Infant Sleep: What Is “Normal,” And When Should We Be Worried?

Sleep is a hot button issue for most families with newborns. How do you know what to expect when so much is changing all the time, and when is it time to ask for help?

Before diving into specific ages and sleep schedules (which this post does not explicitly cover), it is important to recognize that “normal” varies across cultures and individuals. The definition of a “good sleep” may also change over time and with normal developmental changes. There is much that we do not yet know about the functions of sleep, but it is thought to be a time to allow the mind and body to process and organize the activities of the waking hours as well as a way to promote readiness to incorporate new information after a period of much-needed rest. Generally speaking, “good sleep” is reflected in a child who looks well-rested and physically recharged, and who is able to attend to and learn from new stimuli. 

How can parents distinguish between normal or expected “bumps in the road” when the child (and the family) is not getting enough rest, and actual sleep problems? Below we offer some basic information to guide you through what is generally considered normal sleep behavior during infancy. It is always a good idea to consult with your pediatrician if you are concerned about your child’s sleeping patterns or if you believe there is something interfering with the quality of sleep your child is getting.

Children normally don’t sleep “well”…

• Before 4 months of age. In these early months, the sleep cycle is quite erratic and largely dependent on the infant’s need to feed and gain weight. At this stage, the baby’s neurological system is still making sense of day and night and she is gradually learning how to consolidate (piece together) sleeping hours so that eventually infants who are approximately 4 months old can sleep for 4-5 hour stretches at a time (not necessarily at night).
• During growth spurts: this may happen more frequently in the first six months of life, but you might expect sleep regressions anytime a child (even a toddler or preschooler) is going through a growth spurt.
• During illness.
• During developmental transitions or leaps such as teething, learning to crawl, to walk, etc.
• During family changes or stress: For example, traveling, the birth of a sibling, and moving to a new house may affect children’s ability to sleep (not to mention adults’!).

During the times when the family doesn’t sleep well, it is even more important for parents to take good care of themselves. If parents have a partner, they can take turns to check on the baby when she wakes up at night. If the caregiver has a friend, relative, or neighbor who can watch the baby for an hour, then they might use that time to rest if possible. A plant-based diet can also provide an energy boost during those extenuating days, and do anything that’s restorative and helps them go through the day.

Additionally, during these normal phases of sleep deprivation parents can help children get more rest by:

• Not over-stimulating the child with games and toys an hour or two before bedtime.
• Trying to keep a bedtime routine: This may not be possible in times of illness, but it can be helpful when traveling or moving (for example, keep your child’s lovey or favorite blanket accessible even if other things need to be packed).
• Using sleep aids: It is important to recognize when it is OK to use some of the “aids” that parents may have vowed never to use to avoid instilling ‘bad sleep habits’ (the pacifier, white noise machine, driving the child around the block). In times of transition, these aids will likely increase the chances that your family will get some sleep. When things start returning to normal, caregivers can progressively retire these additions.
• Being aware of the sleep environment: a consistent bedtime routine in addition to a comfortable sleep environment can contribute to the length and quality of sleep that your child gets. Be mindful of the temperature and amount of light in the room, and make adjustments as much as possible.

If your child is still struggling with nighttime sleep and you have ruled out a developmental change or illness, and your family has not recently encountered a new stressor or transition, your family might consider the idea of  “sleep training,” which can come in many different forms. Typically pediatricians and other developmental experts  recommend waiting on sleep training until they believe the baby has achieved a healthy weight. This usually happens after 4-5 months of age, when the infant is also more capable of more predictable sleep patterns, but keep in mind that sleep training is a delicate decision for family members to discuss and agree upon before embarking on a specific method.