Nora Hedgecock, OTR/L - January 22, 2021
Sleep is one of the top concerns of new parents, for good reason! As adults, we know how important sleep is for our health and well-being. So when a newborn comes into the family, it is typical to worry about the sleepless nights ahead. Not to mention the constant, and often unwelcome, questions and suggestions about how your new baby is sleeping that can create even more stress.
Most new or expecting parents anticipate that these early months will bring sleepless nights and drowsy days. Still, sleep deprivation, conflicting information online, and well-intentioned, but not always helpful, tips and tricks from family and friends can leave new parents wondering:
Is this normal? How long will it be like this? Am I doing this right?
Understanding sleep development can be a huge help in managing expectations and supporting your mental health in these first few months. So, let’s talk about “normal” newborn sleep.
Babies sleep very differently than their parents.
- Most newborns sleep a total of 14-18 hours a day, usually in 2-3 hour increments.
- Newborns’ sleep follows their own internal clock, not the circadian (day/night) rhythm that organizes our sleep. Babies will typically start producing melatonin between 3-4 months, which gradually helps these two internal clocks sync up so that they can sleep for longer periods at night.
- Newborns spend more time in active, REM sleep than their parents. It is thought that babies spend so much time in REM (the sleep state where we dream and store memories) as they make sense of the flood of new experiences and sensations from their new world. REM is considered “light sleep” where baby is woken more easily compared to quiet, “deep” sleep where baby is quiet and still.
All babies are different.
- There is a huge range in “normal” when it comes to daily sleep totals. Not all babies will fit into the 14-18 hours/day range - some will sleep less and some will sleep more - there is no one-size-fits-all schedule or approach.
- There are so many factors that affect sleep (temperament, sensory preferences, etc.) and there’s no way to predict exactly how your baby will sleep. This means if you have another child, you may have two very different sleepers!
Newborns can’t “sleep through the night”.
- Frequent night waking is normal! None of us, even as adults, sleep through the night without waking up at all. It is typical for a newborn to wake every 2-3 hours in the middle of the night. Baby has not yet developed a circadian rhythm, meaning that they don’t discriminate between day or night as a better time for sleep.
When to wake a sleeping baby.
- Newborns have tiny stomachs that can only hold so much food at a time. Breastfed infants typically need to eat every 2-3 hours or 8-12 times a day. Formula-fed infants will typically take larger and less frequent feedings. In the early days and weeks, if your baby is sleeping and doesn’t wake up to feed on their own, wake them up to feed every few hours (2-3 hrs. for breastfed babies, 4-5 hrs. for formula-fed babies) to ensure they are getting the nutrition they need.
Due to their need for frequent feeds and lack of a day-night rhythm, babies are not developmentally ready for sleep training strategies before 4-6 months of age. That being said, there are definitely developmentally-appropriate strategies to support your little one’s sleep even as a newborn.
- Give baby an opportunity to sleep every 1-2 hours at the max. This will support the just-right amount of “sleep pressure” (the drive to sleep that increases the longer we’re awake), helping baby feel sleepy enough to doze off and preventing them from getting overtired, which makes falling asleep harder.
- Use natural light-dark cycles. Exposing baby to natural light during the day can help establish good nighttime sleep - getting outside is a great way to do this! Natural light, especially sunlight, tells your baby’s brain it’s not time to produce melatonin. Turning off the lights inside and making your home darker in the hour or two leading up to bedtime helps send the signal that it’s time for sleep and tells your baby’s brain to produce melatonin.
- Create a bedtime routine. A consistent bedtime routine is another way to signal to your baby that it is time to sleep. Research suggests that a regular and consistent bedtime routine can help infants fall asleep more easily, reduce night wakings, and increase nighttime sleep. This routine will look different for every family, but may include bathtime, infant massage, quiet time, and reading.
- Use soothing sensory strategies. Once baby’s basic needs are met (e.g. fed, burped, changed), sensory strategies can help lull them to sleep. We love Dr. Harvey Karp’s 5 S's:
- Side- or stomach-holding
- Shushing or white noise from a sound machine
- Swinging or other movement like small, rhythmic bounces
- Sucking on a pacifier or your finger
According to Dr. Karp, these five, centuries-old, techniques mimic the sensations of the womb and turn on a baby’s “calming reflex” to soothe crying and help baby relax so they can fall and stay asleep. One or two of these may be enough to soothe your baby, and sometimes all five together can help you through fussier moments. The 5 S’s can be a helpful guide in these early months - with time, you will find your own perfect way to soothe your baby.
Most importantly, be gentle with yourself and give yourself grace. You and baby are just getting to know one another and this is a time filled with so many changes. You can find comfort in knowing that these sleepless nights won’t last forever. Around 4 months, you will be able to start introducing the sleep strategies and boundaries that feel right for you and your family.
You know your baby the best, and you are the best parent for your baby.
We love these reminders and nighttime mantras from Rachel at HeySleepyBaby:
As always, we are here for you. Join us for our office hours where you can ask about all things baby, sleep and beyond - no question is off limits!
“Amount and Schedule of Formula Feedings.” HealthyChildren.org, American Academy of Pediatrics, 24 July 2018, www.healthychildren.org/English/ages-stages/baby/formula-feeding/Pages/Amount-and-Schedule-of-Formula-Feedings.aspx.
Iwata, Sachiko, et al. “Dependence of Nighttime Sleep Duration in One-Month-Old Infants on Alterations in Natural and Artificial
Photoperiod.” Nature News, Nature Publishing Group, 17 Mar. 2017, www.nature.com/articles/srep44749.
Jenni, Oskar G, and Monique K LeBourgeois. “Understanding Sleep-Wake Behavior and Sleep Disorders in Children: the Value of a Model.” Current Opinion in Psychiatry, U.S. National Library of Medicine, May 2006, www.ncbi.nlm.nih.gov/pmc/articles/PMC2980811/.
Karp, Harvey. The Happiest Baby on the Block: the New Way to Calm Crying and Help Your Newborn Baby Sleep Longer. Bantam Books, 2015.
Mindell, Jodi A, et al. “Bedtime Routines for Young Children: a Dose-Dependent Association with Sleep Outcomes.” Sleep, U.S. National Library of Medicine, 1 May 2015, pubmed.ncbi.nlm.nih.gov/25325483/.
“Raising Good Humans: What's Happening in Your Baby's Brain When They Sleep, with Professor Mark Blumberg, PhD.” Created by Aliza Pressman, and Mark Blumberg.
Thomas, Karen A, et al. “Mother-Infant Circadian Rhythm: Development of Individual Patterns and Dyadic Synchrony.” Early Human Development, U.S. National Library of Medicine, Dec. 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4312214/.