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6 Tips for Sweet Newborn Sleep

Nothing can prepare you for the changes in your sleep when you welcome a newborn baby into your family. Experienced parents will issue dire warnings and tell you to sleep while you can during the last few weeks of pregnancy. (And you will think, yeah right, there’s a large boulder resting on my bladder, and sometimes it kicks for good measure.)

But then the baby arrives, and your world changes forever. Sleep disruption is one of the most immediate and dramatic changes associated with parenthood. It isn’t just that you’re getting less sleep; it’s that your sleep is suddenly dependent on this baby sleeping. And even though newborns sleep a lot – as much as 16-18 hours per day – it feels disorganized and unpredictable.

The thing is, babies, even brand new ones, actually do have organized sleep, it just isn’t organized like yours. But under the surface, baby is working towards being more like you in his sleep. During the first few months, you have no choice but to go with the flow and sleep when the baby sleeps (something I was never good at), but it can help to understand the inherent patterns in your baby’s sleep/wake cycles so that they become more predictable. Your goal is to work with your baby’s biology, find some time for your own sleep, and support your baby in his natural development towards more mature sleep patterns.

In the research for my book, I’ve buried myself in research papers on infant sleep, trying to glean some knowledge that can be helpful to parents in these first few months of baby’s life. Here’s what I’ve come up with so far:

1. Understand newborn sleep cycles. Newborn sleep alternates between active and quiet sleep (akin to REM and non-REM sleep in adults). During the first few months of life, infants usually begin each sleep period in active sleep. Then, after about 25 minutes, they’ll transition to a cycle of quiet sleep, also about 25 minutes long. During active sleep, babies will twitch and flail their limbs, grunt and sigh, and maybe even cry a little. Their eyes move beneath translucent closed lids and may even open from time to time. In quiet sleep, babies breathe slowly and rhythmically, and their bodies are still 1,2.

Why care about the biology of sleep? Because it can help you in these practical ways:

  • Babies wake easily from active sleep, so if your baby falls asleep in your arms, wait until you see signs of that deeper, quiet sleep before you try to move him.
  • Around the 45-50 minutes mark, baby will be finishing up that first active/quiet sleep cycle of 45-50 minutes. Transitioning from one cycle to the next can be tricky for a new baby, so if he wakes during this time (particularly if it’s after just one cycle), see if he wants your help returning to sleep before assuming that he’s ready to eat or play.
  • Active sleep is noisy. Parents often mistake the normal vocalizations of active sleep as the baby waking, and in their efforts to soothe the baby, they’ll actually wake him up. If you think your baby is waking up, pause and watch him for a moment. He may just be dancing in his sleep, or he might be waking briefly only to return to sleep on his own.

IMG_42252. Help your baby find a rhythm. We are adapted to Earth’s 24-hour cycle of light and dark, and our physiological circadian rhythms help us to feel awake during the day and sleepy at night. Newborn babies, on the other hand, sleep just as much during the day as they do at night. It takes them some time to develop rhythms to match our day/night cycle. You can help by sending baby strong environmental and social cues about day and night.

During the day, keep the baby in a light, maybe even noisy place, even as he naps. At night, keep the lights as low as possible and the environment quiet. Even as you’re feeding frequently during the night (and you probably are), keep your interactions with your baby very quiet, uninteresting, and unstimulating. Be boring. With these cues, babies start to show physiological circadian rhythms quickly. A rhythm in body temperature can be detected around one week of age, and by two months of age, babies have robust rhythms of the hormones melatonin and cortisol. By two to three months, most babies are sleeping for most of the night (just waking briefly to feed) and have some distinct periods of wakefulness during the day (with some naps, of course)3–6. One study reported an outlier – a baby that hadn’t developed a day/night circadian rhythm at five months. Turns out that night owl took his night feedings in a brightly lit room – he had received confusing signals about nighttime7.

3. Start to develop a soothing bedtime routine. It’s never too early for this. Find some calming rituals that you repeat each night before bed. These become part of the social cues that will key your baby into the nighttime rhythm and let her know that sleep time is coming. Tell your baby what is happening: It’s almost time for bed, so we’re having a bath. Then you’ll have some milk, and I’ll sing our bedtime song. And then it will be time to sleep. (Bedtime routines have been shown to help babies fall asleep faster and get more sleep during the night, but they’ve only been empirically tested in older infants8. I just think it’s smart to start this within the first few months.)

