What does biologically normal infant sleep actually look like?
We’ve all been there wondering if we are doing our babies a disservice by feeding them to sleep. Questioning whether we are damaging them because they only sleep in 1–2-hour increments at night. You’ve probably pondered if 20-minute naps are harming your baby or if they are actually ok. Most of us at some point have compared our baby to our friend's or neighbour's babe, who is sleeping solidly from 11-5 am every night, and fretted that ours is not even close to matching this feat. We’ve all at one time or another wondered what the heck normal looks like when it comes to baby and infant sleep, surely I’m not alone in this, right?
Can we begin by saying there is no such thing as normal; if we can first understand this it helps us to soften into acceptance on our parenting journey. Whether we’re adults, children, or babies there is so much variation in what makes us human beings, and that's what makes us all so brilliantly unique. So, as we go on to discuss sleep let’s take my use of the word “normal” lightly and instead understand it for what it means in relation to all things human which is “most commonly”.
Infant sleep is one of those things it is impossible to have a normal or centre point for – although some, mainly the infant sleep industry, do try to define one! So, you need to keep in mind during this discussion there is a range that is considered more frequent, but there will always be children and babies who fall outside of this range and guess what! They are normal too!
So, what does “normal” infant sleep look like?
Let’s clear up some of the confusion out there and give you the the low down on the reality of sleep with an infant and what you can expect from a biological perspective. Infant sleep can be a combination of all the following:
Both Less And More:
Well, it’s kind of very variable! A study by Paavonen et. Al (date) found that some newborns slept for only 9 hours over a 24-hour period and others up to 20 and concluded at the end of their study that children at both ends of this spectrum were getting the sleep they needed.
Day to day, the amount of sleep our little babes take can vary and fluctuate too. So it can be tough to give any guidance as to what is right or wrong even for an individual. There are those babies who need a lot of sleep and those who need, well, not so much and sometimes it can flip between both of these. The same goes for us adults, we all know someone who can thrive and get life done on 6 hours of sleep per night and others who need to be tucked up in bed by 8.30 pm each night just to get through the next day.
Check out this table below on the variability of sleep needs in the first 5 years:
Reference: Galland BC, Taylor BJ, Elder DE, Herbison P. (2012) Normal sleep patterns in infants and children: a systematic review of observational studies. Sleep Med Rev. 16(3):213-22.
This study is available online:here
As you can see there is a LOT of normal there! So fear not, what so and so down the road says her baby is up to, know that your baby is unique and their sleep needs will fluctuate from one day to the next.
Cuddles Are Legit Needs
Our babies are born early on in their development compared to other mammals. We are sophisticated primates, who are carrying species, so they come out wired for cuddles. Newborns and little babies still require a lot of nurturing after exiting the warm confines of our wombs and can require a lot of holding and comfort to feel safe enough to relax into sleep. So “normal” can look like needing a whole lot of help and cuddles to find sleep. Again, there will be those who don’t and there will be those who need a LOT more than a lot to feel safe enough for their systems to find sleep and both are a-ok!
They Are Hungry, Often!
Our babies are so tiny when they greet us outside of our bellies and so too are the size of their stomachs. Small babies can only fit a small amount of breastmilk or formula in these teeny tiny tummies at one time and what they do eat is usually digested within two hours. This concept does not suddenly change overnight, and it can be so common for our babies to wake frequently in those early months as they nourish themselves enough to grow. This is particularly noticeable in breastfed babies where the constituents of breastmilk are broken down much quicker than the cow’s milk proteins in formula.
Waking Is A Genius of Biological Design
Imagine back in the days of early human life, or even just before we lived in our comfortable homes with locking doors and double glazing that kept us all toasty and sheltered. Before you could hand bubba over to Aunty Betty with a sterilised bottle of formula and you were their only source of safety and food. Babies, even back then, are underdeveloped in comparison with other mammals and needed a whole lot of care and protection from their caregivers early in their development. It makes complete evolutionary sense that waking in the night crying or seeking caregivers would serve to protect them from predators, keeping them safe and staying aware of being close to their source of food or nourishment. Our babies haven’t known anything other than being intrinsically part of you for 9 months so to expect them to be away from you for 12 hours per night is unrealistic. There will be some little cruisers who naturally find sleep apart from their parents much easier, yet the majority will still need closeness until their nervous systems learn the world is safe because that is how we have been wired.
What about sleeping through the night?
Research by Henderson et. al* has shown that infant sleep often peaks around 2-3 months with the longest self-regulated sleep duration (chunk of time they sleep without signalling for intervention).
