DEAR DOCTOR K: I'm pregnant with my first child, a girl. I keep hearing about how little sleep I'll be getting for the next year. Can you give me a realistic idea of what to expect?
DEAR READER: Two things make your question hard to answer: (1) each baby is different from others, even from his or her siblings; and (2) each baby's sleep patterns change as time goes by.
As you'll see, there are wide ranges of what's "typical" of a baby's sleep -- and some babies don't fall even within that wide range. What's typical for most babies isn't typical for them. Some babies sleep as few as nine hours a day and others sleep as many as 18 hours.
A patient of mine had a little boy who slept 20 hours a day for the first six months of his life. My patient was concerned that there was something wrong with him. She also wondered if her son wouldn't get enough stimulation, and as a result might develop a learning disability. I told her that as long as the boy seemed happy, alert and playful during the few hours he was awake, I wouldn't be concerned. That child is now a sophomore in college and doing fine.
In the first few months, expect your baby's sleep pattern to be completely unpredictable. Over her first year, the pattern should gradually shift to become somewhat regular.
Newborns typically sleep about 16 hours a day, but they don't sleep many hours in a row. Newborns need food every few hours, so nighttime feedings cannot be avoided.
Also, it will take some time for your baby to realize that nighttime is for sleeping. Encourage her to sleep at night by minimizing any stimulation during nighttime feedings and diaper changes. Keep the lights low and don't talk, sing or play.
By 3 months, most babies can sleep for longer stretches, up to six to eight hours in a row, at least on some nights. They may still take as many as three or four daytime naps.
By 4 months, your baby will probably be able to sleep for eight hours without needing to be fed. During the next several months, your baby is likely to sleep one long stretch at night and still have a morning and afternoon nap. Around 8 months, most babies can sleep as many as 12 hours at night. They still are likely to take up to two naps a day throughout the first year of life.
To help encourage your baby to sleep at night (and thereby allow you to sleep at night), here's some advice. Around 4 months is a good time to introduce a bedtime routine that your baby will begin to associate with going to sleep. Any soothing ritual, performed consistently, can make up a bedtime routine. For example, start with a warm bath, and then offer your baby one last feeding, followed by soft singing or reading aloud. And don't worry: It won't matter if you can't carry a tune!
Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.
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