4. If you’re breastfeeding, breastfeed at night. During pregnancy, baby was exposed to mom’s day/night rhythm of melatonin, which increases during the dark night and decreases during the light of day. If you breastfeed, you keep sending that sleepy melatonin signal to your baby through your milk, even before he begins to produce his own melatonin. Human breast milk reflects maternal plasma melatonin concentrations, peaking between midnight and 4 AM and being virtually undetectable during the day9–11. Melatonin during a night feeding should help baby transition peacefully back to sleep. Consider this if you supplement with formula or use pumped breast milk for a nighttime bottle. Nighttime breast milk (pumped or from the breast) might mean better sleep for baby.

IMG_32495. Let your baby practice falling asleep in different ways. You’re going to want to hold him a lot, and so will all his doting family. There is nothing like watching a newborn fall asleep in your arms. He’ll also fall asleep feeding. You might enjoy having him sleep on your chest in a wrap or sling while you go about your day. Enjoy all of these snuggles with your baby. But every once in a while, see if you can put him down sleepy but awake. Some, but not all, babies can be surprisingly flexible during the first months of life about how they sleep. Letting him practice this now may give your baby the skills he needs to sleep well later. Babies that are able to fall asleep without a lot of active soothing (i.e. feeding, rocking, bouncing, walking, driving) tend to be the same babies who sleep well during the night12. This is a great time to encourage flexibility while also providing secure and predictable routines.

6. Observe your baby. Observing your baby means learning his particular signals for when he’s feeling sleepy; then you can work together towards getting comfortable for sleep. Observing your baby may mean that when you hear him start to grunt and move around during the night, you wait a moment and watch to see what he’s doing and if he’s trying to communicate with you. Is he hungry? Uncomfortable? Wet? He’ll let you know that. But he may just be transitioning from one sleep cycle to the next. He may want to go right back to sleep, or he may not have woken at all but instead is in a noisy active sleep period. Babies that learn to transition between sleep cycles without your help will grow into better sleepers later in infancy, but you have to give them a chance to practice this valuable skill12–14. Wait a moment or two to see if he needs your help, and if he does, soothe him quietly.

What advice do you have for helping babies and parents find their groove with sleep?

Slide2REFERENCES:

1. De Weerd, A. W. & van den Bossche, R. A. S. The development of sleep during the first months of life. Sleep Med. Rev. 7, 179–191 (2003).

2. Anders, T., F. in Encycl. Early Child. Dev. (Tremblay, R. E., Boivin, M. & Peters, Rd.) 1–8 (Centre of Excellence for Early Childhood Development and Strategic Knowledge Cluster on Early Child Development, 2010). at

3. McGraw, K., Hoffman, R., Harker, C. & Herman, J. H. The Development of Circadian Rhythms in a Human Infant. Sleep 22, 303–310 (1999).

4. Mirmiran, M., Maas, Y. G. . & Ariagno, R. L. Development of fetal and neonatal sleep and circadian rhythms. Sleep Med. Rev. 7, 321–334 (2003).

5. Custodio, R. J. et al. The emergence of the cortisol circadian rhythm in monozygotic and dizygotic twin infants: the twin-pair synchrony. Clin. Endocrinol. (Oxf.) 66, 192–197 (2007).

6. Ardura, J., Gutierrez, R., Andres, J. & Agapito, T. Emergence and Evolution of the Circadian Rhythm of Melatonin in Children. Horm. Res. 59, 66–72 (2003).

7. McMillen, I. C., Kok, J. S. M., Adamson, M., Deayton, J. & Nowak, R. Development of Circadian Sleep-Wake Rhythms in Preterm and Full-Term Infants. Pediatr. Res. 29, 381–384 (1991).

8. Mindell, J. A., Telofski, L. S., Wiegand, B. & Kurtz, E. S. A nightly bedtime routine: impact on sleep in young children and maternal mood. Sleep 32, 599–606 (2009).

9. Illnerová, H., Buresová, M. & Presl, J. Melatonin rhythm in human milk. J. Clin. Endocrinol. Metab. 77, 838–841 (1993).

