How soon can we start a "sleep plan" for our new baby?

Our first baby never slept well, and I don’t want to make the same mistake with our next.  How soon can we start to get her to sleep through the night?  How soon should we get her on a good schedule?

It’s tempting to correct any mistakes you think you made with your first baby by doing things differently with your second, but before you make a plan it’s a good idea to be realistic.  Newborns sleep a lot no matter what you do, but they aren’t ready to be on the kind of day/night pattern that will come later. First, let’s talk about normal sleep.

 During the newborn period, from birth until about two months of age, most babies will sleep between 15 to 16 hours out of each 24 hour period.  Sleep periods will last anywhere from 20 minutes to five hours and be spread over day and night. (Sometimes babies this age sleep and feed at the same time, so if you think your baby “never” sleeps during the day, notice if she is dozing at the breast.)

From three to four months,  babies usually decrease their total amount of sleep and will begin to have more of their sleeping time during the night. At this point a baby may sleep as long as six to eight hours during one sleep period and a total of 13 to 14 hours out of 24. This is the age when you can begin shaping your baby's sleep patterns.

From five to six months, you can expect your baby to settle in to a sleep pattern in which nighttime sleep is continuous for 10 to 12 hours except for feeding times. During the day, a baby will take two to three naps to bring the total amount of sleep in 24 hours to 13 to 15 hours.

If your baby is sleeping a lot less than these hours, that may be fine for her, even if it is less than average. However, it is possible that your baby needs more sleep if she tends to be fussy or irritable after she’s been awake for an hour.

During the first few months of your baby's life she has to wake up during the night because she's hungry.  A breast fed baby nurses frequently--usually eight to ten times in twenty-four hours. You should respond to her nighttime cries by offering a feeding.  A formula fed baby may not need to be fed as often, but she still may be hungry within three hours of her last feeding. Once your baby has been gaining weight well (between 5-8 ounces per week) she may be ready to stretch out feeding times.

During the night, keep the lights dim and talk quietly to your baby while you feed or change her.  Try to avoid playing with her or talking to her.  If you don't wake her up too much so she may fall back to sleep with less difficulty.

During the day, avoid letting your baby sleep more than two hours at a stretch.  If she sleeps for too long at a time during the day, she will is more likely to want to be awake during the night. 

Try to put your baby in her bassinet or crib or co-sleeper as soon as she seems slightly drowsy rather than waiting until she is yawning, fussing or completely asleep.  If she falls asleep sucking on a pacifier, gently remove it before putting her in her crib.  She will sleep longer if she can learn to settle herself from drowsiness into a deep sleep.

Once your baby is nursing or taking her bottle eagerly and is gaining weight well, you can begin to delay your response when she fusses during the night. If you wait a few minutes before going in to check her  she may settle herself and fall back to sleep. If she continues to cry, check on her, but avoid turning on the light or picking her up. If she escalates her crying, then pick her up to see if she is hungry or otherwise uncomfortable. If she seems hungry, feed her and change her if necessary and put her back into her crib to sleep.

If your baby is more than three months old, if she hasn’t stretched out her sleep at night, you can begin helping her learn to soothe herself without feeding multiple times during the night. Before that, it’s wise to let her nurse whenever she seems hungry.

In my work as an infant sleep consultant I often talk to families who have "tried everything" by the time their babies are three months old.  Often, that is the problem.  A baby's sleep changes week by week during this time, so if a parent keeps changing the approach, the result is usually more frustration, less sleep.  Even if it seems like the approaches above aren't working quickly, stay steady and you may find that you won't need any more suggestions by the time she's four months old.

Sweet dreams (someday),

Meg Zweiback, R.N., CPNP, is an infant sleep consultant in Oakland, California