Newborn Sleep Patterns: What's Normal & When to Expect Changes (0-6 Months)

It's 2am, and as you find yourself rocking your newborn back to sleep for what feels like the tenth time, you find yourself Google searching "when will my baby sleep through the night?" 

If this sounds familiar, you're not alone. Many new parents experience exhaustion and confusion when it comes to newborn sleep patterns. It's normal to wonder if your baby's frequent wakings are normal, and to want to know how to establish better sleep habits. 

As a pediatrician who has cared for thousands of infants, I want to help you set realistic expectations for baby sleep, while providing practical strategies to encourage healthy sleep development. In this guide, we'll cover what normal newborn sleep looks like, common sleep challenges, and steps to support your baby's natural sleep progression.

What "Normal" Baby Sleep Actually Looks Like

Myth: Babies should sleep through the night by three months old. Fact: "Sleeping through the night" is considered a five-hour, uninterrupted stretch at six months old. 

Myth: Sleep training is a strict, regimented process. Fact: Sleep training can be a gentle, adaptable process that builds upon your baby's, and family's, natural rhythms.

Newborns have very different sleep cycles compared with older children and adults. And they are not born with a well-developed internal clock to immediately differentiate between day and night [Wong, et al. 2022]. Instead, what I've seen in practice over the past decade is that infant sleep patterns tend to be influenced by nutritional needs, age, or developmental stages, and environmental factors such as natural light exposure and daytime versus nighttime activity patterns of the family. 

Typical Sleep Patterns by Age: What I See in Practice as a Pediatrician

See the chart at the below👇 

These are the typical sleep hours and nighttime wakings I observe as a pediatrician, aligning with recommendations and averages from the National Sleep Foundation [Hirshkowitz, et al. 2015]. While these numbers can provide a general guide, it's important to remember that every baby is unique, and sleep patterns can vary. Your pediatrician can clarify what's most appropriate for your baby.

I find it a helpful reminder to families that by six months old, the definition of "sleeping through the night" from a pediatrician's perspective is about a five-hour stretch - not a full eight hours, as many parents expect.

Understanding Your Baby's Sleep Development

Biological Sleep Rhythms

Newborns do not produce melatonin (the sleep-regulating hormone) in a predictable way until around three months of age [Paditz, Ekkehart. 2024]. Before then, they rely on frequent feedings and naps, and sleeping in shorter and potentially inconsistent bursts throughout the day and night.

In my practice, I generally observe that newborns nap in 2-3 hour stretches (give or take), both day and night. By the time they reach one month old, these sleep stretches often extend to 3-4 hours. This pattern supports their nutritional needs for healthy physical growth and brain development, and reflects how their bodies gradually adjust to life outside the womb.

Day-Night Confusion

Since newborns are not born with a well-established circadian rhythm, some of them may sleep more during the day and be more alert at night. Helping them transition to a more predictable sleep cycle requires gentle guidance and consistency.

Common Sleep Pattern Changes

The 4-Month Sleep Regression

Around four months old, many babies experience what is commonly termed a "sleep regression." However, after seeing countless infants during this phase, I've come to view it as a progression rather than a setback. At this stage, babies develop object permanence - the understanding that you still exist even when you're not in sight. This can lead to increased night wakings as they become more aware of their surroundings (and when they are alone), leading them to seek reassurance.

They are adjusting to these changes and learning how to self-soothe - this is a good thing!

How to Support Your Baby Through This Phase

I see families benefit from:

• Maintaining (as best possible) consistent naptime and bedtime routines.
• Providing comfort with a gentle hand on their baby's chest rather than immediately picking them up.
• Encouraging self-soothing by placing their baby down drowsy but awake, rather than fully asleep. 

Growth Spurts and Sleep

Babies experience growth spurts around 4-6 weeks, 3-4 months, and 6-7 months old, which can also temporarily disrupt their sleep. They might also wake more frequently due to increased hunger. Ensuring they receive enough calories during the day can help minimize excessive night waking. 

Supporting Natural Sleep

Strategies to Establish Day/Night Awareness

Many parents find it helpful to:

• Expose their baby to natural light during the day (while ensuring proper shade from direct sun exposure).
• Engage their baby in age-appropriate activities such as tummy time, gentle play, and talking or singing to encourage daytime alertness.
• Keep nighttime interactions calm and soothing by using dim lights, soft voices, and minimal stimulation. 

Age-appropriate Routines to Consider

• Morning Routine: Waking your baby at a consistent time each morning, opening the curtains to let in natural light, and starting the day with engaging activities like feeding and play can help set the stage for a predictable rhythm.
• Naptime Routine: A calm pre-nap ritual, such as reading a book or gentle rocking, can help signal that it's time for rest.
• Bedtime Routine: Creating a soothing wind-down routine, such as a warm bath, dimmed lights, a quiet lullaby, and placing your baby in their crib while drowsy but still awake (following safe sleep guidelines).

Remember, these routines don't need to be (and aren't supposed to be) rigid. Instead, think of them as gentle patterns that facilitate structure and consistency while still allowing for flexibility to fit your family's needs. 

🩺 Please consult your pediatrician for advice specific to your baby. 

When to Be Concerned

While sleep variations are normal, some signs that can indicate the need for medical attention include:

• Excessive sleepiness or difficulty waking to feed
• Sounds of snoring, gasping, or pauses in breathing during sleep
• Ongoing difficulty falling or staying asleep beyond six months old

🩺 Remember to consult your pediatrician for guidance specific to your baby.

Conclusion

A baby's sleep will evolve as they grow, and while it may feel unpredictable at times, a combination of consistency, gentle guidance, recognizing their innate patterns and cues, and appropriate expectations can help ease the transition. Remember, every baby is unique, and there's no one-size-fits-all approach.