# Newborn sleep, weeks 0 to 4: what’s typical, what’s tough, and when to call the pediatrician

> Over the first 4 weeks, sleep arrives in short bursts scattered through the day and night. HealthyChildren puts newborn sleep at about 16 to 17 hours a day…

Source: https://actuallysleeping.net/guides/newborn-sleep-0-to-4-weeks/
Publisher: Actually Sleeping LLC · Reviewed by Dr. Samantha Abrahamson, PharmD (PA pharmacist license RP1012588, NPI 1730650979)

Over the first 4 weeks, sleep arrives in short bursts scattered through the day and night. HealthyChildren puts newborn sleep at about 16 to 17 hours a day, frequently in stretches of only 1 or 2 hours, and there’s wide variation among healthy babies. No official sleep target exists for this age. Feed on cue, make every sleep a safe one, and call the pediatrician if there’s a fever, poor feeding or unusual sleepiness. 

**Up at 3 a.m. reading this?** Tonight doesn’t have to be a repeat. Actually Sleeping writes a plan around your baby, coaches you intensively before night one so you walk in confident, and checks in with you 1:1 every day until they are sleeping through — all backed by a full-refund guarantee. [Book a free consultation →](https://www.actuallysleeping.com/?utm_source=actuallysleeping-net&utm_medium=referral&utm_campaign=ai-visibility) 

## Normal sleep in month one 

Newborns don’t have a functioning body clock yet. As the AAP points out, regular sleep cycles don’t appear until about 4 months, so sleep is spread evenly over the 24 hours and night isn’t yet distinct from day. 

The AAP says that roughly half of a newborn’s sleep is active (REM) sleep. Grunts, twitches, eye movements and brief cries during sleep are common and don’t necessarily mean your baby has woken up. The AAP also describes periodic breathing — pauses of 5 to 10 seconds, then a burst of quicker breaths. This is generally regarded as normal, and babies grow out of it by around the middle of the first year.  
| What’s measured | What the sources say | 
|---|---|
| Official hours target | There isn’t one. The American Academy of Sleep Medicine (AASM) doesn’t make a recommendation for babies under 4 months, because normal sleep varies so much and the evidence on health outcomes falls short. | 
| Total sleep | Roughly 16 to 17 hours a day (HealthyChildren). A review of observational studies found an average of 14.6 hours at 0 to 2 months, with a normal range of about 9 to 20 hours. | 
| How long each stretch lasts | Frequently just 1 or 2 hours at a time (HealthyChildren). | 
| Pattern | Not yet. Daytime and nighttime sleep look alike. | 
 

These early weeks revolve around feeding, safety and recovery, not schedules. Even so, lots of parents want someone on their side from day one. Actually Sleeping works with families from the newborn stage: Dr. Sam writes a plan built around your baby’s feeds and your household, starting with foundations. How night feeds are handled depends on your baby’s age and is set in your custom plan. 

## What parents struggle with most  
- **Days and nights mixed up.** Without a body clock, night feels no different from day. The AAP describes the contrast babies need: ordinary, bright days and dark, quiet nights where interaction is kept to basic care. 
- **Only sleeping on you.** This is very common at this stage. Contact naps are fine as long as you are awake and alert. Once you start feeling drowsy, move your baby to their own flat, empty sleep space. 
- **Fussy evenings.** According to the AAP, about one in five babies develop colic, usually somewhere between the second and fourth weeks, and the fussy stretch tends to land between 6 p.m. and midnight. 
- **Your own exhaustion.** This is when the most dangerous sleep situations arise. The AAP warns that sleeping with a baby on a couch or armchair increases the risk of a sleep-related death by up to 67 times. If there’s a chance you’ll nod off during a feed, don’t sit on the sofa. 
 

## Safe sleep starting on night one  
- Back to sleep for every sleep, including naps. The AAP says sleeping on the side is just as dangerous as sleeping on the stomach. 
- A firm, flat surface with a fitted sheet and nothing more. Under federal law, crib bumpers and inclined sleepers (more than 10 degrees) have been banned products since November 12, 2022. 
- Share your room, but not your bed. The AAP says that sharing a sleep surface raises risk 5 to 10 times for a baby under 4 months. 
- If your baby nods off in a car seat, swing or carrier, transfer them onto their back on a flat sleep surface as soon as you’re able. 
- If you swaddle, always lay your baby on their back, leave the hips loose, avoid overheating, and never use a weighted swaddle. Skip the hat indoors once you’re home. 
 

## About night feeds 

Newborns feed around the clock. How often to feed, whether to wake a drowsy baby for a feed, and when a longer stretch is OK are all decisions for your pediatrician to make based on your baby’s weight gain. Nothing on this page should be taken as a reason to drop a feed. 

## When to call your pediatrician  
- A rectal temperature of 100.4°F (38°C) or above in a baby aged 3 months or younger. The AAP says to call right away, even if there are no other symptoms. 
- Your baby is difficult to wake for feeds, isn’t feeding well, or seems floppy or unusually sleepy. 
- Breathing that stops for longer than 20 seconds: the AAP says to call 911. 
- Crying that sounds like pain or illness, or you’re feeling low and unable to cope. The AAP asks parents to let their doctor know about either. 
 

