Evie Summers
Sleep is a precious commodity when you have a newborn, and it can be very challenging for parents and caregivers of babies under a year old to get the sleep they need. Newborns don't yet have a sense of day and night and wake up every couple of hours to eat. They should get 14–17 hours of sleep over a 24-hour period, with some sleeping up to 18–19 hours a day. Co-sleeping is a common practice, with more than half of mothers surveyed in 2015 reporting that they co-sleep. While it can be good for bonding and make breastfeeding easier, it is also associated with an increased risk of sudden unexpected death in infancy (SUDI), including sudden infant death syndrome (SIDS) and fatal sleep accidents.
| Characteristics | Values |
|---|---|
| Number of hours of sleep a newborn needs in a 24-hour period | 14-17 hours |
| Number of hours of sleep a 1-month-old gets on average | 5.7 hours |
| Number of hours of sleep a 6-month-old gets on average | 9.5-11 hours |
| Frequency of waking up to eat | Every 2-4 hours |
| Frequency of waking up for breastfed babies | Every 2-3 hours |
| Frequency of waking up for bottle-fed babies | Every 3-4 hours |
| Recommended sleeping position | On their back |
| Recommended sleeping surface | Firm, flat, and level |
| Recommended sleeping environment | Clear, not too hot, and smoke-free |
| Recommended sleeping location | In the same room as parents, but not in the same bed |
| Benefits of co-sleeping | Bonding, convenience, and ease of breastfeeding |
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What You'll Learn
Co-sleeping risks and safety advice
Co-sleeping, or bed-sharing, is when babies sleep on the same surface as another person, such as a parent or sibling. It can be intentional or unintentional, such as when parents fall asleep on a couch holding their baby. While co-sleeping can have benefits, such as facilitating breastfeeding and bonding, it is important to be aware of the potential risks and safety considerations.
One of the main risks associated with co-sleeping is the increased risk of Sudden Unexpected Death in Infancy (SUDI), including Sudden Infant Death Syndrome (SIDS) and fatal sleep accidents. This risk is particularly elevated if either parent smokes or consumes alcohol or drugs, including prescription medications that cause heavy sleep. Other factors that contribute to the risk include preterm birth, low birth weight, and illness in the baby, as well as extreme fatigue or illness in the parents.
To reduce the risks of co-sleeping and create a safer environment, consider the following recommendations:
- Ensure the baby sleeps on their back on a firm, flat, and level surface, such as a mattress on the floor, to prevent suffocation and promote easy breathing.
- Keep the sleep space clear and free from hazards, including pillows, sheets, blankets, toys, and any items that could create a strangulation risk, such as jewellery or teething necklaces.
- Avoid co-sleeping on couches, chairs, or waterbeds, as these surfaces can obstruct the baby's airways.
- Place the baby on the side of the bed, away from the edge, and next to only one parent. Avoid sleeping with the baby between parents or next to other children or pets to reduce the risk of suffocation.
- Keep the baby's environment smoke-free, as exposure to second-hand and third-hand smoke increases the risk of SUDI.
- Avoid co-sleeping if you or your partner smoke, consume alcohol or drugs, or take medication that causes heavy sleep, as these factors impair your ability to respond to the baby.
- If the sleep space is not big enough, consider alternatives, such as using a separate mattress for older children or placing the mattress on the floor to prevent the baby from rolling off the bed.
- Avoid overbundling and overheating the baby. Use light sleep clothes and light blankets, and evaluate the baby for signs of overheating, such as sweating or a hot chest.
- Avoid using products that claim to reduce the risk of SIDS, such as sleep positioners or monitors, as there are no known products that can effectively do so.
- Ensure that all sleep surfaces and products used are approved by relevant safety commissions and meet federal safety standards.
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How to establish a newborn sleep schedule
Establishing a newborn sleep schedule is a challenge for new parents. Newborns sleep around 14 to 17 hours over a 24-hour period, with sleep times ranging from 2 to 4 hours. During the first few weeks of a baby's life, they are still developing their sense of day and night, so it's normal for their sleep schedule to be erratic.
