My Baby Won’t Wake Up but Is Still Breathing – What To Do

| Reviewed By Sarah Schulze, MSN, APRN, CPNP

If the infant is unresponsive or experiencing erratic breathing, it is crucial to call 911 immediately and check for any blockages in the airway.

If your baby won’t wake up but is breathing, try undressing her, changing her diaper, and placing her in a lukewarm bath. 

It is likely that your baby is in a deep sleep. The Cleveland Clinic explains: “Because stage 3 NREM sleep is so deep, it’s hard to wake someone up from it.”

Being in a deep sleep is not cause for alarm, but consult with your baby’s doctor if she is lethargic, doesn’t regularly wake up on her own for feedings, or shows signs of dehydration and/or lack of nutrition.

Baby Won’t Wake Up But Is Breathing

You will spend hours a day watching your baby breathe. It’s terrifying to see them breathe but not be able to wake them up from a deep sleep. 

Newborns can be hard to wake up, especially when they are in deep sleep.

They may not move often, and this can cause you to listen or feel carefully to ensure they are still breathing.

Newborns not waking easily during deep sleep can be perfectly normal.

How To Wake a Baby Who Won’t Wake Up

You should call for help when your baby won’t wake up, but there are things you can do until help arrives.

  • Continue to try to wake your child by talking to them, bouncing them gently, or tickling their feet. Gently pat their cheeks to see if the sensation causes a reaction. 
  • Hold your infant on her side to ensure there is nothing lodged in the mouth that is causing an issue.
  • Undress your child in the hopes that cool air touching their skin will startle them awake.
  • Change your baby’s diaper. The cool air on their privates is often enough to rouse even the deepest sleepers.
  • If all else fails, strip your baby of clothing, and place them in a lukewarm bath.

Sleepy Baby: When To Worry

There is a time to be concerned when your infant won’t wake, even if she is breathing.

If you have tried to gently wake your baby and then moved on to more aggressive attempts, such as taking off their onesie or changing their diaper, and were unable to wake your baby, you need to call for help. 

It may not be easy to wake up a newborn, and typical sounds around the house probably won’t do it, but it should not be impossible.

What To Do if Your Baby Won’t Wake Up

If your baby won’t wake up, call 911 or have another person in the home do that for you while you continue to try to wake your baby.

  • Tilt her head back to ensure she is still breathing and that nothing is stuck in the airway.
  • If she is breathing, you can hold your child on her side to keep her airway open while help arrives. 
  • Keep talking to your child, even if she isn’t responding. Try to speak in a calm, reassuring tone.

Baby Lethargic or Just Sleepy

When a child is sleepy, that is perfectly normal.

You may have to work a little harder to wake them up, but once they are awake, they should be alert and interested in what is happening around them. 

When your child is lethargic, what you see will be different.

Lethargic Baby Symptoms

A child who is lethargic will have a hard time waking up and won’t be able to stay awake for long.

A lethargic baby or child will be uninterested in what is going on around them, and they may refuse to eat. 

When my son was ill, signs of lethargy were some of the first signs that something was wrong. He was cranky, sleepy, and listless. 

Causes of Lethargy in Newborns

When a newborn is lethargic, there are a couple of different things that may be going on and need to be addressed.

First of all, an infection could be to blame. My son’s lethargy was caused by RSV. The infection affected his ability to breathe, and this made him listless.

Your child may also have low blood sugar. This could be a sign of an underlying problem that should not be ignored.

A young mother bending over the bassinet trying to wake her baby.

When To Wake a Sleeping Baby

Waking a sleeping baby is generally something you’d want to do in specific situations for their well-being.

Here are some instances when it may be necessary to wake a sleeping baby:

  • Feeding Schedule: For newborns, especially in the early weeks, it’s important to wake them for regular feedings. Newborns generally need to feed every 2-3 hours, even during the night.
  • Medical Concerns: If your healthcare provider has advised you to monitor your baby’s feeding patterns, diaper output, or weight gain, you may need to wake your baby to ensure they’re getting the necessary nutrition.
  • Medication Schedule: If your baby has been prescribed medication that needs to be taken at specific intervals, you may need to wake them to administer it.
  • Concerns about Illness or Jaundice: If your baby is unwell or has been diagnosed with jaundice, your healthcare provider may recommend waking them for feedings or medical interventions.
  • Napping Too Long During the Day: If your baby is napping excessively during the day, it might disrupt their nighttime sleep schedule. In this case, you might want to gently wake them from a nap to help regulate their sleep patterns.
  • Developmental Assessments: Occasionally, your healthcare provider may request a developmental assessment that requires your baby to be awake.
  • Safety Concerns: If your baby is in an unsafe sleeping environment (such as in a car seat not designed for overnight sleep), you should wake them and move them to a safe sleeping place.
  • Maintaining a Routine: In some cases, waking a baby at the same time each day can help establish a regular sleep routine, which can be important for overall sleep health.