From around 3 months, sleep duration seems to plateau and fluctuate until about 9 months- then increasing again until 12mo. This is why often, we find sleep is great around 3 months - then sleep becomes more disrupted.
'Sleeping through the night' was agreed upon by Henderson et. al as 10pm until 6am - 8 hours in total. So, not the blissful 12 hours from 7-7 that we hear about in unicorn land!
Henderson’s research showed that around 3 months + 5 months, 50% of infants are regularly sleeping through the night.
Babies in this age range wake on average 1.5- 2.5 times per night between 3 & 6 months (Paavonen et. al).
At 6 months, the majority of babies still wake overnight - a longitudinal study by Sadler (1994) which surveyed the parents of 640 babies found that at 6mo only 16% slept through the night.
Six month old babies wake on average 2.5 times a night and 8-month-old babies 2.4 times (Paavonen et al., 2020).
Eight months is the time parents report most sleeping 'problems' (Paavonen, 2020). This age range shows the largest range of night wakes in Paavonen's study - between 0 and 21! I can attest to this - most of my clients come to me for sleep support around this 8-10 month period.
By 12 months, nearly 3/4 of babies ‘sleep through’ (remembering it’s 8 hours) SOME (but not all) nights, but after 2yo, about 50% of children are still waking once requiring resettling.
The highest rate of self-settling behaviour was seen in 18 month old children, and whilst many still woke in the night, sleep appears to become more consolidated from around this time.
By two years old, a little over a quarter of children still wake up every or almost every night at some stage between midnight and 6am - half of that still having two wakenings for which they needed resettling.
A Rollercoaster Is Normal Too!
So you’re gliding along for the first three months and your babe is sleeping like a champ, and booooom! almost overnight you are concerned your baby has been swapped out in the dead of night as they have started to wake often. Sleep progression in our infants is not linear for the first few years of their life. There are many factors (which I discuss in my sleep courses & upcoming guides) that can affect our baby's and children’s sleep leading to increased waking and the need to be held, supported or fed. It is not uncommon for us to have patches of more disturbed sleep followed by periods of more settled sleep throughout those early years. I am almost positive most mothers you talk to would say the same. So if you’ve hit a rough patch hang in there it is most likely to change again sometime soon.
What we think infant sleep progression looks like:
VS what it actually looks like:
So have you yet gathered your baby is amazing just as they are and most likely “normal”! Waking through the night, requiring comfort to fall asleep and needing to be in proximity to you is the way our infants have been developed over many years of very clever evolutionary design. When we start to separate our expectations of how our infant sleep from the expectations of society, we can start to accept that the path of sleep is not linear. When we do this we can come into relationship with the child in front of us and find unique ways to help them find sleep easier and thus help our whole family find the rest they need.
Infant sleep is a biggy, there are so many factors at play that a one-size-fits-all routine or settling technique is doing a disservice to our innate humanness. There is no denying that sleep deprivation and getting up to our babies each and every night is really hard and that we need support from wider systems to get through these early months. Figuring out your unique child and their nighttime needs is beyond the scope of this article. My Sleep Guide is jam-packed with info to help you understand your child and help find more sleep responsively. If you are struggling on the sleep rollercoaster and would like some personalised guidance I offer 1:1 consults HERE to to get clear on what your child needs and what works for your family.
References
Burnham, M. M., Goodlin-Jones, B. L., Gaylor, E. E., & Anders, T. F. (2002). Nighttime sleep-wake patterns and self-soothing from birth to one year of age: a longitudinal intervention study. Journal of child psychology and psychiatry, and allied disciplines, 43(6), 713–725. https://doi.org/10.1111/1469-7610.00076
*Henderson, J. M., France, K. G., Owens, J. L., & Blampied, N. M. (2010). Sleeping through the night: the consolidation of self-regulated sleep across the first year of life. Pediatrics, 126(5), e1081–e1087. https://doi.org/10.1542/peds.2010-0976
Paavonen, E. J., Saarenpää-Heikkilä, O., Morales-Munoz, I., Virta, M., Häkälä, N., Pölkki, P., Kylliäinen, A., Karlsson, H., Paunio, T., & Karlsson, L. (2020). Normal sleep development in infants: findings from two large birth cohorts. Sleep medicine, 69, 145–154. https://doi.org/10.1016/j.sleep.2020.01.009
Sadler S. (1994). Sleep: what is normal at six months?. Professional care of mother and child, 4(6), 166–167.
Sleep really doesn’t have to be such a THING!
