Infant Sleep
The developmental progression of sleep patterns from birth through 12 months, characterised by gradual consolidation of nighttime sleep and reduction in total sleep hours.
| Total sleep (0–3 months) | 14–17 hours/day |
| Total sleep (4–11 months) | 12–15 hours/day |
| Night sleep consolidation | 6–8 weeks onwards |
| sleep cycles | 50–60 minutes (vs 90 min adults) |
Sleep Architecture by Age
| Age | Night Sleep | Daytime Naps | Total Sleep |
|---|---|---|---|
| 0–6 weeks | 8–9 hours (fragmented) | 7–9 hours (4–5 naps) | 14–17 hours |
| 2–3 months | 9–10 hours | 4–5 hours (3–4 naps) | 13–15 hours |
| 4–6 months | 10–11 hours | 3–4 hours (2–3 naps) | 12–15 hours |
| 7–12 months | 11–12 hours | 2–3 hours (2 naps) | 12–14 hours |
newborn Sleep (0–3 Months)
circadian rhythm: Absent at birth; develops 6–12 weeks. Newborns cannot distinguish day from night.
Sleep states:
- Active (REM) sleep: 50% of total sleep (vs 25% in adults)
- Quiet sleep: Develops gradually
- Transitional periods: Frequent brief wakings
Feeding intervals: Every 2–4 hours, including overnight. Hunger is primary cause of night waking.
Sleep Consolidation (3–6 Months)
developmental milestone: Circadian rhythm matures; melatonin production begins (6–12 weeks).
Longest sleep stretch: Increases from 4–5 hours (newborn) to 6–8 hours by 4 months.
sleep regression: Common at 4 months due to transition from newborn to adult sleep cycles. Increased night wakings may persist 2–6 weeks.
Established Patterns (6–12 Months)
Sleeping through the night: 60–70% of infants achieve 6+ consecutive hours by 6 months. "Through the night" clinically defined as 5 hours continuous sleep.
Nap transitions:
- 4–6 months: Drop to 2–3 naps
- 9–12 months: Transition to 2 naps (morning + afternoon)
self-soothing: Capacity develops 4–6 months. Not all infants achieve this independently.
Safe Sleep Environment
AAP recommendations (2016):
- back sleeping position only
- Firm, flat surface (cot/Moses basket)
- room-sharing without bed-sharing (first 6–12 months)
- No loose bedding, pillows, or soft toys
- Room temperature: 16–20°C
SIDS risk reduction: Back sleeping reduces risk by 50%. Peak risk: 2–4 months.
Common Sleep Challenges
Night wakings: Normal throughout infancy. Frequency varies by feeding method, temperament, developmental stage.
sleep associations: Feeding-to-sleep, rocking, or parental presence may become required for sleep initiation.
separation anxiety: Emerges 6–8 months; may disrupt previously consolidated sleep.
teething: Minimal evidence links teething to significant sleep disruption. Fever or illness more likely causes.
sleep training Methods
| Method | Description | Typical Age |
|---|---|---|
| graduated extinction | Progressively longer check-in intervals | 6+ months |
| controlled comforting | Timed checks without picking up | 6+ months |
| chair method | Gradual parental withdrawal | 6+ months |
| pick-up/put-down | Respond immediately, minimal intervention | 4+ months |
Evidence: No long-term psychological harm from graduated methods when applied after 6 months (Australian research, 2012).
Warning Signs
Consult GP if:
- Snoring, breathing pauses, or gasping during sleep
- Excessive daytime sleepiness despite adequate night sleep
- Inability to fall asleep after 30+ minutes consistently
- Sudden change in established sleep patterns with other symptoms
Feeding and Sleep
Night feeds:
- 0–3 months: Every 2–4 hours (physiologically necessary)
- 4–6 months: 1–2 feeds typical
- 6+ months: Many infants can sleep without feeds; individual variation normal
dream feed: Optional late-evening feed (10–11pm) before parental bedtime. Mixed evidence for effectiveness.
Cultural Variations
co-sleeping: Practised in 60–90% of cultures globally. UK/NHS guidance recommends room-sharing only due to SIDS risk with bed-sharing.
Sleep duration: Asian infants average 1–2 hours less sleep than Western counterparts, with later bedtimes and more parental presence.
Realistic Expectations
- Continuous 12-hour nights are not developmentally typical before 12 months
- Sleep patterns remain variable throughout infancy
- Individual differences exceed age-based averages
- Regression periods coincide with developmental leaps (crawling, walking, language)
See also: Sleep Cycles, SIDS Prevention, [[night weaning]], Sleep Training Methods, Circadian Rhythm Development