Infant’s sleep patterns worry new parents

DEARDOCTOR>> We brought our first baby home from the hospital, and it seems as though all he does is sleep. Is this normal? How much sleep should a newborn be getting? DEARREADER>> First, let us reassure you — as long as your son is feeding, urinating and eliminating regularly (about eight diapers per day) and is gaining weight, all is well. Newborns sleep a lot — anywhere from 14 to 18 hours in a 24-hour period. Some super-sleepy babies may clock as much as 20 hours per day. Even experienced parents who bring a newborn home can be surprised all over again by how much time their newest addition spends in sleep.

In the beginning, your newborn’s sleep patterns can be unpredictable. Day and night are meaningless concepts and can easily become interchanged. Whether your son sleeps in short stretches of 30 to 45 minutes each, or drops off for three or four hours at a time, it’s all perfectly normal.

Thanks to his tiny stomach, hunger will often push your sleepy infant to wakefulness, probably every three hours. Newborns feed anywhere from eight to 12 times in a 24-hour period. However, it’s not uncommon, particularly in the early weeks, to have to wake your baby for a feeding. We recommend that you don’t let your newborn go for more than five hours between feedings.

Likewise, don’t be surprised if he drifts off to sleep in the middle of a meal. Sometimes this is just for a 10or 30-minute nap and he’ll be ready to eat again. Other times he’s down for the count and will go for another few hours before hunger awakens him.

If your son is consistently sleeping through his feeding times, you’ll have to wake him up to eat. For the best results, it helps to recognize his sleep cycles. Just as for an adult, waking from a deep sleep is both difficult and unpleasant. Interrupting sleep during a lighter cycle is less stressful for all involved.

When a newborn falls asleep, he enters what is known as “active” sleep, a cycle similar to REM sleep in adults, the stage in which we dream. That is followed by a “quiet sleep,” a cycle in which deep sleep takes place. When quiet sleep ends, typically after an hour or so, the baby either wakes up or starts a new cycle of active sleep.

For the best results in waking your sleepy boy, watch for his active cycle. It’s a somewhat restless sleep with the same physical motion and rapid eye movement seen in adult REM sleep. When you see the signs of active sleep, you can begin to wake him.

If he’s swaddled, loosening the blanket may rouse him. Use your voice and your touch to draw him out, easing him into the conscious world. Even if he’s still sleepy, he can begin to feed. Meanwhile, know that within three months, the quiet life with a sleepy newborn will have become a faint memory. Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health. Send your questions to askthedoctors@ mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095.