- Learn your baby's cues: Pay attention to your baby's hunger and sleep cues. This will help you develop a feeding and sleep schedule that works for your family. For example, a newborn may signal that they are sleepy by yawning, rubbing their eyes, or pulling at their ears.
- Keep the lights low at night: Avoid playing with or talking to your baby at night. Keep the lights low to send the message that nighttime is for sleeping.
- Create a bedtime routine: Establish a relaxing and predictable bedtime routine, including activities such as feeding, cuddling, rocking, and walking. This will help set the stage for healthy sleep habits later in life.
- Put your baby to bed when they are tired: Learn your newborn's tiredness cues and put them to bed when they are tired but have not yet fallen asleep. This will help them learn to fall asleep on their own, which is a valuable life skill.
- Be flexible and responsive: In the early months, it's important to be flexible and follow your baby's lead. Your baby's cues and body language will help you understand whether they want to sleep, feed, or interact with you. It's okay to go with whatever feels right at the time.
- Room-sharing without bed-sharing: The American Academy of Pediatrics (AAP) recommends room-sharing without bed-sharing. This means placing your baby's crib or bassinet in your bedroom instead of in a separate nursery. This keeps your baby nearby and helps with feeding, comforting, and monitoring at night.
- Create a safe sleep environment: Ensure your baby sleeps on their back on a firm, flat, and level surface, in a clear, smoke-free, and not-too-hot space. Remove any items that could create a strangulation risk, such as jewellery, teething necklaces, or loose bedding.
- Wait until your baby is older to sleep train: Sleep training should wait until your baby is at least 4 to 6 months old. At this age, your baby's bedtime, naptime, and wake times will become more consistent, and you can work towards putting them down while they are drowsy but still awake.
Note: While co-sleeping or bed-sharing can have benefits for breastfeeding and bonding, it is associated with an increased risk of sudden unexpected death in infancy (SUDI), including sudden infant death syndrome (SIDS). If you choose to co-sleep, follow the guidelines above to reduce risks and make co-sleeping safer.
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Room-sharing vs bed-sharing
Room-sharing is when a baby sleeps in the same room as their parent(s) or carer, but in their own separate sleeping space, such as a cot, crib, bassinet, play yard, or Moses basket. Bed-sharing, on the other hand, is when a baby shares the same sleeping surface as an adult for most of the night. While room-sharing is considered safe by the American Academy of Pediatrics (AAP), bed-sharing is not and is associated with an increased risk of SIDS (Sudden Infant Death Syndrome) and other sleep-related deaths.
Room-sharing allows parents to keep their baby nearby, making it easier for feeding, comforting, and monitoring during the night. It is recommended that babies sleep in the same room as their parents for at least the first six months to reduce the risk of SIDS. To create a safe sleep environment, babies should sleep on their back on a firm, flat, and level surface, in a clear space that is not too hot and smoke-free.
Bed-sharing is a traditional practice that has been observed in various cultures for centuries. It can facilitate breastfeeding, enhance bonding, and allow parents to respond more easily to their babies during the night. However, it is important to take precautions to make bed-sharing safer. Babies should always be placed on their back, away from the edge of the bed, and next to only one adult. The sleep space should be free of pillows, blankets, and other items that could cover the baby's head and pose a suffocation risk.
Whether you choose to room-share or bed-share, there are measures you can take to optimize sleep for both you and your baby. For room-sharing, consider using white noise or a fan to buffer noises that may wake your baby. Avoid turning on the lights when you go to bed or wake up, and opt for a vibrating watch instead of an alarm clock to avoid disturbing your baby. If you plan to bed-share, ensure the mattress is firm and large enough to fit everyone comfortably, and avoid bed-sharing if you or your partner smokes or consumes drugs or alcohol.
Ultimately, the decision to room-share or bed-share depends on various factors, including personal preferences, cultural practices, and the needs of the baby and parents. By following safety guidelines and recommendations, you can create a safe and nurturing sleep environment for your newborn.
