How much should a baby sleep, and why is my baby waking at night?

A newborn sleeps about 14 to 17 hours in a day, but in short pieces, and waking at night is normal for most of the first year.^1,2 Sleep grows into longer stretches slowly, and each baby moves at a different speed. Below are the questions parents ask Dr Dutta most, with what the research actually shows.

How many hours should a newborn sleep?

From birth to 3 months, babies need about 14 to 17 hours of sleep in 24 hours, naps included.¹

That sleep comes in short blocks, broken by feeds. A newborn has no sense of day and night yet. Her stomach is small, so she wakes because she is hungry, not because something is wrong.

The normal range is wide. In a large review of studies from many countries, average infant sleep was about 12.8 hours, but healthy babies ranged from under 10 to almost 16 hours.² So if your baby sleeps a little less than the chart, and she is feeding well, growing and alert when awake, she is fine.

How much sleep does a baby need at each age?

The World Health Organization (WHO) gives these daily totals, including naps:¹

• 0 to 3 months: 14 to 17 hours
• 4 to 11 months: 12 to 16 hours
• 1 to 2 years: 11 to 14 hours
• 3 to 4 years: 10 to 13 hours

Studies from Asian countries find children there sleep about an hour less on average than children in Western countries.² In Indian homes, bedtimes are often late because a parent comes home late, and the whole family eats dinner at 10 pm. That is part of family life, but a toddler who goes to bed very late usually does not make it up in the morning.

Is it normal for my baby to wake up at night?

Yes. Night waking is normal for babies, and many children still wake at night in the second year.²

Pooled studies show babies under 2 months wake anywhere from 0 to more than 3 times a night. Children aged 1 to 2 years still wake from 0 to about 2.5 times a night.² Every human, adult or baby, surfaces briefly between sleep cycles. Babies have shorter cycles, and many need help to drift off again.

What matters is whether the waking comes with other problems: poor feeding, poor weight gain, noisy breathing, or a baby who seems unwell. Waking on its own is not a disease.

When do babies sleep through the night?

There is no fixed age. Some babies give long night stretches by 3 to 5 months, while many healthy babies still wake at 6 and 12 months.^3,4

In one study, half the babies were sleeping from midnight to 5 am by about 3 months, and from 10 pm to 6 am by about 5 months.³ Another study of 388 babies found that between 28% and 57% of 6 and 12 month olds did not yet sleep 6 or 8 hours in a row.⁴

The reassuring part: babies who did not sleep through had no difference in their mental or motor development, and their mothers' mood was no different.⁴ Sleeping through the night was linked to lower rates of breastfeeding.⁴ So a breastfed baby who still wakes is doing what many breastfed babies do.

What is the 4 month sleep regression?

The "4 month sleep regression" is a popular name, not a medical diagnosis, for a phase when a baby who was sleeping well starts waking more around 3 to 5 months.

Sleep changes faster in the first 4 months than at any other time in infancy.³ Around this age babies become more aware of the world, roll, and are easily distracted during feeds, so some feed less in the day and wake hungry at night. Sleep becomes more like adult sleep, with lighter phases where a baby is more likely to wake fully.

What helps:

• Feed in a quiet, dim room during the day so she takes a full feed.
• Keep the same bedtime routine every night.
• Put her down drowsy but awake some of the time, so she practises settling.

Most families find this phase passes in a few weeks.

Why does my baby sleep all day and stay awake all night?

This is day night confusion. A newborn's body clock is not set yet, and it learns from light, noise and routine over the first few months.

In a study of babies aged 6 to 12 weeks, the share of sleep that happened at night grew week by week. Babies who were exposed to more light in the early afternoon slept better at night.⁵

Practical steps:

• In the day, open the curtains, keep normal household noise and talk to her during feeds.
• At night, keep lights low, feed quietly and change nappies only if needed.
• In the Kolkata summer, a bright verandah in the afternoon is good, but keep her out of direct hot sun.

Should I wake a sleeping baby to feed?

In the first few weeks, usually yes. The AAP advises that a formula-fed baby who sleeps longer than 4 to 5 hours in the first few weeks and misses feeds should be woken and offered a bottle.⁶

Breastfed newborns usually feed about every 2 hours, which adds up to 10 to 12 feeds in 24 hours.⁷ Babies born early can be sleepy, and premature babies or those with medical problems may need feeds on a schedule set by your doctor.⁷ In her practice, Dr Dutta also asks parents to wake jaundiced or slow-gaining babies rather than let them go long between feeds.

Once your baby has regained her birth weight and is gaining well, and your doctor is happy, you can usually let her wake on her own at night. Grandmothers sometimes say "never wake a sleeping baby". For a healthy older baby that is fine. For a sleepy newborn in the first weeks, it is not.

How many naps does a baby need by age?

Most babies settle into two naps a day by 9 to 12 months, and one afternoon nap by 15 to 24 months.⁸

A rough pattern:

• Newborn to 3 months: many short naps, with no real pattern.
• About 4 to 8 months: often 3 naps, slowly dropping to 2.
• 9 to 12 months: 2 naps for most babies.⁸
• 15 to 24 months: 1 afternoon nap.⁸
• 3 to 4 years: many children still nap, but fewer each year. Naps have usually stopped by about 7 years.⁸

Watch your baby more than the clock. Rubbing eyes, staring, yawning and fussing are signs she is ready to sleep.

What is a good bedtime routine for a baby?