10. Cubero, J. et al. The circadian rhythm of tryptophan in breast milk affects the rhythms of 6-sulfatoxymelatonin and sleep in newborn. Neuro Endocrinol. Lett. 26, 657–661 (2005).

11. Cohen Engler, A., Hadash, A., Shehadeh, N. & Pillar, G. Breastfeeding may improve nocturnal sleep and reduce infantile colic: Potential role of breast milk melatonin. Eur. J. Pediatr. 171, 729–732 (2011).

12. Burnham, M. M., Goodlin-Jones, B. L., Gaylor, E. E. & Anders, T. F. Nighttime sleep-wake patterns and self-soothing from birth to one year of age: a longitudinal intervention study. J Child Psychol Psychiatry 43, 713–25 (2002).

13. Pinilla, T. & Birch, L. L. Help me make it through the night: behavioral entrainment of breast-fed infants’ sleep patterns. Pediatrics 91, 436–44 (1993).

14. Wolfson, A., Lacks, P. & Futterman, A. Effects of parent training on infant sleeping patterns, parents’ stress, and perceived parental competence. J Consult Clin Psychol 60, 41–8 (1992).

 

43 Comments
  1. Alice,

    I’m curious as to what exact age this is? Is it the first month, few months or longer? We did all of the exact opposites in the first few months and created lots of bad habits. Nobody told us that they make sounds when they sleep and I think I woke him up a lot and grabbed him at the very first fuss. I think if I had been more calm and observed more (did less) then things would have been easier. In the end we ‘sleep trained’ him and he was a great sleeper in days.
    http://sydneysteiner.com/2013/04/22/the-gift-of-sleep-our-story-of-respectful-sleep-training/
    This is a great article, thank you.

    Sydney 🙂

    Like

    May 9, 2013
    • elizabeth #

      I did the same thing, Sydney — mistaking little nighttime sounds for some sort of need. We moved her to her own room at 6 weeks, and she immediately began sleeping through the night when we couldn’t hear every peep. I think before that we were getting her up for little sounds when she just wanted to sleep.

      Like

      May 10, 2013
  2. Sydney, that’s a great question, and I know I was vague about that. That was a little intentional, because I think it depends a great deal on the baby. The sleep cycles, circadian rhythms, and observation bits you can do from the very start. The other parts I think depend on the baby and the parents. I think that for us, we were just scraping by for the first couple of months, and we stuck to what we knew worked. It wouldn’t have occurred to us to lay Cee down and see if she could fall asleep without all our active interventions, but in hindsight, I wish we had. I do remember having an epiphany when Cee was just a couple of weeks old that she didn’t ALWAYS need to be fed every time she woke in the night, which is what I had been doing before then. One night I was too tired to pick her up and feed her and tried just patting her for a minute or two. She went right back to sleep for another couple of hours, which is probably exactly what she wanted and needed.

    I didn’t think about most of these things when Cee was a newborn either, and we ended up sleep training her as well. I’ve written a ton about that. I think sleep training is OK, and sometimes it is necessary to back off and give the child a chance to learn to self-soothe, even if that’s hard (and it usually is). But having given this a lot of thought, I also think that sleep training is an imperfect solution, and it comes out of the mismatch in our expectations. We tell new parents to do whatever it takes to soothe their young infants but in the same breath that we expect them to be sleeping well and independently by the time they are 6 months old. I want to think that it doesn’t have to be this hard, that if we hope that our children can sleep on their own (and I think it’s OK to hope for that!) that we can start early to support them in learning to do that – gradually, gently, respectfully, and maybe (maybe!) avoid the stress of sleep training later.

    Like

    May 9, 2013
    • Yes! I read your sleep training story. I think I gave a link on my post to you actually. I agree that if I had does something more like this in the beginning we could have avoided sleep training. They get used to what we give them and hate the change. Also, I wanted to share that a friend of mine was kind of freaked out by the red splatters on your little one’s shirt. At first glance it’s confusing what it is…

      Like

      May 9, 2013
      • Oh no! I didn’t even think about that. It’s just some very homemade tie dye:)

        Like

        May 9, 2013
  3. inbabyattachmode #

    For us co-sleeping was the best option to all get some decent sleep. At first baby slept in a co-sleeper and from 5 months on he slept in our bed (with all the safety precautions of course). He still (22 months) has never slept through the night, but this way that isn’t that big of a deal.
    I think your tip of knowing baby sleep cycles is really helpful, it’s good to know what normal looks like.

