were getting ready to leave the hospital and her exhaustion was obvious. She had given birth after laboring all night and had gotten little sleep ever since. “He just wakes up so easily, and he only sleeps as long as I am holding him, but how on earth can I do that long term?”

This is one of the most common questions parents ask about their baby’s sleep. While sleep following a baby’s birth will almost always be a rough period of heavy sleeplessness, knowing what to expect, and some strategies to try to encourage your baby to sleep, can help you ease into knowing things will certainly improve with time and a little bit of effort.

Learn Baby’s Sleep Cues

Watch for baby’s cues that they’re getting sleepy:
  • Notice if baby is rubbing her eyes, yawning, or getting fussy. Start your routine before your baby is overtired, which can make settling and falling asleep more difficult.
  • Plan to start your bedtime routine 30 minutes to 1 hour before bedtime.
  • Dim lights, slow activities, and reduce noise and stress; keep baby’s bedroom fairly dark at bedtime.
  • If baby likes baths, consider a warm soak or just gently wash their face and put them to sleep in cozy pajamas, blanket sleeper and wrap in a swaddle blanket.
  • Feed baby but never let baby take a bottle of breastmilk or infant formula to bed.
  • Offer and encourage a pacifier; experts at the American Academy of Pediatrics advise using a pacifier to help baby settle and reduce the risk of sudden infant death syndrome.
  • Swaddle the baby either with a thin blanket or put them into a commercial sleep sack. Stop swaddling once baby shows signs of wanting to roll over.
  • Sing or quietly talk to your baby while preparing for bedtime.
  • Play soft music, read a book, or sing some songs and lullabies together.
  • Use a fan or other rhythmic/white noise in baby’s room.
  • Make sure the room is comfortably cool, but not cold.
  • Finally, lay baby in their crib or bassinet when he is nice and drowsy but not yet asleep. At 4 months of age, start to lay your baby down to sleep before they’ve fallen asleep. They will likely be used to falling asleep in your arms, while being rocked, or breastfed, and may have trouble going to sleep without these activities.
  • Maintain the same routine each night; be as stress-free and quiet as possible; eventually your baby will fall asleep on their own without your help.
  • If baby cries when placed in the crib, quietly soothe and pat them with your hand, but do not take them out of the crib. Leave the room, wait a few minutes, then return to reassure with patting and calm, reassuring words. Say goodnight and leave again. Return to the room as needed so they know you are close, but that it is bedtime.
  • For night awakenings that are light and probably not due to hunger (after the first few months), wait a few moments to see if your baby will fall back asleep on their own. If not, follow the same pattern of offering quiet reassurance.

What Exactly is a “Good” Sleeper?

Did you know that it is normal, expected, and safer for babies to wake up often, especially in the beginning? This may not sound like great news, but it’s not as bad as it sounds.

Newborns, of course, need to feed 8 to 12 time a day, including at night, so this should be expected at the beginning. Frequent waking also provides a safety-net for the baby in that if he can awaken easily, he can fuss if he is not able to breath appropriately or get enough oxygen (for instance if his head gets covered with blankets). So, sleeping deeply is not considered healthy for an infant in the early months.

What is considered healthy, or a “good” sleeper, is an infant who can awaken briefly and can get himself back to sleep without your help. Babies, of course, will also have needs in the night, such as feeding or a diaper change. Still, experts at the American Academy of Pediatrics urge parents that babies who have their needs met quickly and quietly, and are able to “self-soothe” themselves back to sleep will be better able to create healthy sleep habits in the long run, which means they’ll be less dependent on you, mom or dad, to fall and stay asleep.

Bedtime Routines and Circadian Rhythms

Before you think about establishing bedtime routines, self-soothing strategies, and other sleep tips, first learn what “normal” sleep looks like – or more precisely, the broad range of what’s considered normal sleep, and what you can expect as baby grows and develops.

We all have circadian rhythms; they’re our internal clock that tells us when to wake up and go to sleep. Our rhythms are generally synchronized to daylight and nighttime. You’ve likely got this down, but newborns must establish this rhythm once they’re born, and it is not always easy!

You can help your baby start to set their rhythms by creating an environment for baby that is more “in-sync” with the appropriate time of day. Some families find using dark window shades in the bedroom (at night) and exposing baby to plenty of natural daylight during the day helps. You can also create a soothing, darker environment with quiet activities (such as reading, bathing, or singing) at night, which can cue baby that bedtime is approaching.

Sleep Cycles

Most of us know that at times we sleep lightly and at other times we experience deeper (and more restorative) sleep. We cycle through different depths of sleep during the night or a nap, and this is the same for your growing infant.

Baby has two basic sleep states: REM sleep, for rapid eye movement, which is light active sleep. Baby’s deeper or “quieter” sleep is called non-REM sleep. When we are in “active” sleep we awaken more easily, which is what we see in newborns and infants.