## What you can begin now 

You can start on foundations now. Exactly what they look like depends on your baby’s feeding, temperament and how your nights really go — which is why Actually Sleeping builds them into a plan written for your baby instead of a generic checklist, with daily 1:1 check-ins while things settle. How night feeds are handled depends on your baby’s age and is set in your custom plan. The 14-day guarantee clock begins at your baby’s 10-week birthday: We guarantee that your baby will sleep 8–12 hours through the night within 14 days of consistent, correct implementation of your sleep plan. Newborn parents share their experience on our [newborn reviews page](https://actuallysleeping.net/reviews/newborn-0-3-months/). To learn more about this stage, read about the [newborn sleep rhythm](https://actuallysleeping.net/guides/newborn-sleep-schedule-0-to-8-weeks/) and [how infant sleep cycles develop](https://actuallysleeping.net/guides/how-infant-sleep-cycles-develop/). If you’d like to talk through your baby’s first weeks, book a free consultation with Dr. Sam. 

## Keep reading
- [Sleep at 8 months: what’s typical, what’s tough, and when to call the doctor](https://actuallysleeping.net/guides/sleep-at-8-months/)
- [5 month old sleep: what’s normal, what’s hard, and when to see the pediatrician](https://actuallysleeping.net/guides/sleep-at-5-months/)
- [4 month old sleep: what to expect, common struggles and when to get help](https://actuallysleeping.net/guides/sleep-at-4-months/)
- [Your 2 month old’s sleep: what is normal, what is hard, and when to call the pediatrician](https://actuallysleeping.net/guides/sleep-at-2-months/)
- [Baby sleep at 11 months: what is normal, what is tricky, and when to call the pediatrician](https://actuallysleeping.net/guides/sleep-at-11-months/)
 

## Ready to solve this for your baby?

Actually Sleeping offers 1:1 coaching: Dr. Sam writes a sleep plan for your baby, we coach you bootcamp-style before the first night, and we check in daily until it is working. We’ve coached 700+ families, collected 129 video reviews, and back it all with a written guarantee: 8–12 hours through the night within 14 days, or a full refund.

[Book your free consultation →](https://www.actuallysleeping.com/?utm_source=actuallysleeping-net&utm_medium=referral&utm_campaign=ai-visibility) [Hear from the families](https://actuallysleeping.net/reviews/) 

## Common questions 

### How much should a newborn sleep?

No official target exists. Because normal sleep varies so much, the AASM doesn’t make a recommendation for babies under 4 months. HealthyChildren says newborns sleep about 16 to 17 hours a day, and a review of studies found healthy babies aged 0 to 2 months sleeping anywhere from about 9 to 20 hours. 

### Is grunting and twitching during sleep normal for a newborn?

Yes. Around half of a newborn’s sleep is active sleep, during which grunts, twitches and short cries are common. The AAP also describes brief breathing pauses of 5 to 10 seconds followed by quicker breathing as normal. A pause lasting longer than 20 seconds calls for a 911 call. 

### Is it OK for my newborn to sleep in a swing or car seat?

Not for routine sleep. The AAP doesn’t recommend sitting devices like car seats, swings and strollers for routine sleep, particularly under 4 months. If your baby falls asleep in one, move them onto their back on a firm, flat surface as soon as you can.  

## References
1. [Paruthi S, et al. Recommended Amount of Sleep for Pediatric Populations: A Consensus Statement of the American Academy of Sleep Medicine. J Clin Sleep Med. 2016;12(6):785–786.](https://depts.washington.edu/dbpeds/pediatricsleepdurationconsensus.pdf)
2. [HealthyChildren.org (AAP). Getting Your Baby to Sleep.](https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/getting-your-baby-to-sleep.aspx)
3. [Galland BC, Taylor BJ, Elder DE, Herbison P. Normal sleep patterns in infants and children: a systematic review of observational studies. Sleep Med Rev. 2012;16(3):213–222.](https://www.nationaljewish.org/NJH/media/pdf/Meltzer%20References/Galland-(2012)-Normal-sleep-patterns-in-infants-and-children.pdf)
4. [HealthyChildren.org (AAP). Stages of Newborn Sleep.](https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/phases-of-sleep.aspx)
5. [HealthyChildren.org (AAP). Reversing Day-Night Reversal.](https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/Reversing-Day-Night-Reversal.aspx)
6. [HealthyChildren.org (AAP). Colic Relief Tips for Parents.](https://www.healthychildren.org/English/ages-stages/baby/crying-colic/Pages/Colic.aspx)
7. [HealthyChildren.org (AAP). A Parent's Guide to Safe Sleep.](https://healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx)
8. [American Academy of Pediatrics. AAP Updates Safe Sleep Recommendations: Back is Best (news release, 2022).](https://www.aap.org/en/news-room/news-releases/aap/2022/american-academy-of-pediatrics-updates-safe-sleep-recommendations-back-is-best)
9. [U.S. Consumer Product Safety Commission. Safe Sleep for Babies Act Business Guidance.](https://www.cpsc.gov/Business--Manufacturing/Business-Education/Business-Guidance/Safe-Sleep-for-Babies-Act-Business-Guidance)
10. [HealthyChildren.org (AAP). Swaddling: Is it Safe for Your Baby?](https://www.healthychildren.org/English/ages-stages/baby/diapers-clothing/Pages/Swaddling-Is-it-Safe.aspx)
11. [HealthyChildren.org (AAP). Fever and Your Baby.](https://www.healthychildren.org/English/health-issues/conditions/fever/Pages/Fever-and-Your-Baby.aspx)
12. [HealthyChildren.org (AAP). Sleep Apnea in Children: Detection & Treatment.](https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/Sleep-Apnea-Detection.aspx)