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Your Top 10 Questions About Sleep—Answered!

Rest easy. Here's everything you need to know.

New parents often worry about their baby’s sleep: Is he sleeping too much or not enough? Is he in the right position? Where should he sleep? Don’t let these questions keep you up at night— the answers are easy once you know the basics.

A newborn’s circadian rhythm, or internal clock that tells the body when to sleep, is not well developed at birth. As a result, he can sleep as easily during the day as he does at night. A normal, full-term newborn sleeps about 14 to 18 hours a day but rarely for more than a few hours at a time. And when he does sleep, he may twitch, smile, frown, make sucking movements or breathe irregularly. A lot of parents think that their baby isn’t sleeping well as a result, but this is totally natural.

Around 2 to 3 months of age, sleep becomes more regular as the circadian rhythm kicks in. Babies become more aware of darkness and light, and feedings and nighttime routines begin to make their sleep and waking patterns seem more conventional.

As your baby grows, he’ll need less sleep. At 2 to 6 months of age, most infants need 15 to 16 hours total each day and will sleep up to 6 hours at a time, but by 6 to 9 months, they can be down for up to 7 hours at a time. At 9 to 12 months, most babies sleep 14 to 15 hours a day and can sleep through the night for up to 10 to 12 hours. One or two daytime naps are usually fine. With these patterns in mind, read on for details.

1. Is my baby getting enough sleep?

Each baby is unique: Some need much more sleep than others. If your baby wakes up in a good mood, appears alert and happy during the day, and can fall asleep easily at night and at naptime, he is most likely getting enough rest.

2. When will my newborn sleep through the night?

Sleeping through the night is generally defined as sleeping 5 hours straight without waking. Newborns are physically unable to sleep for long periods of time because they need to eat every 2 to 3 hours. However, by the time full-term babies are 2 to 3 months old, their stomach has grown and can hold enough milk to keep them satisfied for 5 to 6 hours at a time, so they can sleep for longer periods during the night.

3. How do I help my child learn to sleep through the night?

Starting around 3 or 4 months of age, try to give your baby most of his feedings during the day. You should also try to keep him awake for longer periods during the day to help him differentiate between day and night. During the day, play with your baby, listen to music, sing songs and involve him in normal family activities. At night, keep the house quiet and the lights down to signal that night is time to rest. If your baby wakes up at night for a feeding or a diaper change, keep the lights low, and don’t engage him. This reinforces that nighttime is for sleeping, not for playing.

4. How do I wake my newborn for a feeding?

Newborns often wake to eat every 2 to 3 hours, although breastfed babies eat more often than bottle-fed ones. If your newborn has gone more than 4 hours without eating, you should gently get him out of his crib and begin to talk to him. Try undressing him, changing his diaper or turning on lights and soft music to wake him up.

5. Where should my newborn sleep?

Babies should sleep in a crib until they are ready to be moved into a toddler bed (usually at around age 2 or 3). The American Academy of Pediatrics (AAP) now recommends that babies sleep in their parents’ room, in their own crib, to lower the risk of Sudden Infant Death Syndrome (SIDS). Bed-sharing is not recommended because it can increase the risk of SIDS and make it harder to move your baby to his own crib or bed when he is older. (See Stopping SIDS.)

6. When is it safe to let my baby sleep on his stomach?

The AAP recommends that all babies be put down for sleep on their back to greatly reduce the risk of SIDS. But, at around 6 months of age, babies learn to roll over. Fortunately, once your baby can easily roll from his back to tummy and then to his back again, his risk for SIDS lowers. At this point, with your healthcare provider’s approval, he can sleep on his stomach.

7. When should I give my child a pillow?

Pillows are not recommended for children under 2 years old because they can easily smother a child. The best time to give your baby a pillow is when he moves from the crib to the bed (at around 2 to 3 years of age). If you decide to give your baby a pillow, choose a small one, about the size of an airline pillow, that is firm (soft or feather pillows increase the risk of smothering), and change the case regularly.

8. When and how should I teach my little one good sleep habits?

Good sleep routines should be started early. As soon as you bring your newborn home from the hospital, try to put him to sleep in his own crib awake, not in your bed. Babies thrive on consistency; so once yours is 2 to 3 months old, try to maintain a sleep schedule with a set bedtime, wake time and naptimes. A consistent feeding schedule will also help your infant develop a daily ritual. A short bedtime routine such as a bath, diaper change and then pajamas each night will signal that it’s time for bed. Putting your baby down to sleep when he is drowsy but still awake will teach him how to fall asleep on his own and will also help him learn to fall back to sleep by himself after he wakes at night.

9. How can I teach my baby not to cry for me after I put him down to sleep or after a nighttime awakening?

Babies need to learn how to fall asleep without your help both at bedtime and after they wake up at night. After your baby is 2 to 3 months old, you can begin to teach him this skill. If he’s crying, check on him to make sure nothing is wrong. Try not to hold or rock him; this will reinforce the crying. You may allow him to cry for a little while (if you can handle it), but always check on him every few minutes. Eventually, he’ll learn how to self-soothe.

10. When and for how long should my child nap?

Newborns nap throughout the day without a set schedule, but older infants usually have a longer period of sleep at night and two naps during the day, in the morning and afternoon. It is best for him to nap at the same time each day (such as 10a.m. and 2p.m.). To keep your baby on his sleep schedule, you can wake him from his nap. In general, he should not nap past 4p.m.; otherwise he’ll have trouble falling asleep at bedtime. And if possible, have your baby nap at home in the same place where he sleeps at night. This way, when he’s in his crib, he’ll know it’s time to sleep.

Stopping SIDS

Sudden Infant Death Syndrome (SIDS) is the death of an infant, frequently while sleeping, which cannot be explained after an autopsy and extensive examination of the place of death. A baby’s risk for SIDS is low during the first month of life and peaks between 2 and 3 months of age, and almost all SIDS deaths occur before 6 months of age, with 10 percent occurring between the ages of 6 months and 1 year. Boys, African-American and American Indian babies and babies whose parents smoke are at highest risk.

Since the American Academy of Pediatrics (AAP) released its first SIDS-prevention guidelines in 1992, the death rate has been cut in half. However, SIDS continues to be the leading cause of death in infants 1 month to 1 year of age, claiming about 2,000 lives each year in the United States, according to the AAP. Last year, the AAP updated its SIDS-prevention advice as follows:

• All babies should be placed on their back to sleep, not on their side or stomach.
• Babies should sleep in their own crib in their parents’ room.
• Bedding should be minimal—just a firm mattress covered by a sheet. Excessive blankets, stuffed animals and pillows should be kept out of the sleeping space. Bed-sharing is not recommended.
• Pacifiers are now recommended to be offered (not forced) when the baby is put down to sleep but not to be replaced once the baby falls asleep. For breastfeeding babies, pacifiers should be used after 1 month of age to ensure that breastfeeding is well established.
• Babies should be dressed comfortably but not too warmly while sleeping to avoid overheating.
• Devices such as home monitors and positional aids are not proven to decrease the risk of SIDS.
• To avoid flattening of the back of the head, give your baby tummy time Hold him upright when he’s awake, and alternate the side of the head he sleeps on each week. Avoid frequent use of carseat carriers and bouncy seats.
• All caregivers (babysitter, daycare provider, friend, relative, etc.) should be aware of these guidelines since 20 percent of SIDS deaths occur when a baby is in nonparental care.

Katherine Finn Davis, PHD, RN, CPNP, is a pediatric researcher at the Emory University School of Medicine in Atlanta, specializing in infectious disease and sleep. She has authored numerous articles and book chapters on pediatric sleep issues.