A short, calm routine done the same way every night helps babies and toddlers sleep better, and the more nights you do it, the better it works.⁹

A study of over 10,000 young children in 13 countries, India included, linked a regular bedtime routine to earlier bedtimes, falling asleep faster, fewer night wakings and longer sleep.⁹ Children whose families did a routine more often slept better than those who did it now and then.⁹

A simple, short routine might be:

1. A warm wash or bath, or an oil massage if your family likes it
2. Clean nappy and night clothes
3. A feed in a dim room
4. A song, a short story or a prayer in the same words each night
5. Into the cot, drowsy, with the light off

The steps matter less than doing them in the same order each night.

Is sleep training safe for my baby?

Gentle behavioural sleep methods used after about 6 months have not been shown to harm a child's emotions, behaviour or bond with parents.^10,11

A review of 52 studies by the American Academy of Sleep Medicine found that these methods worked in 94% of studies, and over 80% of children improved, with the gains lasting 3 to 6 months.¹²

The worry many parents have is long-term harm. An Australian trial followed children for 5 years after their parents used sleep methods at 8 to 10 months. At 6 years, there was no difference in emotional problems, behaviour, stress, closeness to parents, or mothers' mental health.¹⁰ A smaller trial measured stress hormone in saliva and found no sign of extra stress, and no change in attachment a year later.¹¹

Sleep training is a choice, not a duty. If night waking is not a problem for your family, you do not need to do it.

What are the gentle sleep training methods?

The American Academy of Sleep Medicine review found the strongest support for unmodified extinction (putting the baby down and not going back until morning, unless she is ill or unsafe) and for preventive parent education (learning about routines and settling before problems start). Graduated extinction (checking on your baby at longer and longer gaps) and bedtime fading with positive routines (moving bedtime later until the baby falls asleep quickly, then slowly earlier) were also supported.¹²

A small trial tested graduated extinction and bedtime fading. Both helped babies fall asleep faster, and graduated extinction also cut night wakings.¹¹ Neither showed signs of extra stress, and attachment was no different 12 months later.¹¹ Many families find the gentler, gradual methods easier to stick with.

Some tips if you try it:

• Wait until your baby is healthy, gaining weight, and at least 6 months old.
• Agree as a family first. Sleep methods fail when a grandparent picks the baby up at the first cry.
• Choose a calm week, not the week of a wedding or a move.
• Stop and see your doctor if your baby is unwell.

Is it safe for my baby to sleep in our bed?

The American Academy of Pediatrics (AAP) advises room sharing without bed sharing: your baby sleeps in your room, but on her own firm, flat surface.¹³

The safe sleep basics are:¹³

• Always on her back to sleep
• A firm, flat, non-tilted surface, such as a cot or a separate baby bed next to yours
• No pillows, soft quilts, bolsters or toys in the sleep space
• Do not let her overheat, which is a real risk under heavy blankets in a closed room
• Breast milk, routine vaccines and a smoke-free home all lower the risk

Bed sharing is common in Asian countries. In one large survey, it ranged from about 6% of families in New Zealand to over 80% in Vietnam.¹⁴ Dr Dutta understands why families do it. If you do, please keep the baby away from pillows and gaps, and never sleep with her after alcohol, smoking or sedating medicine, or on a sofa.

Why do Indian babies go to bed so late?

Late bedtimes are common across Asia, India included, and children there tend to sleep less in total than children in Western countries.¹⁴

In a survey of almost 30,000 young children, those in mostly Asian countries had later bedtimes and shorter total sleep, and their parents more often felt their child had a sleep problem.¹⁴

Late bedtimes in Kolkata often come from family schedules: a father home at 9, dinner at 10, a TV on in the shared room. Small changes help. Try an earlier dim, quiet corner for the baby even if the rest of the house is awake, and keep screens away from the sleep space.

How can I cope with so little sleep as a new parent?

Share the nights, sleep when you can in the day, and ask for help early. Broken sleep in the first months is normal, but it should not leave you hopeless.

Some ideas that work for families Dr Dutta sees:

• Split the night into shifts. If you are breastfeeding, a partner or grandmother can do the nappy change and settling.
• Take one daytime nap, even 30 minutes, while someone else watches the baby.
• Keep visitors to a minimum in the first weeks.
• Never drive or hold the baby on a sofa when you are about to fall asleep.

If you feel low, anxious, or cannot sleep even when the baby sleeps, tell your doctor. That can be a sign of postnatal depression, which is common and treatable.

When should I move my toddler from a cot to a bed?

There is no fixed age. Most families move their child when she starts climbing out of the cot, or when she is tall enough that the cot is unsafe.

Keep the same bedtime routine when you switch, so only one thing changes at a time. Put the bed low, against a wall, with a guard rail on the open side. If a new baby is coming, make the move a few months before the birth or wait until the baby has settled in, so your older child does not feel pushed out.

When should I see a doctor about my baby's sleep?

See a doctor if poor sleep comes with signs of illness, or if your baby is hard to wake. Get urgent help for:

• A baby under 3 months with a temperature of 38 degrees C or more¹⁵
• A baby who is floppy, very drowsy, or too sleepy to feed
• Breathing pauses, gasping, or loud snoring most nights
• Fewer wet nappies, or poor weight gain
• Crying that you cannot settle, with vomiting or fever
• A sudden change, such as a happy sleeper who now screams at night for days
• You feel unable to cope, or worried you might harm yourself or your baby