    Like

    May 9, 2013
    • I think that sleeping close is great advice. I’m wary of recommending bedsharing with a newborn because of the safety concerns – which can be debated, but still… – but I think cosleepers are a perfect solution. It makes it easier to observe your baby and try some gentle soothing like patting after a night waking, without baby having to get worked up and you getting out of bed. I also think it makes it a little harder to wait a bit before responding, but everyone is different in whether or not they’re comfortable with this anyway.

      Like

      May 9, 2013
  4. Larah #

    Great post! This is one of my favorite subjects to research regarding newborns and infants. I am due with tiny one #2 on June 4 so this came right on time!

    Like

    May 9, 2013
  5. I shared this on facebook and someone asked me, why does the baby have blood all over the onesie?

    Hmmm… haha….???

    Like

    May 9, 2013
    • OK, OK, I changed the photo! You’re the second person to say this. It’s just a homemade tie-dye… let’s try one with no shirt:)

      Like

      May 9, 2013
  6. Shari #

    You make such a good point about how newborn sleep seems so unpredictable & how maddening it can be so reliant on that. It would be much easier to handle lack of sleep if you knew which hours you would be awake & knew when to expect your next opportunity for a nap & how long that nap would last.

    That being said, I feel like baby #2 has been so much easier in many ways. Probably a lot of it has to do with his temperament, but I would like to think that I can take some credit too for how happy he is & that he is a good sleeper. Calmer & self-assured mom makes for a calmer & reassured baby?

    Anyway, thanks for another great post 🙂

    Like

    May 9, 2013
    • Yes, I think the unpredictability of it is the hardest part. I think a lot of new moms do end up getting a decent amount of sleep (in terms of hours), if they have good help, but the fact that you’ll go to bed having no idea what the night will bring, or you lay down for a nap knowing it might last just 15 minutes – that’s the biggest adjustment.

      Like

      May 9, 2013
  7. diah indri #

    Reblogged this on Knitknotlove.

    Like

    May 9, 2013
  8. n = 1 for me, but I am a big fan of the bedtime routine that we started around 3 months (bath, pajamas, nurse/eventually bottle, bed) and think that it helped maintain good sleep patterns, especially after 6 months or so, even when we traveled for the holidays.

    That said, I’ve got a pretty mellow baby who is also easy to read for tired signals. We don’t always start bed time at the same time, just wait for him to show us he’s tired as it can vary about a half hour in each direction from 7pm on any given day. I remember reading about looking for the tired signs before he was born and the idea that we should put him down before he got too tired was one of the most useful pieces of advice I got.

    Like

    May 9, 2013
    • The advice to watch your baby for signs of tiredness and to prepare him for sleep before he’s over-tired is really important. Your post inspired me to add something about this in my book chapter. The reason it wasn’t in there initially is that there’s actually very little research on how long babies can go for wakefulness, although there are lots of studies on “sleep/wake” patterns. Everyone is more interested in the sleep! But wakefulness is obviously a part of the rhythm, too. Once you get used to watching your baby, I think you learn the signs easily and can sort of help baby keep a natural rhythm that works well for him.

      Like

      May 15, 2013
  9. Great article – thank you! I have tweeted this as I am sure many people will find it useful

    Like

    May 10, 2013
  10. Lovely post. I’m going to forward this to my 30 week pregnant friend! Under point number five I appreciate that you included the caveat “some, but not all” since my son fell in the “not all” group. I would encourage you to include a word about recognizing the individuality of babies, and not internalizing their sleep habits as a testament to your worth as a mother. It is not your fault if you have a challenging sleeper, and the sleep choices you make are going to be the absolute best for you and your baby in your situation. This is such a difficult thing for me to remember!

