Most of what is described as a baby's sleep problem in the first year is not a problem at all. It is normal infant sleep, which is broken, light and frequently interrupted by design, and which keeps parents very tired for a long time without anything being wrong.
That distinction matters, because the small number of things that genuinely need attention are easy to miss among the many that do not.
The ranges are wide and the variation between healthy babies is enormous:
A baby at either end of these ranges is not necessarily in difficulty. What is worth noticing is a change — a baby who was sleeping and suddenly is not, or a baby who becomes very hard to rouse.
Newborns wake repeatedly through the night for the first few months. Their stomachs are small, their sleep cycles are short, and waking frequently appears to be protective rather than accidental.
"Sleeping through the night" is also a far softer phrase than it sounds. In the research it has often meant an unbroken stretch of five hours, which is not what most exhausted parents mean by it, and a majority of babies do not do it reliably in the first year.
The practical consequence is that the problem to be solved in the early months is usually the parents' sleep rather than the baby's. Sharing night duty, taking one feed each, an occasional expressed bottle once breastfeeding is established, or a relative staying for a few nights all do more good than any attempt to make a newborn sleep differently.
Newborns have no body clock to speak of; it develops over the first few months, and the environment is what sets it. The approach that helps is to make daytime and night-time feel unmistakably different:
None of this makes a baby sleep longer in the short term. It teaches a distinction that pays off over months.
A short, calm, repeated sequence in the same order each evening — a bath, a change, a story or a song, dimmed lights, a cuddle — works as a signal rather than as a sedative. It can be introduced from around three months, and it is worth keeping short and portable, because a routine that depends on a particular room or a particular object is harder to reproduce away from home.
Over-stimulation late in the evening is one of the commonest reasons an otherwise settled baby will not go down.
Several pieces of older advice on this subject are wrong, and one of them is unsafe.
Solid food does not make a baby sleep. It is a persistent belief and it has not held up. Solids are introduced at around six months because of what a baby then needs nutritionally and developmentally, not to lengthen sleep, and starting earlier carries its own risks.
Fruit juice has no place in the first six months, at bedtime or at any other time. After that, if it is given at all, it belongs diluted and at mealtimes, because of teeth. Milk, by contrast, is the feed — there is nothing to avoid about a milk feed near bedtime in the first year.
Feeding a baby to sleep is not a mistake. It is what babies do, and in the early months there is no reason to interrupt it. It does build an association, so a baby who only ever falls asleep at the breast or on a bottle may need that again at each waking; parents who want to loosen the link can begin offering the feed earlier in the routine once a baby is a few months old. That is a matter of preference rather than of health.
Nothing sweet should go on a dummy, and a bottle should never be propped or left with a baby to fall asleep on.
This appears in a great deal of writing about newborn sleep and it is simply a category error. Both belong to later childhood: night terrors generally begin at around 18 months to three years, and nightmares from the point at which a child has the imaginative capacity for them, usually from about two. A newborn crying in the night is hungry, uncomfortable, unwell or in need of contact.
For completeness, since the two are routinely confused: nightmares happen in REM sleep, later in the night, and are remembered. Night terrors happen in deep sleep, in the first hours, and are not remembered — the child appears awake and terrified but is not awake, and should not be woken. The mechanism is set out under how sleep works, and the practical handling under bedtime and night fears in children.
Babies breathe irregularly. Short pauses, fast and slow runs, snuffles and the occasional noisy breath are normal in the early weeks and do not indicate a disorder.
What is not normal, and does need a doctor:
Obstructive sleep apnoea does occur in children — it affects around three in a hundred — and it is usually caused by large tonsils or adenoids. Snoring alone is far commoner, at roughly one child in ten, and most children who snore do not have apnoea. Where it is suspected, assessment is by overnight oxygen monitoring at home or a sleep study in hospital, and a recording of the child asleep is genuinely useful to a GP. Where tonsils and adenoids are the cause, removing them is usually effective. It is much more often a question in toddlers and older children than in babies.
A persistent piece of writing on this subject suggests buying a monitor that alerts a parent when the baby stops breathing, and says that gently waking the baby will let them resume.
That is not the response to a baby who has stopped breathing. A baby who is not breathing needs emergency help and resuscitation, immediately, and an ambulance called at once. Home movement and breathing monitors are not recommended for healthy babies, have never been shown to prevent sudden infant death, and generate false alarms often enough that they tend to be mistrusted and switched off. Where a baby genuinely needs monitoring, it is arranged and supervised by a hospital team, with training for the parents in what to do.
Every parent of a small baby is worth the twenty minutes it takes to learn infant resuscitation. It is taught free in many areas and the technique is not the same as for an adult.
No medicine should be given to a baby to make them sleep. Sedating antihistamines are not appropriate for infants, and melatonin is a prescription medicine in the UK, used in children only under specialist supervision and for a small number of specific conditions. Herbal and homeopathic sleep preparations marketed for babies have no good evidence behind them, and some have had safety problems.
Health visitors are the right first contact for infant sleep and will usually be more use than a book, because they can see the particular household. A GP is the route for anything involving breathing, feeding, growth or persistent distress. Parents who are not coping with the exhaustion should say so plainly and early; it is a common and treatable situation, and it is taken seriously rather than judged.
Where and how a baby should sleep, which is a separate and safety-critical question, is covered under safer sleep for babies.