Understanding Newborn Sleep Cycles

Every child is different, but there are some basic patterns you can look for in newborn sleep.

Types of Sleep

In newborns, sleep is divided into different stages, including two main types: rapid eye movement (REM) sleep and non-rapid eye movement (NREM) sleep.

These stages play a crucial role in a baby’s growth and development.

Light Sleep (NREM1 and NREM2)

  • NREM1: This is the initial stage of sleep, also known as drowsiness. It’s a transitional phase between wakefulness and deeper sleep. In this stage, the baby is easily awakened, and muscle activity begins to decrease.
  • NREM2: This is considered “true” light sleep. In NREM2, the baby’s heart rate and breathing start to slow down, and body temperature decreases. It’s still relatively easy to wake the baby during this stage.

Deep Sleep (NREM3)

This is the stage of deep, restorative sleep. It’s often referred to as slow-wave sleep (SWS).

During this stage, the baby’s body does important repair work, such as tissue growth and repair, and the release of growth hormones.

It’s more challenging to wake a baby during deep sleep, and if awakened, they may be disoriented or groggy.

The sleep cycle in newborns typically follows this pattern:

  • Onset: The sleep cycle usually begins with a period of light sleep (NREM1 and NREM2).
  • Transition: After a period of light sleep, the baby transitions into deeper sleep (NREM3).
  • REM Sleep: Following deep sleep, the baby enters REM sleep. REM sleep is characterized by rapid eye movements, increased brain activity (similar to when awake), and vivid dreams. This is when a baby may exhibit twitches, smiles, or slight movements.
  • Repeat: The cycle then repeats itself, with the baby cycling through stages of light and deep sleep, interspersed with REM sleep.

Newborns spend a significant portion of their sleep time in REM sleep, which is believed to be crucial for brain development and learning.

As the night progresses, the proportion of REM sleep decreases, and the amount of deep sleep increases.

What Is Normal

Expect your baby to sleep 14-17 hours a day in 2-4 hour spurts. Your child will go from light sleep to deeper sleep and then back to light sleep about every 45 minutes.

What Is Not Normal

It’s not normal for your child to have trouble staying awake right after a nap or to be hard to wake up after every sleep.

Your child should wake up on their own most of the time without you having to coax them awake.

A mother's hand resting on her sleeping baby's forehead to check for overheating.

Baby Won’t Wake Up: Different Scenarios

As a parent, worrying comes naturally. Here are several common situations that cause worry or panic in new parents.

Baby Hard To Wake Up

If your baby won’t wake up when offered food or after a reasonable time of rest, he or she could be suffering from low blood sugar or illness.

See your pediatrician to rule out causes.

Can Not Wake Up Baby at All

If, despite your best efforts, you can’t wake up your baby, call 911. Even if your child is still breathing, you need to seek medical attention.

Baby Sleeping Too Much Suddenly

Your child’s sleep schedule will fluctuate, but if your child is suddenly sleeping more than normal, there may be a problem. Problems can include:

  • Dehydration.
  • Not enough food.
  • Jaundice.
  • Heart problems.
  • Respiratory issues.
  • Infections.

Safe Sleep Practices

  • Back to Sleep: Always place your baby on their back to sleep, for naps and at night. This has been shown to reduce the risk of Sudden Infant Death Syndrome (SIDS).
  • Use a Firm Sleep Surface: A crib, bassinet, portable crib, or play yard that meets the safety standards of the Consumer Product Safety Commission (CPSC) with a firm mattress and a fitted sheet should be used.
  • Avoid Soft Bedding: Keep the sleep area free of pillows, blankets, bumper pads, and stuffed animals. These items can pose a suffocation risk.
  • Room Sharing, Not Bed Sharing: Share a room with your baby for the first six months to a year, but avoid bed-sharing. Instead, use a separate sleep surface such as a bassinet or crib.
  • Avoid Overheating: Dress your baby in sleep clothing, such as a wearable blanket or a sleep sack, to keep them warm without the need for loose blankets.
  • Avoid Smoking and Alcohol/Drug Exposure: Avoid exposing your baby to secondhand smoke. Do not use alcohol or drugs that could impair your ability to provide a safe sleep environment.
  • Breastfeeding: Encourage breastfeeding, as it has been shown to reduce the risk of SIDS.
  • Pacifier Use: Consider offering a pacifier at naptime and bedtime. This has been associated with a reduced risk of SIDS.
  • Avoid Products That Claim to Reduce SIDS Risk: There is no evidence that products like sleep positioners, wedges, or other commercial devices reduce the risk of SIDS.
  • Tummy Time: Provide supervised tummy time when the baby is awake to help with development.