13 Things For Parents To Know About Infant Sleep

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Does your baby “sleep like a baby?” What does that even mean? If you’re reading this, maybe you’re wishing for some rest yourself. Maybe you’re wondering if your baby’s sleep is normal. I am happy to clear some things up about infant sleep, even if I don’t have easy tips to make every baby sleep soundly. Sometimes just a little information can help.

As I discussed in my booklet about newborns (affiliate link), there is no magic tip to make all babies sleep well and solidly for exactly the right amount of time. For every nap. And every night.

People (including babies!) vary too much. What settles some babies may not settle others.

And, sort of like learning to use a potty or eating, sleep is something we can’t really will another person to do.

We must also acknowledge all the routines, rituals, and physical things surrounding sleep. Some babies have music at bedtime. Others a massage. There’s a lot of family preference that goes into bedtime for little ones. With that in mind, we see that infant sleep varies from one culture to the next, even one family to the next.

I would even venture to say that frequently-advertised baby sleep coaches are helpful only if they understand your family and culture. There is not a universal approach.

Looking Closer at 5 Common Infant Sleep Beliefs

Some baby sleep information is constantly thrown about as if it is universally true. This is a problem! A lot of common thoughts about how infants sleep are based on very few people’s experiences. So, when someone sees that their baby doesn’t fit into these common belief systems, they worry unnecessarily. Or, they think they need to change something about their baby’s bedtime when, in fact, everything is fine.

1. There is very little data behind sleep regressions happening at specific ages.

A sleep regression refers to when a baby who previously slept “well” then struggles to sleep the same way for a few days or weeks before returning to their usual routine. Maybe they have several nights where they don’t want to be put back in their crib, sleeping best in a parent’s arms. Or, maybe they just wake up more frequently.

While many babies do go through phases of changes in their sleep, not all do. And, it can happen at any time. Some people claim it happens at the same specific ages for all babies. The reality is: data shows this actually varies a lot. A lot. So much so that we can’t count on sleep regressions at specific ages. (This article is a great summary on how scant the data is).

2. Babies cannot be spoiled.

This is good news: Babies cannot be spoiled! It’s okay to hold a baby when they cry. Always. Yes, always. If a baby cries at night, it is always okay to soothe them. The details about how that looks vary from one family to the next. And, it may not always be practical (that’s okay).

This is not a comment on letting a baby fuss for a couple of minutes while a parent completes a task or catches their breath or takes care of their own mental health. I’m just saying that if you are wondering whether or not to pick up and soothe a crying baby out of fear of spoiling them: fear no more.

Along those same lines, despite a lot of common advice about placing a baby “drowsy but awake” into their crib, many babies do perfectly fine being held or rocked to sleep. If it’s working, there’s no need to change things.

3. There’s no good data about breastfeeding a baby to sleep.

In other words: if it feels right to breastfeed your baby to sleep, it probably is right. This is such an individual preference. And, it’s such a powerful bonding time that we don’t have a good reason to discourage it. See this post on how breastfeeding at night is related to dental health.

Some people have theories about not feeding to sleep based on creating habits and associations. This may be true for some babies. So, if something doesn’t feel right, then it’s a good idea to try something else.

It’s also worth remembering that feeding to sleep at bedtime is different than feeding with every waking overnight (especially in babies closer to a year of age. Younger babies may actually need those frequent feeds). This is one reason I’ve found the research on this topic tricky. Studies often don’t differentiate. (If you’re aware of one that does, please share!)

Also, please note that we do have data on bottle feeding to sleep. A baby falling asleep while drinking from a bottle should be discouraged due to risks of tooth decay and ear infections.

4. There is no clear agreement on whether frequent night time waking is related to cognitive development.

Some people ask if “smarter” babies wake less or more often overnight. There has been a fair amount of research looking into this! A recent paper found no connection between cognitive development and infants waking up overnight. Others have found correlations, but with conflicting results. There are many ways to study both how babies are sleeping and their development later on, so it makes sense that it would be hard to get consistent results.

So, if someone asks if sleeping through the night makes their baby smarter, the answer is it depends. Or, we don’t know. Personally, my answer would be to not overthink that aspect of baby sleep.

