How long is my preemie supposed to sleep?
There are two reasons why I get this question.
The first is that the parents are worried the baby is sleeping too much. The second is that they are concerned the baby is sleeping too little. In either case, they’re worried!
How Long? It Depends
The answer to the question depends on a number of things, not least being “corrected gestational age”. This is simply the age of the premature baby corrected for the baby’s actual due date. Take, for example, a baby born at 36 weeks gestation. She was born four weeks early. So when she is 8 weeks old (her “chronological age”), we say her corrected gestational age is 4 weeks.
The corrected gestational age is a way of “cutting slack” for a baby who may not achieve the developmental milestones you’d expect at a certain age. Those milestones include sleep. With premature infants, I assume their sleeping habits approximate what they should do at their corrected gestational age, not their chronological age. I don’t expect a baby to sleep like a full-term infant until she reaches her due date!
How Long Do You Cut Slack?
Now the question becomes “how old does a baby have to be before you can stop calculating corrected gestational age?” Doesn’t it get silly at some point?
Both my children were born prematurely. The younger was born at 35 weeks, or 5 weeks early. At this writing he is now a Freshman in high school. And I tell people he is still 5 weeks behind. It’s a joke of course. To his enduring credit, my former preemie laughs politely when I tell that joke in his presence.
The serious answer to the question is: stop correcting for prematurity some time between 6-12 months.
Premature babies sleep a lot. They can spend between 20-22 hours per day asleep. This tends to be a lighter sleep, meaning that it does not take much for these babies to be aroused. And in fact, preemies do wake more often than full-term babies, but never for very long, and they do not often reach a very alert state.
This is why it’s especially important for a premature baby to sleep in a place that is as free from stimulation as possible: low noise, low light, and as little handling as possible.
The exception of course is feeding. A premature baby’s number one priority is feeding and growing. Your pediatrician may advise you to wake the baby every two to three hours to feed, at least in the early stages. This is one of two instances in which I recommend violating the “never wake a sleeping baby” rule! (The other instance is twins.)
Back to the Parent’s Question
Precisely because feeding and growing is the number one job, the answer to the question “how long should my preemie sleep?” is “how ever much time allows the baby to feed and grow well”. You will probably discuss “how much is enough” with your pediatrician. In general, a premature infant will eat and sleep, and do very little else for the first 2 months or so. It’s much tougher and more labor-intensive than it sounds!
It will be several months before your preemie will be able to sleep through the night. If a full-term baby can sleep through the night (meaning 5-6 hours) between 4-6 months, you can expect your premature baby will be able to accomplish the feat at 4-6 months corrected gestational age. That may mean more weeks of sleep deprivation than you might otherwise get!
Here are the important take-home messages.
- Premature infants can sleep 22 hours per day, never very deeply, with frequent drowsy but awake periods
- Have the baby sleep on her back, swaddled, on a firm surface.
- You may have to violate the “never wake a sleeping baby” rule in order to get her to make “catch-up growth”
- Expect she’ll adopt more “normal” baby sleeping habits when she reaches her due date.
Any issues getting your premie to sleep? I can help you!