    Like

    May 10, 2013
    • Yes! I do think this is an important caveat, and I’ve included it in the book. One study showed that a significant predictor of “self-soothing” at 12 months was the percent of sleep time spent in quiet sleep (vs. active sleep) at birth. That, to me, indicates that at least some of a baby’s sleep “temperament” is already determined at birth. That isn’t to say that parenting doesn’t matter, but it’s obviously a complex set of factors that determines what kind of sleeper you have. Parents who have more than one child – different types of sleepers – can attest to this as well!

      Like

      May 15, 2013
  11. A good thing to keep in mind to help baby (from the beginning) learn to fall asleep on their own and therefore transition on their own to different phases of sleep cycles is to try to avoid letting them fall asleep with a passy or breast in their mouth. If they want to keep sucking but are tired enough that they are trying to sleep, let them suck to soothe and calm down and before they’re actually asleep take it out. Keep repeating this until they fall asleep without it. Same thing with holding/rocking. If they want to be eld or rocked, soothe them until they’re calm and just beginning to drift off, lay them down. If they start to wake again, pick them up gently and calmly continue to rock or soothe them until they’re drifting off again. Repeat! 🙂

    Thank you for your post. Great information!
    Maeve

    Like

    May 10, 2013
    • Good advice! I’ve heard from other parents that this routine works to help teach baby to fall asleep on his own. I don’t think it is something that you have to do all the time or from the moment of birth, but if you want your baby to be able to fall back asleep after a normal night waking (assuming he isn’t hungry, sick, etc), then learning to fall asleep without really active soothing is key.

      Like

      May 15, 2013
  12. Erin #

    For me, the biggest thing is just having a system — not rules, but a system — to feel like we are not just floating around without a plan for sleep. This isn’t for the baby, but it’s for our own hope and sanity.

    Our system since 6 weeks has been to wait for a set amount of time (we started at 2 minutes; now we wait 5 minutes) of fussing/grunting OR escalation to crying, whichever happens first. Then we have flexible systems to deal with either scenario — basically a step-by-step plan or mental flow chart of interventions. Paci & white noise, check; next, try patting and quiet talking; next, try holding or rocking; next, try walking; next, try walking outside.

    She is an easy sleeper, so usually we just have to pop the paci back in her mouth. But for me, it’s not about actual sleep outcomes. It’s about having a system so we don’t have to feel hopeless or panicked if we have a bad night. There’s always something more to try. If we get to extreme and unsustainable measures (go for a drive at midnight), it’s still on that mental flow chart. Even running out of options and waiting for her to cry to exhaustion is there on the chart. It would suck, but it’s reassuring to know that “Wait It Out” is there as a final resolution.

    Like

    May 10, 2013
    • This is an excellent suggestion. In the middle of the night, it is nice to have a clear plan – good for parents and I can see how this would be good for baby, too. It adds some predictability for her. She knows if she really needs you that you will come, but she knows it won’t be instant. Thanks for sharing this – great advice!

      Like

      May 15, 2013
  13. Maggie #

    We saw that our daughter had a 45 minute fuss, and if we left her alone she really would go back to sleep, and sleep for hours. Now I know why! Thank you.

    Like

    May 10, 2013
    • My daughter, on the other hand, would wake at 45 minutes and not be able to go back to sleep, but she would be clearly grumpy, needing more (for naps – she did better at night). Every once in a while, she would nurse back to sleep, but not often. That lasted from about 6 weeks to 4-5 months, and then she suddenly started linking sleep cycles together and taking 2 hour naps.

      Like

      May 15, 2013
  14. The Joys Of Life #

    As the mother of a 3 year old son, and in charge of an 8 year old and a 10 year old, I find my sleep still off from before I got pregnant. The waking for every little sound does not change from 3 weeks to 3 years. Every sound the dog makes, a car driving down the street, my son falling out of bed, everything makes me jump up to investigate. I now find that my son is refusing naps. My husband and I go to sleep around 10, it usually takes me 2 hours or so to fall asleep. The 8 year old and 10 year old arrive at about 6am, then they go to the bus stop around 7:30am. My 3 year old wakes up from the noise about 7am. Nap time is usually my nap time as well, and now that he is refusing naps, I find myself more sleep deprived than the day he was born.

    This was a great post! Thank you for sharing!
    Tiffany

    Like

    May 10, 2013
    • maggie #

      Tiffany – try the foam ear plugs from the local pharmacy. They worked wonders for me – and three night were enough to reset my sleep patterns. They let through the big sounds, but cancel the little ones. So you WILL hear screaming, but not cars outside, etc.