5. Many babies do not sleep through the night at ages 6 and 12 months.

This 2018 paper is one of my favorite to quote. It normalizes what many parents already experience. Between 27% and 57% of babies in this study did not sleep “through the night” at 6 months and at age 12 months. (Sleeping through the night was defined as uninterrupted sleep for 6 – 8 hours).

Why do I like to quote it? Because many parents feel like something is wrong if their baby wakes occasionally at night. Nope. As I mentioned earlier, culture plays a huge role in baby sleep expectations. Some families feel pressure to “sleep train,” for example. Generally speaking, there is no medical reason for this. That being said, see below on reasons to seek professional help regarding baby sleep, which includes parental mental health.

Tips for Safe Baby Sleep

Despite the lack of knowledge in many areas of infant sleep, there is one area that has been (thankfully) researched a lot: Sudden Infant Death Syndrome (SIDS) prevention. SIDS refers to the tragedy of a baby under age one year unexpectedly and suddenly dying (likely in their sleep). There are a few recommendations to lower the risk of SIDS. This is not a complete list. This, from the AAP, is a more comprehensive review. Many factors influence a baby’s risk for SIDS.

1. Babies should always be placed on their backs, face up. Sleeping on their side or on their belly is not safe.
2. They need a firm and flat sleeping surface designed for infant sleep with no blankets, pillows, or toys. The 2022 American Academy of Pediatrics guidelines for safe sleep emphasize the flat sleeping surface. No incline is recommended. All spaces designed for infant sleep should meet standards set by the Consumer Product Safety Commission (CPSC). Even bedside sleepers should be approved by the Consumer Product Safety Commission.
3. Nothing else should be in a baby’s crib or bassinet. This means no crib bumpers (mesh or otherwise). This means no wedges.
4. Ideally, a baby should sleep in the same room as their parent for at least their first 6-12 months.
5. If a parent is holding their baby and thinks that they themselves may accidentally fall asleep (it happens, especially in the middle of the night when they’re trying to soothe a baby back to sleep), they can prepare for a lower-risk situation. They can avoid recliners and couches and opt to hold their baby on a firm flat surface instead. The most obvious place is the parent’s bed without any bedding other than a fitted sheet. This can lower the risk of accidental suffocation. (When the parent wakes up, the baby needs to be returned to their own sleeping space). Ideally no other people or pets are in the bed either.

Again, this list is far from complete, but it is a good starting point for someone trying to prepare a sleeping space for their baby. And, as always, this is a topic your baby’s pediatrician can help with, to offer individualized advice.

A Few Times to Seek Help for a Baby’s Sleep

Perhaps you don’t have to “sleep train” or worry about soothing a baby to sleep. But. There are a few things regarding infant sleep that do require some intervention. If any of the following are present in your baby or your family, please seek medical attention. Even if these things are sometimes common, they’re not necessarily normal and may need evaluation.

Most importantly, if you’re concerned, talk to your pediatrician. Even if it’s not on this list. Most sleep questions are best addressed on an individual basis.

1. Snoring. If a baby (or a child, for that matter) snores, please tell their pediatrician. More investigation is needed. This investigation can usually start in the pediatrician’s office.
2. Any face color changes while asleep. If a baby looks blue or pale around their mouth or nose, wake them up and seek immediate medical attention.
3. Parental mental health is suffering. Sleep deprivation is no joke. If a parent is struggling due to interrupted or insufficient sleep, then please seek help. This may mean the parent’s health care professional. Or, it may mean the pediatrician to discuss ways to help everyone get enough rest.
4. Anything you’re worried about. If it’s not an emergency, then taking a short video to share with the pediatrician later can help.

Summary: We know more about infant sleep safety than infant sleep “behaviors.”

As long as a baby is sleeping in the safest way possible (emphasis on being placed face up with no extra bedding), there’s a lot of reasonable variation in all the other little quirks and customs of infant sleep. There are many “right” or effective ways to help a baby fall asleep, to soothe them in the middle of the night, and to also take care of yourself. This doesn’t mean it’s easy. It does mean you have options and can adjust to what feels right for your family.

Maya M. Mahmood, D.O., F.A.A.P. is a board-certified pediatrician and mom. She is passionate about parents having evidence-based information to help their families be healthier. Don’t want to miss a post? Subscribe to the newsletter.