Knowing Your Newborn Sleeping Schedule and Patterns

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The basic routine of a newborn baby is sleeping and eating.  New parents may have concerns about whether or not their child is sleeping too much, however, there is no written rule that applies universally to every child.  On average, a newborn baby will sleep between 8 and 9 hours during the day time, and an additional 8 to 9 hours during the night.  Newborns also have a tendency to have their days and nights confused, and will oftentimes be more awake during the night time hours.  Newborns have very small stomachs, and will typically wake from sleep when they are hungry.  On average, a baby may wake approximately every 3 hours to be fed, but this also depends largely on whether or not they are being breast fed or formula fed.  Should you have any thoughts about whether or not you should wake your baby in order to give them a feeding, it is highly suggested that you discuss it with your health care provider first.  It is also suggested that you play close attention to your baby’s sleep patterns as they change and develop, because if they make a sudden switch from consistently sleeping for particular lengths of time to erratically sleeping or waking before expected, it may be an early indicator that something is wrong, like an ear infection.  Bear in mind though that changes in sleep patterns sometimes result from developmental changes or overstimulation, and that it is not always a sign of illness.

Parents of newborns may wonder how long it will take before their baby sleeps through the night.  Typically, a baby is usually at least three months before it will sleep for a period of six to eight hours without waking, however, this also varies greatly from child to child.  Some babies will not effectively start sleeping throughout the night until they are closer to twelve months.  Babies start to develop their general sleeping patterns while they are still in the womb, typically during the later stages of the pregnancy, and often with a progression from active sleep to quiet sleep by the eighth month.  Babies are similar to adults in that they also have various stages of sleep, and different depths of sleep within those stages, with the two general types of sleep being essentially categorized as REM (rapid eye movement) sleep and non-REM sleep. 

REM sleep is a light sleep characterized by a rapid back and forth movement of the eyes, which is usually an indicator of active dreaming.  As stated previously, newborns sleep approximately 16 hours during the course of a single day, and about half of that time is spent experiencing REM sleep.  By comparison, adults and older children spend less time sleeping, and far less time in active REM sleep.  The remainder of a baby’s sleep cycle is spent in non-REM sleep, which is comprised of four distinct stages; stage 1 is a state of drowsiness, stage two is a state of light sleep, stage 3 is a state of deep sleep, and stage 4 is a state of very deep sleep.  Typically, a normal non-REM sleep pattern will progress sequentially through the four stages and then back out in reverse order, ultimately ending in a return to REM sleep.  The activity levels of the baby within stages 3 and 4 are relatively similar, and it is difficult to wake the babies during these stages.  Stage 2 is characterized by slight movements while sleeping, and the tendency to awaken or be startled by sounds and noises.  Stage 1 typically entails drooping eyes and general drowsiness, and you may find that the eyes of the baby open and close.  It is quite common for babies to awaken as they progress from deep sleep to light sleep, and when they do, it may be difficult for them to return to sleep afterwards.

Parents should be aware that newborn babies also have various stages of alertness as they awake from a sleep cycle.  This is generally important because the levels of alertness can progress to a point where the baby starts actively crying, and there are times when the level of overstimulation associated with active crying can result in the baby refusing to be fed and refusing to quickly calm down.  Upon awaking, the baby first enters what is described as a quiet alert phase, where they are very still and actively observing the nearby objects and sounds in their environment.  From this phase of alertness, a baby usually progresses to an active alert phase, which is categorized by an enhanced level of activity and elevated responsiveness to sights and sounds.  From this phase, a baby will usually progress into a crying phase, which is marked by erratic body movements in conjunction with the crying.  Again, understanding these phases will help a parent to acknowledge the active alert phase, and understand that interceding at this point to get the baby to calm down and eat may be extremely beneficial.  Should you not intercede quickly enough, a good approach to help calm a crying baby may be to hold them close, swaddle them in a blanket, or rock them gently.  In newborns, crying can be a late sign of hunger, and as stated previously, it may be difficult to get an actively crying baby to calm down and eat.