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Breastfeeding and co-sleeping
The topic of co-sleeping with a newborn is a highly debated one, with some doctors and researchers claiming that it puts an infant at risk of sleep-related death. However, it is a common practice, with many parents choosing to co-sleep for various reasons, including the convenience of breastfeeding and the facilitation of bonding.
Co-sleeping is convenient for breastfeeding at night, and it has been found that mothers who co-sleep with their babies tend to breastfeed longer and keep exclusively breastfeeding for longer than those who do not co-sleep. Breastfeeding also provides babies with important immune factors, such as antibodies and white blood cells, which may help protect them from Sudden Infant Death Syndrome (SIDS). Additionally, breastfed babies suffer fewer infections than formula-fed babies.
When a breastfeeding mother co-sleeps, she usually lies in a protective "C" shape around her baby, keeping the baby at the level of her breast with an arm between the baby's head and the pillow. This position prevents the mother from rolling over onto the baby. It is important to note that breastfeeding alone does not create a safer bed-sharing environment, and other factors, such as a firm, flat mattress, are necessary to reduce suffocation risks.
The practice of bed-sharing is not new, with anthropologist Mel Konner stating that Homo sapien mothers and their newborns have been sleeping together for more than 200,000 years. Bed-sharing is a tradition in at least 40% of all documented cultures, and some cultures even consider it cruel to separate a mother and baby at night.
While co-sleeping can be beneficial, it is important to be aware of potential risks and take steps to make it safer. Some recommendations include:
- Placing the baby on their back to sleep
- Avoiding swaddling or wrapping the baby
- Keeping the baby away from pillows, blankets, and sheets
- Ensuring the mattress is firm, flat, and level
- Moving the bed away from the wall to prevent the baby from becoming trapped
- Avoiding bed-sharing if you or your partner smokes
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Newborn sleep environment
Newborns sleep around the clock, waking every few hours to feed. They should get 14–17 hours of sleep over a 24-hour period, with some sleeping up to 18–19 hours a day. During the first weeks of a baby's life, some parents choose to room-share, keeping their baby close by in a crib, portable crib, play yard, or bassinet. This practice is known as room-sharing and is recommended by the American Academy of Pediatrics (AAP), which advises against bed-sharing due to the risk of Sudden Infant Death Syndrome (SIDS) and other sleep-related deaths.
To create a safe sleep environment for your newborn, follow these guidelines:
- Always place your baby on their back to sleep, on a firm, flat, and level surface.
- Keep the sleep space clear of any items that could cause suffocation or strangulation, such as pillows, sheets, blankets, toys, and loose jewellery.
- Ensure the room is well-ventilated and smoke-free. Exposure to second-hand and third-hand smoke is harmful to babies.
- Avoid co-sleeping on a couch, armchair, or other soft, lumpy surfaces, as these can create air pockets that make it difficult for newborns to breathe.
- If co-sleeping, place your baby on the side of the bed, away from the edge, and next to only one parent. Avoid placing them between parents or next to other children or pets.
- Keep lights low at night, and resist the urge to play or talk to your baby. This will help them understand that nighttime is for sleeping.
- Establish a consistent schedule for feeding and napping, as newborns don't yet have a sense of day and night.
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Frequently asked questions
Co-sleeping can be controversial and is advised against by many doctors and leading health organizations in the U.S. due to the risk of sleep-related death, including SIDS. However, many families still co-sleep, and it is a tradition in at least 40% of documented cultures. If you choose to co-sleep, there are ways to do it more safely, such as placing your baby on their back, on a firm, flat, and level surface, and keeping their sleep space clear of pillows, sheets, blankets, and other items that could cause suffocation.
Co-sleeping can promote bonding, help children feel safe, and make nighttime nursing easier. It can also be more convenient for parents, as it allows them to respond to their baby's needs quickly and with minimal interruption to their own sleep.
Newborns typically sleep around the clock, waking up every couple of hours to eat. They should get 14-17 hours of sleep over a 24-hour period, and some newborns may sleep up to 18-19 hours per day. By 6 months, the average infant sleeps 9.5 to 11 hours per night, with 1-3.5 nighttime wake-ups.