So then, this light sleep not only provides some safety for baby, but research has also shown that this active sleep is critical for baby’s brain development. The goal is not to get rid of this active sleep, but rather to help baby fall back to sleep with self-soothing strategies, and with as little fuss as possible!

How Long will My Baby Sleep?

Newborns sleep about 16-18 hours a day, including nighttime and multiple naps. In the first weeks, babies spend about 50% of their sleep time in this “active” or REM sleep, which helps explain the frequent awakenings (and their need to feed).

By 3 months of age, babies will sleep 14-15 hours a day with about half of the time in “active” sleep. Baby is now ready to sleep for longer periods of time, say 5-6 hours, and an exhausted parent may finally exclaim, “baby slept through the night!”

By 6 months of age, most babies will sleep 13-14 hours a day, with more of this time at night (and with fewer naps). By 6-8 months babies are in this active sleep only 25% of the time, meaning they are now sleeping more deeply, and are less prone to waking.

If you’re longing for a full 8 hours of uninterrupted sleep, then just know that at 9-12 months of age, most (70%) of babies may sleep this long at night—but not every night.

What does this mean for exhausted parents? As your baby grows, sleep will most certainly become easier for baby, and you will begin to get more restorative rest yourself!

Establish Good Sleep Habits & Bedtime Routines

Still, there’s a lot you can do early on to help your baby learn how to sleep better on their own, and quickly go back to sleep when they awaken.

From baby’s birth forward make it your goal to develop an enjoyable sleep routine! Successful sleeping includes baby going to sleep on their own in their own bed, and being able to self-soothe and go back to sleep when they lightly wake. Here’s how to make this happen:

Healthy Sleep Checklist
  • Establish a bedtime sleep routine your baby will come to anticipate and enjoy.
  • Make it a special time each time for you and your baby.
  • Help your baby learn to self-soothe.
  • Keep the same routine each night—this helps baby anticipate what’s next.
  • Keep your routine the same each night so baby will know the day is winding down.

Sleep Safety

There are a lot of safety considerations when it comes to infant sleep, so it’s important to keep in mind safe infant sleep recommendations when building a bedtime sleep routine. Some strategies parents might try are quite dangerous and should not be used as they’re associated with increased risks of sudden infant death syndrome:
  • Never bring baby into your own bed—even with the best intention of “just for nursing”—you risk falling asleep with your baby in the bed and suffocating them with your bedding or body.
  • Don’t place baby to sleep on their tummy.
  • Never lay a baby down with a bottle—that is a significant choking hazard.
  • Avoid using fluffy blankets, stuffed animals and soft, loose bedding—all of which are hazards for babies.

Remember, every baby is different, and each has their own unique personality and temperament. Some babies will be more “night owls” and some will be “early birds.” Some will sleep more, while others sleep less. Some may be more “secure” by themselves, while others may fuss without you nearby or holding them.

Get to know your baby: learn their sleep cues, try different sleep and comfort strategies, and seek out help from your baby’s healthcare provider if you continue to struggle in setting up a good bedtime routine and habit. As baby grows, their sleep changes. Take comfort in the fact that you have the tools and strategies to master each stage—eventually everyone will get good sleep again—well, until at least baby’s teenage years.

Safe Sleep Recommendations from the American Academy of Pediatrics

  1. Do not sleep with your baby (called bedsharing). Room-share instead.
  2. Position baby completely on their back for all sleep. Side positioners are not safe.
  3. Use a safety-approved crib, bassinet, or pack-n-play with a firm mattress and tight sheet.
  4. Keep all soft stuff out of the crib or basinet, including blankets, pillows, bumper pads, and stuffed toys.
  5. Breastfeed! It’s protective and the more the breastmilk baby gets the better.
  6. Offer your baby a pacifier – it’s protective against sudden infant death syndrome.
  7. Avoid tobacco smoke exposure during pregnancy and after baby is born.
  8. Avoid alcohol, marijuana, or illicit drugs during pregnancy and after the infant is born.
  9. Keep from overheating the baby with either clothing or high room temperatures.
  10. Go to all prenatal visits when you are pregnant.
  11. Provide all recommended immunizations for the baby – this is protective of baby’s health!
  12. Avoid devices marketed to reduce the risk of SIDS.
  13. Do not use sitting and carrying devices for routine infant sleep
  14. Provide “tummy time” when the baby is awake and supervised
  15. Educate everyone who cares for your baby about these safe sleep rules, including grandparents, relatives, babysitters, siblings, and friends

Sharon C. Hitchcock, DNP, RNC-MNN

Sharon C. Hitchcock, DNP, RNC-MNN, is a nurse with more than 35 years of experience. She teaches obstetrics at the University of Arizona College of Nursing.

The information contained on this article should not be used as a substitute for the medical care and advice of your health care professional.