New parents should know that babies will oftentimes find it difficult to establish their own consistent pattern of sleeping and waking, in particular when it comes to going to sleep.  The more assistance that a parent can provide in this approach, the better.  That being the case, the parents should first learn to recognize the telltale signs of sleep readiness in a baby, so that they can take the proper steps to ensure a safe and comfortable sleeping environment for their child when they grow tired.  The primary signs of sleep readiness are generally described as rubbing of the eyes, looking around without a particular area of focus, active yawning, and overall fussiness.  As babies do not inherently understand how to put themselves to sleep, the parents must learn to develop and follow a consistent routine prior to putting the baby down. This will help the baby to eventually grow accustomed to the routine that precedes going to bed, and will ultimately give them the ability to fall asleep on their own. 

One of the key features of the established sleeping routine should be not to allow the baby to completely fall asleep in your arms, either while feeding or being rocked.  This is quite commonly the approach that is taken by new parents, but many experts agree that this may serve to establish a pattern where the baby has to be held before it can fall asleep.  This will prove to be counterproductive to the baby learning to sleep on its own.  The better approach would be to put the baby down as they are starting to get sleepy, but while they are still awake.  Once in their crib, a parent can use singing, humming, or soft music to help calm them to the point where they can fall asleep.  Studies have shown that a baby that can learn to fall asleep while not being held will transition to being able to fall asleep on their own far more quickly than those children that are rocked to sleep or fed until they fall asleep.

It was previously stated that the responsibility of the parent is also to provide a sleeping environment for their child that is safe, as well as comfortable.  The primary point of consideration for the safety of a sleeping baby is most often the position that you put them in before they go to sleep.  Over the years, numerous studies have been conducted that have proven that there is a definitive link between babies that are sleeping on their stomach (in a prone position) and sudden infant death syndrome (SIDS).  This being the case, most experts agree that the best position for a sleeping or a napping baby is on their back (it should be noted that side sleeping is better than stomach sleeping, but that it does carry a greater risk of SIDS).  In fact, in 1992, the American Academy of Pediatrics (AAP) made a recommendation that they entitled “back-to-sleep.”  Since that recommendation was made, the SIDS rate has dropped by more than 50%.  There are other factors that should be taken into consideration that have been directly related to SIDS, such as putting the baby to sleep on loose bedding, soft surfaces, or with excessive amounts of blankets, which can contribute to overheating.  If any of these other circumstances occur in conjunction with a baby sleeping on their stomach, the inherent risk of SIDS substantially increases.

Understanding sleeping patterns, the stages of sleep, and the indicators of sleep readiness will prove to be a useful tool for parents experiencing life with a newborn baby.  Ultimately, a consistent sleep routine and pattern will help as your baby grows and develops, and you can take definitive steps to try to help establish that routine.  You will always have the responsibility of keeping your child safe, and that role extends to the sleep environment that you create for your baby.  This issue is so significant that a task force comprised of members of the AAP, the U.S. Consumer Product Safety Commission, and the National Institute of Child Health and Human Development, specifically comprised a list of recommendations and guidelines regarding proper infant bedding.  The following is a synopsis of items from that list:

•    Place your baby on his or her back on a firm, tight-fitting mattress in a crib that meets current safety standards.

•    Remove pillows, quilts, comforters, sheepskins, stuffed toys, and other soft products from the crib.  Also remove any soft, pillow-like crib bumpers.

•    Consider using a sleeper as an alternative to blankets with no other covering.

•    If using a blanket, put your baby with his or her feet at the foot of the crib.  Tuck a thin blanket around the crib mattress, only as far as the baby's chest.

•    Make sure your baby's head remains uncovered during sleep.

•    Do not place your baby on a waterbed, sofa, soft mattress, pillow, or other soft surface to sleep.

•    The AAP recommends that parents room share, but not bed share. Their report advises the following:

a. Parents should consider placing the infant's crib near their bed for more convenient breastfeeding and parent contact for the first 6 months.

b. Infants can be brought into the parents' bed for feedings and comforting, but should be returned to their own crib for sleep.

c. Infants should not bed share with others, including adults and siblings or other children. Twins and other multiples should sleep separately.

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