Infant Sleeping

Dear Lisa

My newborn baby seems to have his days and nights mixed up. He sleeps for most of the day and after feeding goes right back to sleep. At night he is up every two hours and doesn’t fall asleep after feeding. What can I do to get some sleep?

“In need of sleep in N.Y.”,

Dear “In need of sleep"

Unfortunately many babies aren’t born with a circadian rhythm that is congruent with our lifestyles. The circadian rhythm or sleep cycle determines when a baby sleeps and when it is awake. It is mainly influenced by the timing and intensity of light. (1) Therefore if your baby seems sleepier during the day and more awake at night, you can help change the rhythm by the use of light.

Starting in the morning around 7 a.m. open all of the shades or blinds in your home and turn on all of the lights. Feed, burp, change, bathe, interact and play with your baby in a common area, where there is a lot of traffic (such as the kitchen or family room). Wake your baby every 3 hours if necessary by unwrapping him and changing his diaper, followed by feeding. Don’t let him nap in a dark room away from the activity in the home.

At night, starting at 9 or 10 p.m., put your baby in a dark room, in the “back to sleep” position, with blinds and shades drawn, away from all of the activity. When the baby wakes to feed, do not turn the lights on, but use a night light instead. The interaction should be limited. Only feed, burp and change the baby, avoid play time and too much interaction. For most healthy children, there is no need to wake a baby at night to feed, especially if it fed every 3 hours during the day. Your baby should wake on its own at night to feed, every 3 to 5 hours depending on the baby. If your child is a preemie, has jaundice, has a problem gaining weight, or other health concerns your Doctor or Nurse Practitioner may ask you to wake your baby more often at night.

By three months old an infant develops its circadian rhythm, begins to sleep more at night and has an established daytime nap schedule. (1) In order to help an infant establish its circadian rhythm you can institute measures that encourage light during the day and darkness at night. Most babies should be able to sleep through the night by 3 months of age. (2) Sleep through the night usually means about 6 hours of uninterrupted sleep.

In the mean time, you should nap during the day while your baby is napping and recruit help from friends and family so that you can get the well deserved rest that you need. You will be better equipped mentally and physically to care for your baby with the proper rest.

Congratulations on your new baby.


(1)Rosen G. General Overview of Neuroanatomy and Neurophysiology of Sleep. Presented at: Pediatric Sleep Disorders Conference;May 31, 2002:Edison.
(2)Chow M, Durand B, Feldman M, Mills M. Handbook of Pediatric Primary Care. Albany, New York:Delmar Publishers Inc. 1984:341-342.

Lisa Kelly R.N., P.N.P., C.
Certified Pediatric Nurse Practitioner

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