In the first six months, your little one's sleep patterns can feel like a chaotic, ever-changing mystery. One week they sleep for hours, the next they're up every 90 minutes.
It's easy to be confused by these shifts and wonder if your baby's sleep is normal. The truth is that infant sleep is incredibly variable and a constant state of development. While there are general patterns, every baby is unique. This guide will help you understand general trends in a baby’s sleep and what might warrant a closer look by your pediatrician. Remember: if you have any concerns about your baby's sleep, behavior, or health, always contact your pediatrician.
The newborn stage (0-3 months)
For newborns, sleep is primarily driven by hunger and discomfort, not by day or night. They haven't yet developed a circadian rhythm (their internal body clock).
What's normal:
Short bursts of sleep: Newborns typically sleep in short stretches, often 1-2 hours at a time. This is because their stomachs are small and they need to be fed regularly.
Lots of sleep overall: Expect around 16 hours of sleep in a 24-hour period, but not all at once.
Big range of “normal”: Babies under four months of age have a wide range of what is considered typical.
Frequent wakings for feeds: Babies, especially breastfed ones, need to eat frequently (every 2-3 hours) due to their tiny tummies and rapid growth. These wakings are absolutely normal and necessary. Your pediatrician may advise you to wake your baby for feedings if they need to increase their weight.
What's not normal (seek medical advice if your baby is):
Lethargic or difficult to wake: If your baby is unusually difficult to wake for feeds, seems unresponsive, or sleeps excessively (more than 18 hours with very little awake time for feeds).
Consistently not waking for feeds: Especially in the first few weeks, if a baby sleeps for more than 4-5 hours at a stretch without waking to feed, consult your pediatrician.
Prolonged, inconsolable crying: While all babies cry, if your baby cries for hours and nothing seems to soothe them, even after feeding and changing, it could indicate discomfort.
Entering a new phase (4-6 months)
Around the 4-6 month mark, you might start to see more predictable patterns emerge as your baby’s circadian rhythm begins to develop. Regular sleep cycles don’t emerge until approximately 6 months of age.
What's Normal:
Longer stretches at night: Babies typically start sleeping 5-6 hour stretches, or even longer, at night. Total sleep might be 12-16 hours in 24 hours.
More predictable naps: Naps may become more regular and structured, often 2-3 naps per day.
Sleep regressions (commonly around 4 months): Just when you think you've figured it out, sleep can suddenly go haywire. The 4-month sleep regression is very common, often due to a developmental leap, brain changes, and the shift from newborn to more mature sleep cycles. Increased night wakings, shorter naps, and fussiness are normal during this period.
Self-soothing attempts: Your baby might start finding their thumb or fingers to suck as they try to self-soothe back to sleep.
What's not normal (seek medical advice if your baby has):
Sudden changes in behavior or feeding: Beyond a typical sleep regression, if there are dramatic changes in appetite, mood, or activity levels.
Persistent signs of discomfort: Excessive arching during or after feeds, recurrent spitting up that seems painful, or constant fussiness that suggests underlying issues.
Disinterest in feeding: If you’re having trouble urging your baby to eat, reach out to your doctor.
Developmental concerns: If you notice any worrying delays in reaching milestones.
Important reminders for all sleep in the first 6 months:
Safe sleep practices are non-negotiable: Regardless of your baby's age or sleep phase, always follow the ABCS of Safe Sleep. Place your baby Alone, on their Back, in a Crib (or bassinet/play yard), in a Smoke-free environment for every single sleep, day and night. The sleep surface must be firm and flat, with no loose blankets, pillows, bumpers, or toys.
Room-sharing, not bed-sharing: Sleeping in the same room as your baby, but not the same bed, can help facilitate night feeding and wakings. It also reduces the risk of SIDS or suffocation. These risks are highest in the first six months of your baby’s life.
Consistency helps: Even a simple, consistent bedtime routine (bath, books, feed, lullaby) can signal to your baby that it's time for sleep. These times can also provide bonding opportunities for parents and caregivers.
Differentiate day from night: During the day, keep things bright and active; for night wakings, keep lights dim and interactions quiet.
When to Call the Pediatrician
If you have any concerns, big or small, about your baby's sleep, behavior, or health, always contact your pediatrician.
Navigating baby sleep in the first six months is a marathon, not a sprint. There will be good nights and tough nights, periods of predictability and sudden regressions. Remember that you are doing an amazing job, and your baby's sleep journey is unique. Focus on providing a healthy daytime routine, a safe sleep environment, and trust that patterns will eventually emerge.
About SIDS of Illinois
Sudden Infant Death Services of Illinois, Inc., is a not for profit, 501(c)(3) organization dedicated to the prevention of sudden, unexpected infant death by providing educational programs to families, healthcare professionals, law enforcement, childcare providers, and the general public as well as bereavement services to families and any others who have experienced the tragedy of sudden, unexpected infant death. Donate here to become a Safe Sleep Supporter!
