In the first few weeks of life, the newborn's central nervous system is still immature and disorganized. His sleep-wake cycles are random, and he is likely to sleep 16 to 18 hours a day in three- to four-hour cycles, waking three or four times during the night, and needing your help to go back to sleep. By about three months, as his brain matures and he is becoming "entrained" to the routines around him, he is consolidating his sleep, sleeping through two six-hour sleep cycles at night, and taking one or two long daytime naps. You can reassure yourself that by one year most babies sleep 10 to 12 hours at night and can go back to sleep on their own if they do wake.
But just as there are adult "larks" who rise with the dawn and "owls" who are ready to party at 11 PM, infants also vary in their natural body clocks. Research published in Child Development shows correlations among the regulatory processes of sleeping, eating, and crying in infants. Some babies are described as "fussy," showing more reactivity to stimuli of all kinds, and these babies are most likely to experience sleep disruptions and to have trouble getting themselves back to sleep without help.
When Difficult Becomes Problematic
Most parents of infants will experience sleep deprivation in their child's first year of life, particularly with night waking and difficulty returning to sleep. And most infants become "discombobulated" on occasion when Grandma comes to visit or the family is traveling. But when does sleep deprivation become a "sleep problem?"
Medical experts have been unable to reach consensus about when sleep becomes a medical issue. Your doctor may focus on how often your baby wakes during the night, how long she stays awake, and whether you have to take her to your bed just to get some sleep. Has the occasional night spent in the rocking chair turned into your regular routine? Perhaps more important are the consequences of the sleep problems. Is either parent having difficulty performing daily tasks at work or home due to sleep deprivation? Are siblings falling asleep at school because of nightly waking? Finally, are family relationships suffering due to impatience, hostility, and lack of relaxed family time?
Ruling Out Physical Problems
A number of common medical issues can cause sleep problems, such as congestion or teething, so it is wise to discuss sleep issues with your pediatrician at your child's regularly scheduled well-child visits. These routine issues should be differentiated from chronic illnesses requiring medical attention, such as ear infections, asthma, reflux, or milk allergy.
According to Klaus Minde, author of The Sleep of Infants and Why Parents Matter, your physician also may rule out sleep apnea, a condition in which an infant awakens periodically because he stops breathing.