      Like

      May 13, 2013
    • Tiffany, I’m a much lighter sleeper now that I am a mom than I was before. I feel for you! Maybe work on some calming routines for yourself before bedtime! Avoiding screentime is definitely helpful for me, I find, although it takes some willpower at times:)

      Like

      May 15, 2013
  15. Reblogged this on Pregnancy Birth Premature Baby & Beyond and commented:
    any tips are an advantage to aid a newborn baby sleeping pattern routine

    Like

    May 13, 2013
  16. Jessica #

    New mom question: I’m finding that after about 2 hrs of sleep my newborn seems to transition between active and quiet sleep as quickly as every 5 minutes, when he does finally wake up it is usually with a lot of crying. In this scenario would it be better to get him up when he first starts to rouse? Thanks for the advice and great article!

    Like

    November 8, 2014
  17. Liz #

    Jessica,
    I’m on baby #2, and I have the same issue. I’ve started picking him up when he starts fussing instead of waiting until he’s having a total meltdown. What I’ve discovered about mine is that he won’t send any hunger signals (lip smacking, sucking motions) while he’s sleeping, and then totally freak out when he wakes up, not understanding why he’s not eating at that *very* moment. I try the preemptive strike method of picking up and having breast or bottle ready.

    Like

    November 16, 2014
  18. Danelle #

    New mom question: Our little boy is 3 weeks old today and in the last week or so he’s gone from being a great sleeper to being very difficult to get to sleep. He sleeps better at day than night but definitely doesn’t get 16-18 hours of sleep. He also seems to want to feed every 1.5 – 2 hours (rather than the textbook 3 – 4 hours during day and longer at night) – is that okay and should I feed him that much? We’re trying Dr Karp’s 5 S’s which definitely helps to calm him but 5 minutes after he’s been put down he wakes up and wrestles himself out of the swaddle. Without the swaddle his flailing arms and legs wake him (he also startles very easily). Another regular occurrence (after almost every feed) is that he gets the hick-ups in his sleep and then wakes up. The first 2 weeks he slept on me after feeding but for the last week we’ve been trying to get him to sleep in a crib next to the bed as we both get so hot with him on me (and I don’t end up sleeping very well either). We also use white noise (day and night) to help him transition sleep cycles and not startle at noises.

    Your article on the 6 tips is great and my husband and I will definitely try it out but I guess what I would like to know is if there are any other tips for our little one and/or feedback on what we’re currently doing?

    Thank you

    Like

    December 17, 2014
    • Teresa #

      I know this is an old comment, but I just want to answer your question about feeding for anyone else that sees this.
      For a baby that is only a few weeks old it is normal and expected that he will be hungry every 1.5 to 2 hours. They have very small tummies, and for breastfed babies, mother’s milk digests in about that amount of time. If you are nursing, frequent feedings during the first several weeks are important for increasing milk supply. And if your are giving formula it is still better to go by your own baby’s signals than what a book says. (Do make sure that baby gets a full meal when he eats, not drifting off to sleep or getting distracted. Snacking will leave him hungry more frequently than necessary). My 7 week old generally sleeps for a 5-7 hour stretch at night (plus another 2-3 hours), but during the day she still eats about every 2 hours.

      Like

      May 20, 2015
  19. Franca #

    When my bubs was about 5 weeks he stopped sleeping through to the next feed and was constantly waking during the day which meant I had to sit/lay next to his bassinet and rock him back to sleep at every noise he made. Now that he is 6 weeks i noticed that he would rustle around 10-15 minutes into a sleep cycle and when I left him he actually fell back asleep himself ( wish I knew that last week when I had no sleep during the day at all!). He also wakes at exactly 45 minutes into a sleep cycle too and if I don’t catch him in time hes wide awake but if I gently rock his bassinet as soon as I see his eyes open hes sound asleep again! If a cousin ( and also recently new mum) didn’t come over and tell me these things I would not have known and would’ve been unsettling bubs by trying to put him back to sleep unecessarily and would be severely sleep deprived due to no daytime naps! This article makes alot of sense of it now! Thanks!

    Like

    March 28, 2016

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